Liver Disorder

The liver is your body’s largest internal organ, performing hundreds of vital tasks every day—from filtering toxins to helping digest food. When the liver becomes damaged, it can affect your entire body, but many types of liver damage can be treated, slowed, or even reversed with early action and healthy lifestyle changes.

Table of contents

• What is liver disorder?
• Where is the liver located?
• How common is liver disorder?
• Types of liver disorders
• Stages of liver damage
• Symptoms
• Causes and risk factors
• How is liver disorder diagnosed?
• Treatment options
• Can liver damage be reversed?
• How to prevent liver disorder

What is liver disorder?

Liver disorder is a general term that describes any condition affecting your liver. Your liver is a large and powerful organ that performs hundreds of essential functions in your body. One of its most important functions is filtering toxins from your blood. While your liver is well-equipped for this job, its role as a filter makes it vulnerable to the toxins it processes. Too many toxins can overwhelm your liver’s resources and ability to function. This can happen temporarily or over a long period of time^[1][2].

When healthcare providers refer to liver disease, they’re usually referring to chronic conditions that do progressive damage to your liver over time^[2]. There are many kinds of liver disorders. Some can be passed through families, called inherited. Anything that damages the liver also can cause liver problems, including viruses, alcohol use and obesity^[1].

Where is the liver located?

The liver is located mainly in the upper right portion of the abdomen, beneath the diaphragm (the muscle that separates your chest from your abdomen) and above the stomach. It sits just under the rib cage on the right side of the abdomen^[1]. In an adult, a healthy liver is about the size of a football and can weigh up to 4 pounds (1.8 kilograms)^[1][7].

How common is liver disorder?

Liver disorder is very common. Approximately 1.8% of U.S. adults (4.5 million adults) have liver disease. It causes about 57,000 U.S. deaths a year. Globally, it causes about 2 million deaths per year, or 4% of all deaths^[2]. Liver disease affects males twice as often as females^[2].

However, the actual number of people with liver disease may be much higher. More than 100 million people in the United States actually have liver disease but don’t know it because they have no symptoms^[7]. Liver disease is the ninth most common cause of death in the U.S.^[7].

Types of liver disorders

There are many different types of liver disorders, which can have different causes. Understanding the type of liver disorder you have is important for proper treatment^[3][4].

Hepatitis

Hepatitis means inflammation of the liver. This condition is caused by exposure to toxins, alcohol misuse, infection or immune disease. Viruses cause the majority of hepatitis cases, and are known as viral hepatitis^[8]. There are several types of viral hepatitis, including hepatitis A, hepatitis B, hepatitis C, hepatitis D, and hepatitis E^[3][5].

Hepatitis A is highly contagious and spreads mainly through contaminated food or water. It is an acute, short-term type of hepatitis that usually does not require treatment as it goes away on its own with no long-term effects^[8]. Hepatitis B infection occurs through the spread of bodily fluids such as blood and semen. It can cause an acute or chronic infection^[8]. Hepatitis C can also be acute or chronic and is spread through contact with blood from someone with hepatitis C. Chronic infections can lead to permanent liver damage in later stages, but symptoms often don’t show up until this stage^[8].

Fatty liver disease

Fatty liver disease is a condition in which too much fat builds up in your liver. There are two main types^[8]. Nonalcoholic fatty liver disease (NAFLD) is not related to heavy alcohol use. When there is fat buildup but no inflammation or liver cell damage, it is called simple fatty liver. When there is inflammation and liver cell damage, it is called nonalcoholic steatohepatitis (NASH)^[8]. This type of fatty liver disease is often caused by being very overweight, and may cause fat to build up in the liver^[6][14].

Alcoholic fatty liver disease, also called alcoholic steatohepatitis, is caused by heavy alcohol consumption^[8]. Regularly drinking too much alcohol can lead to this condition^[6][14].

Autoimmune liver diseases

An autoimmune liver disease develops when your own immune system mistakes normal, healthy tissue for a foreign body. As a result, the immune system attacks healthy liver cells or bile duct cells^[4]. May be caused by a problem with the immune system^[6][14].

Cirrhosis

Cirrhosis is severe, permanent scarring in your liver. This is the stage where fibrosis is no longer reversible. Over time, conditions that damage the liver can lead to scarring, called cirrhosis. Cirrhosis can lead to liver failure, a life-threatening condition^[1][2].

Liver cancer

Cancer is the growth and spread of unhealthy cells in the body. Cancer that starts in the liver is called primary liver cancer. Those with cirrhosis or certain types of chronic liver disease (like hepatitis B or C) are at much greater risk of developing liver cancer^[4][9].

Other liver disorders

Other types of liver disorders include haemochromatosis, a gene that runs in families and may be passed from parents to children; inherited diseases; and liver disease caused by drugs, poisons, or certain metabolic conditions^{[1][2][6][14]}.

Stages of liver damage

Chronic liver disease progresses in roughly four stages. Understanding these stages can help you know what’s happening in your body and why early treatment is so important^[2][12].

Stage 1: Hepatitis (inflammation)

Hepatitis means inflammation in your liver tissues. Inflammation is your liver’s response to injury or toxicity. It’s an attempt to purge infections and start the healing process. Acute hepatitis (an immediate and temporary response) often accomplishes this. But when the injury or toxicity continues, so does the inflammation. Chronic hepatitis causes hyperactive healing that eventually results in scarring^[2][12].

Stage 2: Fibrosis

Fibrosis is a gradual stiffening of your liver as thin bands of scar tissue gradually add up. Scar tissue reduces blood flow through your liver, which reduces its access to oxygen and nutrients. This is how your liver’s vitality begins to gradually decline. Remarkably, some amount of fibrosis is reversible. Your liver cells can regenerate, and scarring can diminish if the damage slows down enough for it to recover^[2][12].

Stage 3: Cirrhosis

Cirrhosis is severe, permanent scarring in your liver. This is the stage where fibrosis is no longer reversible. When your liver no longer has enough healthy cells left to work with, its tissues can no longer regenerate. But you can still slow or stop the damage at this stage. Cirrhosis will begin to affect your liver function, but your body will attempt to compensate for the loss, so you might not notice at first^[2][12].

Stage 4: Liver failure

Liver failure begins when your liver can no longer function adequately for your body’s needs. This is also called “decompensated cirrhosis”—your body can no longer compensate for the losses. As liver functions begin to break down, you’ll begin to feel the effects throughout your body. Chronic liver failure is a gradual process, but it is eventually fatal without a liver transplant. You need a liver to live^[2][12].

Symptoms

Most types of liver disease do not cause any symptoms in the early stages. Chronic liver disease often won’t cause symptoms until the liver is already damaged and scarred^[2][6][14]. This is one reason why liver disease can be so dangerous—you may not know there’s a problem until significant damage has occurred^[10].

Once you start to get symptoms of liver disease, your liver is already damaged and scarred. This is known as cirrhosis^[6][14]. If there are symptoms of liver disease, they may include^[1][2][6]:

• Yellowing of the skin and the whites of the eyes, called jaundice. Yellowing of the skin might be harder to see on Black or brown skin
• Belly pain and swelling
• Swelling in the legs and ankles
• Itchy skin
• Dark urine
• Pale stool
• Constant tiredness or feeling very tired and weak all the time
• Nausea or vomiting
• Loss of appetite, which may lead to weight loss
• Bruising easily
• Loss of sex drive

Causes and risk factors

There are many factors that can damage the liver enough to affect its ability to function correctly. Understanding what causes liver disease can help you take steps to prevent it^[9].

Main causes

The three main causes of liver disease are obesity, an undiagnosed hepatitis infection, and alcohol misuse^[6][14]. Liver disease can be caused by viruses, reactions to medicines or chemicals, genetics, autoimmune diseases, being overweight and eating a poor diet, or drinking too much alcohol^[10].

Risk factors

You’re more likely to get liver disease if you^[6][14]:

• Are overweight, particularly if you have a lot of fat around your stomach and waist
• Do not have a healthy diet or are not very physically active
• Have type 2 diabetes
• Have polycystic ovary syndrome
• Have high blood pressure or high cholesterol
• Are over 50
• Drink too much alcohol regularly
• Smoke

Liver disease now affects 1 in 3 Australians^[10]. The disease also hits some ethnic and racial groups harder than others. For example, Black men are 60% more likely to have liver-related cancers and die from them than non-Hispanic White men^[7].

How is liver disorder diagnosed?

Finding the cause of liver damage and how bad it is helps guide treatment. Your healthcare professional starts with a health history and complete physical exam^[11][23].

The first thing your doctor will want to do is find out why you have liver disease and figure out how bad it is. They will probably examine your belly to see if your liver feels larger than it should. They will also talk to you in detail about your lifestyle. For example, they may ask about your diet and your weight, how much alcohol you drink, whether you could have been exposed to a hepatitis virus^[10]. Be as open and honest as you can.

Your healthcare professional may then suggest^[11][23]:

• Blood tests. A group of blood tests called liver function tests can diagnose liver disease. Other blood tests can be done to look for certain liver problems or conditions caused by gene changes.
• Imaging tests. An ultrasound, CT scan and MRI can show liver damage.
• Checking a tissue sample. Removing a tissue sample, called a biopsy, from the liver may help diagnose liver disease. A liver biopsy is most often done using a long needle put through the skin to get a tissue sample. The sample is then sent to a lab for testing.

Treatment options

Treatment for liver disease depends on the diagnosis. Some liver problems can be treated with lifestyle changes^[11][23]. Treatment for liver disease depends on the type you have and how severe it is^[6][14].

Healthy lifestyle changes can help with some types of liver disease. For example, alcohol-related liver disease may improve if you stop drinking alcohol. Some types of liver disease (such as certain types of hepatitis) may need to be treated with medicine^[6][14].

If you have severe liver damage and scarring (cirrhosis), you may need a liver transplant^[6][14]. Some of the most common types of liver disease are treatable with diet and lifestyle changes, while others may require lifelong medication to manage. If you begin treatment early enough, you can often prevent permanent damage^[2][12].

Can liver damage be reversed?

Yes, liver damage can be reversed. Your liver can repair itself! The liver is an amazing organ. It’s the only organ in the body that can repair itself by creating new tissue^[17]. If you take care of it, and make some changes to the way you live, eat and drink, you can reverse a lot of damage and avoid serious complications in the future^[17].

The earlier you find the problem and remove the cause of the liver damage, the better the chances of your liver healing. Sometimes liver damage can be caused by a virus or autoimmune condition. There are effective treatments for these conditions. It’s never too late. See your doctor and follow a healthy lifestyle to reduce inflammation, reverse scarring and improve how your liver works^[17].

Fibrosis can be reversed if you address it early enough. Even at the stage of cirrhosis, fixing the underlying condition can reverse cirrhosis and prevent complications like liver failure. So it’s never too late to make a change^[17].

The best way to reverse the damage is to remove whatever is causing it. For example, if you have fatty liver caused by drinking alcohol, it’s important to stop drinking. If it’s caused by your diet or being overweight, then it’s important to eat healthily and lose weight^[17].

How to prevent liver disorder

You can reduce your risk of many types of liver disease with some simple lifestyle changes^[6][14]. Living a healthy lifestyle helps your liver work as efficiently as possible and lowers your risk for liver disease^[20].

Recommendations for preventing liver disease include^[6][14][20]:

• Trying to maintain a healthy weight
• Eating a healthy, balanced diet
• Exercising regularly—aim to do at least 150 minutes of exercise a week
• Not drinking too much alcohol—keep to the recommended limit of no more than 14 alcohol units a week
• Not smoking
• Only taking medications that you need and carefully following dosing recommendations

Vaccines are available for hepatitis A and hepatitis B. These are recommended if you’re at risk^[6][14]. Some forms of liver disease, such as hepatitis B, are preventable with the help of a vaccine^[20].

You do not have to drink an excessive amount of alcohol to risk damaging your health. Regularly drinking just over the recommended levels can be harmful^[6][14].