There are many types of liver disease. Some of the most common types 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. But you may not have symptoms in the early stages. Late-stage liver disease is more complicated to treat.
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.
When healthcare providers refer to liver disease, they’re usually referring to chronic conditions that do progressive damage to your liver over time. Viral infections, toxic poisoning and certain metabolic conditions are among the common causes of chronic liver disease. Your liver has great regenerative powers, but constantly working overtime to restore itself takes its toll. Eventually, it can’t keep up.
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Chronic liver disease progresses in roughly four stages:
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 (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.
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.
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.
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. Deaths are mostly from complications of cirrhosis, with acute liver failure accounting for a small portion. Liver disease affects men and people assigned male at birth (AMAB) twice as often as women and people assigned female at birth (AFAB).
Chronic liver disease often won’t cause symptoms in the early stages. But sometimes it begins with an episode of acute hepatitis. For example, if you get a viral hepatitis infection, there’s an acute phase before the chronic phase sets in. You might have a fever, stomachache or nausea for a brief period while your immune system works to defeat the infection. If it doesn’t defeat it, it becomes a chronic infection.
Some other causes of liver disease might also begin with more acute symptoms or have occasional episodes of acute symptoms. Early symptoms of liver disease tend to be vague. They might include:
You might begin to notice more symptoms when your liver function begins to decline. This happens in the later stages of liver disease. One of the first side effects of declining liver function is that bile flow stalls in your biliary tract. Your liver no longer produces or delivers bile effectively to your small intestine. Instead, bile begins to leak into your bloodstream. This causes specific symptoms, including:
As liver disease advances, it can affect your blood flow, hormones and nutritional status. This can show up in various ways. You may see signs and symptoms in your skin and nails, such as:
You may see signs of fluids leaking from your blood vessels and accumulating in your body, such as:
Liver disease symptoms in people assigned female at birth may include:
Liver disease symptoms in people assigned male at birth may include:
End-stage liver disease refers to decompensated cirrhosis and liver failure, when your liver has lost the ability to regenerate and is slowly declining. The most significant side effects of end-stage liver disease are portal hypertension and primary liver cancer (hepatocellular carcinoma). Complications of these two conditions are the leading causes of hospitalization and death in people with cirrhosis and liver failure.
Portal hypertension happens when scarring in your liver compresses the portal vein that runs through it. High blood pressure in the portal vein causes your body to divert blood flow to other veins connected with it, which become enlarged and stretched thin. These veins can leak, break and bleed. Internal bleeding from these varices can be sudden, severe and life-threatening.
Additional complications, though rare, include:
While not everyone with chronic liver disease gets primary liver cancer (hepatocellular carcinoma), most people who do get liver cancer have chronic liver disease. The cycle of inflammation, repair and scarring changes your liver cells in ways that make them more likely to change into cancer. Healthcare providers also believe that chronic hepatitis viruses, in particular, may interfere with the DNA in your liver cells.
There are over 100 types of liver disease, but they fall into a handful of subtypes. Causes include:
You may be more likely to get liver disease if you:
A healthcare provider checking for liver disease will begin by physically examining you. They’ll look for visible signs and ask about your symptoms. They may also ask about your diet, lifestyle and health history. Finally, they’ll use lab tests and imaging scans to check for liver disease. These may include:
Some types of liver diseases have specific medical treatments. For example, antivirals treat viral hepatitis, while corticosteroids and immunosuppressants treat autoimmune diseases. But in many cases, lifestyle changes are the primary treatment for liver disease. Reducing the toxic load on your liver is important with any type of liver disease, but essential for those caused by excess fat storage, alcohol or other toxins.
However, early recognition is key to treating liver disease effectively before permanent damage is done. Unfortunately, not everyone discovers liver disease in time to reverse its course. If you already have cirrhosis or liver failure, you might need additional treatments for complications like portal hypertension or liver cancer. Your liver might not be able to recover, and you might eventually need a liver transplant.
You can help prevent liver disease by:
Liver disease can be reversed in the early stages if you and your healthcare team are able to remove or manage the cause effectively. This depends on the cause and how treatable it is. Once you have cirrhosis, you can’t undo the scarring that’s already been done, but you may be able to prevent further damage or slow it down. Chronic liver failure isn’t reversible, though it can still take years to progress.
Many types of liver disease are curable. Toxic and alcohol-related liver disease can improve when you’re no longer exposed to the toxin. Diet and lifestyle changes can relieve non-alcohol related fatty liver disease. Other types of liver disease aren’t curable, but they’re often manageable with medications. Certain inherited diseases, autoimmune diseases and viral infections may need lifelong treatment.
If you have liver disease, you can help take care of your liver by:
A note from Cleveland Clinic
Your liver plays such a large role in your overall health that when it’s sick, it affects you in all kinds of ways. But you won’t always feel the effects of liver disease until it’s already advanced. To protect your liver, it’s important to be aware of the kinds of things that can harm it and try to avoid those things. Keeping up with your regular healthcare checkups can also help catch liver disease sooner rather than later.
Last reviewed by a Cleveland Clinic medical professional on 10/04/2023.
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