Hepatomegaly (Enlarged Liver)

What is an enlarged liver?

If you have an enlarged liver (hepatomegaly), your liver is swollen beyond its normal size. This is most often a symptom of another problem like liver disease. But sometimes, it’s a disease in your blood or heart.

Your liver is one of your essential organs — one you can’t live without. It performs many important bodily functions, including filtering toxins from your blood and regulating your blood cholesterol. A healthy liver can perform all these functions, but an enlarged liver can’t. No matter the cause, you and your healthcare provider will need to find it and treat it to preserve your liver function.

How serious is an enlarged liver?

You should take it seriously, but the exact seriousness depends on the cause. An enlarged liver could be an emergency or a warning. There’s no way to know until your healthcare provider does some investigating. Sometimes, your liver swells in response to a short-term condition, then goes back to normal. Other times, a long-term condition is causing slow but progressive damage.

What are the symptoms of an enlarged liver?

You likely won’t notice an enlarged liver on your own. In some severe cases, you might notice a feeling of bloating or fullness in your belly or an ache in your upper right abdomen (where your liver is). It’s more likely your healthcare provider will discover it during an exam. They might notice that your liver feels different from what it should when they touch your belly.

If a swollen liver is a sign of liver disease, it might come with other related symptoms, such as:

• Fatigue
• Nausea or lack of appetite
• Jaundice (yellowing of the skin and eyes)
• Dark-colored pee and light-colored poop
• Itchy skin (pruritus)
• Enlarged spleen (splenomegaly)

What is the most common cause of an enlarged liver?

Your liver could be swollen or enlarged by:

• Inflammation, a response to infection or too many toxins in your liver
• Fat, if your liver is storing too much
• Blood, if the vessels that run through your liver are engorged or blocked
• Growths, either malignant or benign

Common causes include:

• Alcohol-associated hepatitis, which is hepatitis from drinking too much alcohol
• Toxic hepatitis, often due to a medication overdose
• Viral hepatitis due to infection with hepatitis A, B or C
• Fatty liver disease, due to alcohol or metabolic syndrome
• Mononucleosis, a common viral infection

What are the other possible causes?

Less common causes of hepatomegaly include:

Genetic disorders

• Hemochromatosis
• Wilson’s disease
• Gaucher disease
• Amyloid light chain amyloidosis
• Glycogen storage disease
• Neimann-Pick disease
• Sickle cell disease

Liver lesions

• Liver cysts
• Benign liver tumors like hemangioma or adenoma
• Liver cancer

Systemic cancers

• Leukemia
• Lymphoma

Bile duct diseases and strictures

• Primary biliary cholangitis
• Primary sclerosing cholangitis

Heart and vascular causes (congestive hepatopathy)

• Congestive heart failure (due to back pressure from the heart)
• Pericarditis
• Budd-Chiari syndrome

How is an enlarged liver treated?

Your healthcare provider will work with you to determine the cause. They may take blood tests and imaging tests to look for evidence of various diseases. If your condition appears severe, they may want to take a liver biopsy to test a sample of your liver tissue in a lab. They’ll offer treatment options based on the results of these tests.

What medications treat hepatomegaly?

There isn’t a medication to treat an enlarged liver. Rather, there are medications that can treat certain conditions that cause an enlarged liver.

Can an enlarged liver be reversed or cured?

Sometimes. Your liver has a remarkable ability to repair itself when there’s enough healthy tissue left. If your enlarged liver happens suddenly, treating the condition will allow your liver to heal.

If it’s the result of chronic (long-term) liver disease, it can potentially be reversed and, in some cases, cured with lifestyle changes.

For example:

• If you have alcohol use disorder, get help to quit drinking alcohol
• If you have non-alcohol-associated fatty liver disease, ask your provider how to maintain a weight that’s healthy for you
• Take steps to manage high blood pressure, high cholesterol and high blood sugar
• Eat nutritious foods and get a little exercise each day

When should I see my healthcare provider about my liver?

If the upper right side of your belly feels swollen or sore for any reason, make sure to have it checked out. Call your healthcare provider right away if you have other strange or severe symptoms, such as:

• Persistent fever
• Confusion or disorientation
• Weakness and lightheadedness
• Yellow eyes or skin
• Change in urine or stool color