Liver Disease

When there is inflammation or damage to the liver, it is known as liver diseases or hepatic disease. The Liver is the largest intra-abdominal organ in the body. It lies just below the right lung and protected by the rib cage. It can be broadly divided into right and left lobes when viewed from the above. It can be divided into four lobes when viewed from below. They are the left lobe, the right lobe, caudate lobe, and quadrate lobe. The functions of the liver are digestion of nutrients, storage of vitamins and minerals, synthesis of proteins, and enzymes.

9 Causes of liver disease

It can be caused by several elements. They are:

Infections

Infections with hepatitis virus can affect the liver and cause hepatitis. There are five types of hepatitis virus, A, B, C, D, and E. Hepatitis A and E are caused by food contamination normally. Hepatitis B, C, and D are caused by sexual transmission, blood transfusion, and intravenous drug abuse.

Immune system problems

Autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis are caused by autoimmune mechanism, in which the immune system affects the liver by mistake.

Cancers and tumors

 Liver cancer or hepatocellular carcinoma, hepatic adenoma, and bile duct cancer can affect the liver. Infections with hepatitis B virus and alcoholism can increase the risk of developing liver cancer.

Genetic disorders

Some genetic disorders can affect the liver and runs in families. They are hemochromatosis, hyperoxaluria, Wilson’s disease, gilberts syndrome, cystic fibrosis, and alpha-1 antitrypsin deficiency.

Other causes:

Chronic alcohol abuse can cause cirrhosis of the liver, portal hypertension (increased blood pressure in hepatic blood vessels), hematemesis (blood vomiting), and hepatic encephalopathy. This condition is called alcoholic liver disease.

Drug abuse in the form of increased duration of usage or overdose of drugs. Some of the hepatotoxic drugs are acetaminophen, diclofenac sodium, rifampicin, amoxicillin, valproate, sulfasalazine, and methotrexate. This can cause damage to liver cells and cause symptoms.

Nonalcoholic liver disease

 It is most commonly seen in obese individuals or people consuming fatty foods. Fat accumulation in the liver can cause damage to the liver and impairs the functions of the liver.

Risk factors of liver disease

Certain risk factors increase your chances of developing this disease. They are:

1. High-risk sexual behavior
2. Alcohol abuse
3. Intravenous drug use
4. Health care workers
5. Diabetes
6. Obesity

Liver disease symptoms

The signs and symptoms of this disease are:

1. Enlarged liver or increased liver span
2. Jaundice
3. Yellowish discoloration of skin, conjunctiva, nails, and urine
4. Decreased appetite
5. Abdominal pain
6. Fatigue
7. Swelling of the legs
8. Nausea or vomiting
9. Distension of abdomen
10. Engorged veins around the umbilicus
11. Itching of the skin
12. Dizziness
13. Easy bruising
14. Gynecomastia (enlarged breasts in males)
15. Loss of libido
16. Loss of body hair
17. Blood vomiting in severe cases of liver disease
18. Black tarry stools in alcoholic liver disease due to upper gastrointestinal bleeding
19. Pale, foul-smelling stools difficult to flush in jaundice

Diagnosis of liver disease

Diagnosis of liver disease can be done by considering clinical examination findings, blood tests, radiological investigations, and biopsy.

Blood Tests

The blood tests performed to diagnose liver diseases are screening for Hepatitis virus, total and differential leukocyte count to rule out infections, liver function tests to know the extent of damage by analyzing the enzyme levels and serum bilirubin levels. Other tests specific for certain conditions such as hemochromatosis and alpha-1 antitrypsin deficiency are also performed.

Urine test

Doctor may advise you to go for Urine test to confirm the presence of bilirubin in the urine

Scanning

Ultrasound abdomen, CT abdomen, and MRI abdomen can show the enlargement of the liver and the damage.

Biopsy

Biopsy of the liver is performed under local anesthesia using a long thin needle. Biopsy of the liver can confirm a specific diagnosis.

Treatment

The Liver has a high capacity for regeneration. So the prognosis for liver diseases is good except for certain diseases causing irreversible damage. The treatment of the liver disease depends on the causative factor. They are:

1. Stopping alcohol use: Liver can start regenerating and can even completely regenerate and become normal in patients with alcoholic liver disease after stopping consumption of alcohol.
2. Antiviral drugs: Antiviral drugs are used in the treatment of viral hepatitis
3. Steroids: Steroids are used in the treatment of autoimmune hepatitis
4. Ursodeoxycholic acid: It is used in the treatment of jaundice in liver diseases.
5. Losing weight: Losing weight can help in managing fatty liver.
6. Discontinue hepatotoxic drugs: Discontinue hepatotoxic drugs can help in regeneration of the liver.
7. Liver transplantation: In case of severe liver damage, doctor may advise the patient to go for liver transplantation

Diet:

Diet with low sodium, low fat, low protein, high in fiber, rich in omega-3 fatty acids, rich in antioxidants, and low in processed sugars; Including whole grains, fruits, and vegetables can help in managing symptoms of liver diseases and in maintaining a healthy liver.

References:

1. Liver Diseases. medline plus. [Online] [Cited: july 19, 2019.]

2. staff, mayo clinic. Liver disease. mayoclinic. [Online] [Cited: july 20, 2019.]

3. Liver Diseases: What You Should Know. webMD. [Online] [Cited: july 20, 2019.]

4. Benjamin Wedro, MD, FACEP, FAAEM. Liver Disease. medicineNet. [Online] [Cited: july 19, 2019.]

5. Melissa Conrad Stöppler, MD. Liver Disease. emedicine health. [Online] [Cited: july 21, 2019.]

6. Liver disease. wikipedia. [Online] [Cited: july 19, 2019.]

7. Liver disease. NHS. [Online] [Cited: july 19, 2019.]

8. Diseases of the Liver. american liver foundation. [Online] [Cited: july 21, 2019.]

Author: Dr. Pulasthi MilanPulasthi Milan Lankarathna is a graduated doctor from the Faculty of Medicine, University of Colombo, Sri Lanka. Currently, he is working as a medical-officer at the National Hospital of Sri Lanka. Writing has been his passion throughout his life. He loved to read books since his childhood. He believes that the essence that he gained by reading, motivated him to be a writer. He started writing as a creative writer during his College days. He has written over hundreds of short stories, poems, and articles, etc. After graduating as a Doctor, he switched himself to write about medical topics with an idea of improving the medical knowledge among the general population.