Liver Disease

What Is Liver Disease?

Many different liver conditions fall under the umbrella of liver disease. Causes of liver disease vary widely, and it can be caused by infection, overconsumption of alcohol, and genetics, among other reasons. Oftentimes, liver disease is very treatable, as the liver is very resilient. However, a liver disease that involves scarring of the liver, such as cirrhosis, is much more serious. It’s best to diagnose liver disease in its earliest stages to help prevent the development of scar tissue. It’s estimated that 1 in 10 Americans have liver disease, with about 5 million Americans suffering from cirrhosis or chronic liver disease. 

What Are the Different Types of Liver Disease?

Diseases of the liver have separate causes, so the severity and treatment vary widely for each type of disease. Different types of liver disease include:

• Viral hepatitis. Hepatitis A, B, and C are conditions that are caused by viral infections. The cause of each type of hepatitis is different. 
  • Hepatitis A is caused either by sexual contact or fecal-oral reasons (i.e., someone does not wash their hands after having a bowel movement, which can pass the disease onto others just by touch). Hepatitis A can also be present in contaminated food or water. 
  • Hepatitis B is a viral infection that is spread by sexual contact or by coming in contact with bodily fluids. 
  • Hepatitis C is spread by coming into contact with infected blood, such as sharing intravenous needles. Less commonly, hepatitis C is spread through sexual contact. All forms of viral hepatitis cause inflammation of the liver. 
• Cancer. Tumors can develop in the liver after abnormal cells begin to spread. However, tumors of the liver can also be noncancerous (benign).
• Some autoimmune disorders. Conditions of the immune system can cause liver disease. These include primary biliary cholangitis and autoimmune hepatitis.
• Alcohol. Overconsumption of alcohol over time can lead to alcoholic fatty liver disease and alcoholic hepatitis, which often progresses into cirrhosis. 
• Fatty liver. You can develop nonalcoholic fatty liver disease (NAFLD) by regularly consuming excessive calories and developing obesity. It is often associated with other metabolic disorders like hypertension (high blood pressure), elevated cholesterol, and diabetes. 

What Are the Symptoms of Liver Disease?

Because the term liver disease comprises many conditions, symptoms can differ across diseases. However, the most common symptom of liver disease is jaundice, which is a yellowing of the eyes and skin. This occurs when there is too much bilirubin that the liver can’t process. Those with NAFLD may experience no symptoms at all. Other common symptoms of liver disease include:

• Edema (swelling in the arms and legs)
• Unexplained fatigue
• Abdominal pain (often on the right side)
• Changes in bowel habits or stool
• Changes in urine color
• Nausea and vomiting
• Bruising easily

If you experience any of these symptoms for more than a day or two, consult your gastroenterologist, particularly if you notice a yellowing of the skin or eyes. Liver disease must be treated by a healthcare provider so that it does not progress to scarring. Also, some types of liver disease increase the risk of liver cancer. 

How Is Liver Disease Diagnosed?

Your physician will first conduct a physical exam and talk with you about your symptoms. Liver disease can be diagnosed with one or more of the following diagnostics:

• Blood tests. If there is an issue with your liver, it will be present in the blood. If your liver enzyme levels are too high, this will alert your provider that something is amiss. Your doctor may also perform an international normalized ratio (INR), which is a blood clotting test that looks for liver disease. 
• Liver biopsy. If the disease is suspected, your physician may use a thin needle to extract tissue from the liver for examination. This can help your doctor provide the correct treatment. 
• Imaging diagnostics. Your gastroenterologist may use ultrasound, CT scans, or MRIs to diagnose liver disease. There is also a specific liver ultrasound diagnostic, called a fibroscan, that can detect scarring and the degree of damage. 

How Is Liver Disease Treated?

How liver disease is treated depends on the type of disease and severity. Some liver disease is easily managed, while other patients may require a liver transplant in serious cases. 

Medications are often the first-line treatment for viral infections (liver disease such as hepatitis). In these cases, antiviral medications are used, such as entecavir (Baraclude) and tenofovir (Viread) for Hepatitis B and glecaprevir/pibrentasvir (Mavyret) and sofosbuvir/velpatasvir (Epclusa) for Hepatitis C. Severe cases of chronic viral hepatitis that are left untreated may require a liver transplant.

Your physician will also likely recommend changes in lifestyle habits if these are contributing factors to your liver disease. Abstaining from alcohol is recommended for fatty liver disease, even if you have NAFLD. Abstinence from alcoholic fatty liver disease is imperative to reverse damage in the early stages, otherwise, cirrhosis can develop. Cirrhosis may require a liver transplant. If you have NAFLD, your doctor may recommend limiting your caloric intake, adding more fiber into your diet, and a regimen to reduce weight.

If liver disease is not successfully treated, liver failure is imminent. At this stage, a patient may need a liver transplant, which replaces a damaged liver with a healthy one. 

How Can I Prevent Liver Disease?

Some types of liver disease are inherited, and prevention isn’t possible. However, other types of liver disease are preventable. To help prevent the development of liver disease, you can:

• Avoid overconsumption of alcohol
• Avoid fatty, fried foods
• Limit refined carbohydrates (white pasta, white rice, sweets, etc)
• Limiting red meat consumption
• Exercising regularly
• Using some over-the-counter medications, such as acetaminophen, sparingly

Hepatitis can also be avoided by practicing safe sex, not sharing needles, and washing your hands often.