Liver Disease

What is liver disease?

Your liver is your body’s second-largest organ (after the skin). It sits just under your ribcage on the right side and is about the size of a football. The liver separates nutrients and waste as they move through your digestive system. It also produces bile, a substance that carries toxins out of your body and aids in digestion.

The term “liver disease” refers to any of several conditions that can affect and damage your liver. Over time, liver disease can cause cirrhosis (scarring). As more scar tissue replaces healthy liver tissue, the liver can no longer function properly. Left untreated, liver disease can lead to liver failure and liver cancer.

How common is liver disease?

Overall, about 1 in 10 Americans (30 million in total) have some type of liver disease. About 5.5 million people in the U.S. have chronic liver disease or cirrhosis.

Some types of liver disease are becoming more common in the U.S. because they are related to rising rates of obesity. An estimated 20% to 30% of adults have excess fat in their liver, a condition called non-alcohol rekated fatty liver disease (NAFD). This may be renamed metabolic-associated fatty liver disease (MAFLD) to reflect its relationship to metabolic syndrome and conditions like diabetes, high blood pressure, high cholesterol and obesity.

What causes different types of liver disease?

Different types of liver disease result from different causes. Liver disease may result from:

• Viral infections: Hepatitis A, hepatitis B and hepatitis C are diseases caused by a viral infection.
• Problems with your immune system: When your immune system mistakenly attacks your liver, it can cause autoimmune liver diseases. These include primary biliary cholangitis and autoimmune hepatitis.
• Inherited diseases: Some liver problems develop because of a genetic condition (one you inherit from your parents). Inherited liver diseases include Wilson disease and hemochromatosis.
• Cancer: When abnormal cells multiply in your liver, you may develop tumors. These tumors may be benign (noncancerous) or malignant (liver cancer).
• Consuming too many toxins: Alcohol-related fatty liver disease is the result of alcohol use. Non-alcohol related fatty liver disease (NAFLD) results from consuming too much fat. NAFLD is becoming more common as rates of obesity and diabetes rise.

What are the symptoms of liver disease?

Some types of liver disease (including non-alcohol fatty liver disease) rarely cause symptoms. For other conditions, the most common symptom is jaundice — a yellowing of your skin and the whites of your eyes. Jaundice develops when your liver can’t clear a substance called bilirubin.

Other signs of liver disease may include:

• Abdominal (belly) pain (especially on the right side).
• Bruising easily.
• Changes in the color of your urine or stool.
• Fatigue.
• Nausea or vomiting.
• Swelling in your arms or legs (edema).

What are the complications of liver disease?

Some types of liver disease can increase your risk of developing liver cancer. Others, if left untreated, continue to damage your liver. Cirrhosis (scarring) develops.

Over time, a damaged liver won’t have enough healthy tissue to function. Liver disease that isn’t treated can eventually lead to liver failure.

How is liver disease diagnosed?

To accurately diagnose and find the cause of liver disease, your provider will also recommend one or more tests. These may include:

• Blood tests: Liver enzymes measure levels of liver enzymes in your blood. Other tests of liver function include a blood-clotting test called the international normalized ratio (INR). Abnormal levels may indicate problems with your liver function.
• Imaging tests: Your provider can use ultrasound, MRI or CT scan to look for signs of damage, scarring or tumors in your liver. Another specialized type of ultrasound called fibroscan can be used to determine the degree of scarring and fat deposition in the liver.
• Liver biopsy: During a liver biopsy, your provider uses a thin needle to remove a small sample of liver tissue. They analyze the tissue to look for signs of liver disease.

How is liver disease managed or treated?

Treatment for liver disease depends on the type of liver disease you have and how far it has progressed. Possible treatments include:

• Medications: Healthcare providers treat some types of liver disease with medication. You may take medicine for viral infections like hepatitis or inherited conditions like Wilson disease.
• Lifestyle changes: You can use your diet to help manage certain types of liver disease. If you have fatty liver disease, avoiding alcohol, limiting fat and calories and increasing fiber intake can help. Alcohol-related liver disease can improve with abstinence from alcohol.
• Liver transplant: When liver disease progresses to liver failure, a liver transplant may be the best treatment option. A transplant replaces your liver with a healthy liver.

Can liver disease be prevented?

You can take steps to prevent some types of liver disease — especially those affected by your diet and lifestyle. If you are at risk for liver disease, your provider may recommend lifestyle changes including:

• Avoiding or limiting alcohol.
• Avoiding foods and drinks that contain trans fats or high-fructose corn syrup.
• Carefully managing your intake of prescription and over-the-counter medications to avoid liver damage, as medications like acetaminophen (Tylenol®) are a common cause of liver injury.
• Getting regular exercise.
• Limiting consumption of red meat.

You can minimize the likelihood of contracting viral hepatitis by practicing safe sex and not sharing needles.

What is the prognosis (outlook) for people with liver disease?

With early treatment and effective lifestyle changes, many people with liver disease can avoid serious liver damage and prevent liver failure.

When should I call the doctor?

You should call your healthcare provider if you experience:

• Changes in the color of your urine or stool.
• Jaundice or yellowing of your eyes.
• Pain in the upper right side of your abdomen.
• Swelling in your arms or legs.

What questions should I ask my doctor?

You may want to ask your healthcare provider:

• What lifestyle changes should I make to help keep my liver healthy?
• What early warning signs of liver disease should I watch out for?
• Should I avoid any medications to help prevent liver damage?
• If I have an inherited liver disease, should my family get genetic testing?
• Will I need to have a liver transplant?

A note from Cleveland Clinic

Liver disease can result from infection, an inherited condition, cancer or an overload of toxic substances. Healthcare providers can treat many types of liver disease effectively with medication or lifestyle changes. If you have severe liver disease, a liver transplant may restore your health and extend your life.