Liver Disease

The liver is one of the largest organs in your body. It performs hundreds of functions, but its primary jobs are to help digest food, store energy, remove harmful substances from your blood, and fight disease.

The liver can be damaged by several diseases and conditions. These include:

• Hepatitis [hep-eh-TYE-tuhs]. Hepatitis is a viral disease that causes inflammation and damage to the liver. There are several types of hepatitis.
• Autoimmune hepatitis. Autoimmune hepatitis is not caused by a virus, but by a person’s own body. An autoimmune condition is when the body’s immune (disease-fighting) system attacks the body. In this case, it attacks liver cells, causing inflammation and damage to the liver. Autoimmune hepatitis is classified as type 1 or type 2.
  • Type 1 is more common in North America. It can start at any age but most often begins in adolescence. It is more common in females and in people who have other autoimmune disorders, such as celiac disease, Crohn’s disease, and lupus.
  • Type 2 occurs less often. Children are more likely to get it, especially if they have another autoimmune disorder.
• Fatty liver disease. This is a condition in which fat builds up in your liver cells, causing the liver to swell and scar. The types of fatty liver disease are:
  • Nonalcoholic fatty liver disease (NAFLD). While some people get NAFLD for no reason, it is often closely tied to obesity and an unhealthy diet. Over time, NAFLD creates swelling and scar tissue (cirrhosis) in the liver and may lead to liver failure. NASH, which stands for nonalcoholic steatohepatitis [stee-at-ut-hep-uh-TAHY-tis], is a form of nonalcoholic fatty liver disease.
  • Alcohol-related fatty liver disease. This condition results from drinking heavily over a long period of time and is almost always preventable. There are 3 main types of alcohol-related liver disease:
    1. Fatty liver. This is the most common type of alcohol-related liver disease and may go away if the person stops drinking.
    2. Alcoholic hepatitis. Three out of 10 people who drink heavily will get alcoholic hepatitis. A severe, acute form can cause life-threatening problems.
    3. Cirrhosis. Cirrhosis is when the liver becomes so scarred from alcohol or disease that it can’t work properly. Cirrhosis can be a life-threatening disease.
• Hemochromatosis [hee-muh-kroh-muh-TOH-sis]. This is a medical condition in which too much iron builds up in the liver. The body needs iron to help deliver the oxygen in the blood to the rest of the body. But, too much iron can damage the liver and other glands as well as the joints. There are 3 types of hemochromatosis:
  1. Primary hemochromatosis is a genetic (inherited) condition.
  2. Secondary hemochromatosis usually results from having a lot of blood transfusions to treat conditions, such as anemia.
  3. Neonatal hemochromatosis is a rare condition that causes liver failure and death in babies in the womb or after they are born.
• Liver cancer. Liver cancer is when cancer (malignant) cells form in the liver. Cancer that starts elsewhere in the body and spreads to the liver (metastatic) is not liver cancer.

Liver disease symptoms vary depending on which type of disease one has. In some cases, there may be no symptoms. Common symptoms associated with 1 or more liver diseases include:

• Yellowing of the eyes and skin (jaundice)
• Chalky (gray) stools
• Nausea and vomiting
• Pain in the upper right part of the belly
• Pain in the joints
• Bloating or swelling in the belly
• Loss of appetite

See your healthcare provider if you have:

• Any of the symptoms listed above, especially jaundice
• Been exposed to hepatitis
• Symptoms that are not explained by a recent illness or injury
• Symptoms that continue to worsen

Liver disease causes depend on the type of disease:

For different types of hepatitis, a virus that is spread from person to person in a variety of ways:

• Hepatitis A is caused by the germs found in stool (poop) and is spread by poor sanitation habits (not washing hands, etc.). It is usually a temporary (acute) infection that gets better on its own.
• Hepatitis B is passed from one infected person to another through bodily fluids such as semen, blood, or saliva. For example, it can be passed from a mother to her baby during birth, by having unprotected sex with someone who is already infected, or by sharing needles with an infected person. It can be an acute or long-term (chronic) infection.
• Hepatitis C is the most common blood infection in the U.S. Most of the people who have hepatitis C are “baby-boomers” born between 1945 and 1965. It is mainly spread by contact with blood from someone who already had the infection.
• Hepatitis D is rare and only affects people who already have hepatitis B. This is called a coinfection. You are more likely to get a coinfection if you use injection drugs, live with someone who already has hepatitis D, or live someplace where hepatitis D is more common.
• Hepatitis E is more common in countries where clean water is limited and sanitation is poor. It can also be acute or chronic. In the U.S., hepatitis E more likely results from eating undercooked meats, such as pork, venison (deer), or other wild game.
• Autoimmune hepatitis is a long-lasting disease that may cause cirrhosis and liver failure. Doctors do not yet know the exact cause of autoimmune hepatitis.

For fatty liver disease:

• NAFLD typically occurs when one is overweight or obese or has diabetes or high levels of fat in the blood (triglycerides and cholesterol). Some people get it for no known reason.
• Alcohol-related liver disease  is caused by drinking too much alcohol over a long period of time.

For hemochromatosis:

Doctors don’t know exactly what causes hemochromatosis. They do know that it is inherited. About 5 out of every 1000 people in the U.S. have it. It is most common among people of western European heritage.

For liver cancer:

Liver cancer is most commonly found in those who have:

• Chronic hepatitis B or hepatitis C
• Cirrhosis from drinking excessively over a long period of time
• Hemochromatosis
• Metabolic syndrome, which is a combination of high blood pressure, high blood glucose (sugar), high blood fats (triglycerides and cholesterol), and extra fat around the waist

Liver cancer can also be caused by eating foods containing aflatoxin, a poison found in fungi growing on corn, peanuts, and other foods in warm, humid areas.

To diagnose liver disease, a healthcare provider will likely ask about medical history and perform a physical exam. This may include feeling the abdomen and checking eye color. Depending on the symptoms, the following tests may be ordered:

• Blood tests to check the number of red and white cells and the amount if iron in the blood. They will also test for other substances that may indicate cancer or that the liver is not working correctly.
• Imaging tests, such as a:
  • CT scan. This test uses a series of detailed x-rays to show changes or damage to the liver.
  • MRI. This test uses magnets and radio waves to create detailed images of the tissues in the body.
  • Ultrasound. This test uses high-speed sound waves to create images of the organs.
• Biopsy to remove pieces of the liver and/or surrounding tissue to be examined under a microscope.

Treatment for liver disease depends on the type.

For hepatitis types A through E, treatment includes:

• Taking medicine to relieve symptoms and improve liver function
• Resting to help the body heal
• Maintaining good nutrition and hydration to nourish the body and relieve inflammation in the liver

For autoimmune hepatitis, treatment includes:

• Taking medicines to keep the body from attacking the liver cells and reduce inflammation in the liver
• Having a liver transplant to replace a liver that is not working properly

For NAFLD, treatment can often include:

• Eating a healthy diet
• Losing weight
• Lowering cholesterol and triglyceride levels
• Avoiding alcohol
• Controlling diabetes (if appropriate)

For alcohol-related liver disease, treatment includes:

• Giving up alcohol completely
• Eating a healthy diet
• Taking medicine to reduce inflammation in the liver
• Having a liver transplant

For hemochromatosis, this condition can be treated effectively and easily with blood donations. Donating blood will help remove excess iron from the body each week until it becomes normal. Any complications from hemochromatosis can also be treated as appropriate.

For liver cancer, treatment depends on the severity and type of liver cancer one has and includes:

• Watching and waiting. The cancer care team may recommend this strategy if the tumor (lesion) is smaller than 1 cm. The team will recommend check-ups every 3 months.
• Surgery. It may be necessary to remove part of the liver. The tissue that is left will continue to support the needs of the body and may regrow.
• Transplant. You may be able to get a transplant if the cancer has not spread outside of the liver.
• Medicines. Cancer-fighting medicines can be used to target specific cells. The medicine finds and attacks the type of cell it is designed to fight.
• Radiation. High-intensity x-rays are used to shrink or kill tumors or to keep them from spreading.

Prevent both child and adult hepatitis by:

• Washing hands before eating and after going to the bathroom or changing a diaper
• Practicing safe sex
• Not sharing needles, razors, or toothbrushes
• Getting vaccinated for hepatitis A and B

There is no known way to prevent autoimmune hepatitis.

Prevent fatty liver disease by:

• Eating lots of fresh fruits and vegetables
• Getting regular exercise
• Avoiding alcohol
• Lowering cholesterol

There is no known way to prevent primary hemochromatosis.

Prevent liver cancer by following the above liver disease prevention recommendations. Long-term complications from liver disease increase the risk of getting liver cancer.

American Liver Foundation

MedlinePlus

National Cancer Institute

National Institute of Diabetes and Digestive and Kidney Diseases

The liver is one of the largest organs in your body. Its job is to help digest food, store energy, and remove harmful substances from your blood. It performs many important functions, but can be damaged by many different conditions, such as hepatitis, hemochromatosis, fatty liver disease, and alcohol use disorder. Long-term damage to the liver can cause serious complications or liver cancer and may require a liver transplant. Learn more about liver disease.