Liver disease is varied and there are many conditions that affect this vital organ, including cirrhosis, alcoholic fatty liver, and hepatitis. Primary sclerosing cholangitis is a type of inflammatory liver disease affecting the bile ducts. Hepatocellular carcinoma is a type of liver cancer that is among the most serious of liver diseases.
Liver disease is any condition that causes liver inflammation or tissue damage and affects liver function. The liver is a vital organ located in the upper right-hand side of the abdomen. It is as large as a football, weighs 2-3 pounds, and performs numerous functions for the body: converting nutrients derived from food into essential blood components, storing vitamins and minerals, regulating blood clotting, producing proteins and enzymes, maintaining hormone balances, and metabolizing and detoxifying substances that would otherwise be harmful to the body. The liver makes factors that help the human immune system fight infection, removes bacteria from the blood, and makes bile, which is essential for digestion.
Bile, a greenish-yellow fluid consisting of bile acids or salts and waste products such as bile pigments, flows through small bile ducts inside the liver. The bile moves from these small ducts into larger ones, like streams into a river, eventually converging into the common bile duct and exiting the liver. Some of the bile flows directly to the duodenum; the rest is stored and concentrated in the gallbladder. After a person eats, the gallbladder, a fist-sized organ that sits next to the liver, releases some of the stored bile into the small intestine, where it helps to digest fats.
Hepatitis of the liver comes in different forms and is contracted in various ways. Hepatitis A, B, C, and D are the classifications of this disease. The hepatitis A virus may cause symptoms of fatigue, jaundiced skin, and mild fever. This is generally the mildest form and requires no prescribed medications. The general course of treatment is bed rest and the use of a fever reducer or pain reliever.
Some individuals with hepatitis B may not show obvious symptoms and may not feel ill in the chronic stages of this liver disease. Over time, deterioration of the liver and its functioning may result. The disease is contagious even with no apparent symptoms. The same course of treatment as prescribed with hepatitis A is typically recommended.
The hepatitis C virus generally produces no symptoms in many patients, although over the course of time, damage to the liver will manifest. A liver disease known as cirrhosis, which causes scarring of liver and decay, may develop. For those patients who have pronounced symptoms, sharp pain in the abdomen may be present, as well as nausea and vomiting.
Hepatitis D is also known as delta agent. This type of liver disease manifests in patients who have contracted the hepatitis B virus. Abdominal pain and gastrointestinal symptoms may be present with this disease. A liver biopsy may tell if a patient with hepatitis B has the delta agent present as well.
Alcoholic liver disease generally manifests in patients who have been heavy alcohol drinkers for several years. With this condition, a patient may develop cirrhosis of the liver. The liver may become irreversibly damaged if alcohol consumption is continued after a diagnosis has been made. In some cases, the damage may be so severe that the only recourse would be for the patient to undergo a liver transplant.
Some types of liver disease may impair the organ's ability to function. Cirrhosis, whether due to excessive alcoholic consumption or other factors, may impair the liver's capacity to function properly over time. The liver may not be able to filter toxins from the blood, and as a result, frequent infections may occur.
Liver cancer that has originated in the liver is medically known as Hepatocellular carcinoma. There are various forms of cancer that originate in other areas of the body that metastasize or spread to the liver, however. In such cases, this can often be life threatening. Any form of liver cancer can potentially be fatal within a relatively short span of time.
Classic symptoms of liver disease include:
nausea,
vomiting,
right upper quadrant abdominal pain, and
jaundice (a yellow discoloration of the skin due to elevated bilirubin concentrations in the bloodstream).
Fatigue, weakness and weight loss may also be occur.
However, since there are a variety of liver diseases, the symptoms tend to be specific for that illness until late-stage liver disease and liver failure occurs.
Examples of liver disease symptoms due to certain conditions or diseases include:
A person with gallstones may experience right upper abdominal pain and vomiting after eating a greasy (fatty) meal. If the gallbladder becomes infected, fever may occur.
Gilbert's disease have no symptoms.
Individuals with cirrhosis will develop progressive symptoms as the liver fails. Some symptoms are directly related to the inability of the liver to metabolize the body's waste products. Others reflect the failure of the liver to manufacture proteins required for body function and may affect blood clotting function, secondary sex characteristics and brain function. Symptoms of cirrhosis of the liver include:
easy bruising may occur due to decreased production of clotting factors;
bile salts can deposit in the skin causing itching;
gynecomastia or enlarged breasts in men may occur because of an imbalance in sex hormones; specifically an increase in estradiol;
impotence (erectile dysfunction, ED), and shrinking testicles are due to decrease in function of sex hormones;
confusion and lethargy may occur if ammonia levels rise in the blood stream (ammonia is a waste product formed from protein metabolism and requires normal liver cells to remove it);
ascites (fluid accumulation within the abdominal cavity) occurs because of decreased protein production; and
muscle wasting may occur because of reduced protein production.
Additionally, there is increased pressure within the cirrhotic liver affecting blood flow through the liver. Increased pressure in the portal vein causes blood flow to the liver to slow and blood vessels to swell. Swollen veins (varices) form around the stomach and esophagus and are at risk for bleeding.
Hepatitis is an inflammation of the liver that can be caused by a virus, inherited disorders, and sometimes by certain medications or toxins such as alcohol and drugs. Scientists have identified four main types of viral hepatitis: hepatitis A, hepatitis B, and hepatitis C, and hepatitis D. A fifth type, hepatitis E, is generally not found in North America.
Hepatitis A is waterborne and spread mainly via sewage and contaminated food and water. Hepatitis B is transmitted by contact with infected semen, blood, vaginal secretions and from mother to newborn. Hepatitis B is most commonly spread by sharing of infected needles (including those used for tattooing, acupuncture, and ear piercing). Hepatitis C spreads via direct blood-to-blood contact. Hepatitis D is spread by infected needles and blood transfusions.
Improved screening of donated blood has greatly reduced the risk of catching hepatitis B or C from blood transfusions. Both hepatitis B and C can be spread through sharing of razors, toothbrushes, and nail clippers.
The main cause of cirrhosis is chronic infection with the hepatitis C virus. Other causes include:
long-term, excessive alcohol consumption
chronic infection with hepatitis B virus
inherited disorders of iron and copper metabolism
severe reactions to certain medications
fatty liver caused by obesity
infections from bacteria and parasites usually found in the tropics
repeated episodes of heart failure with liver congestion and bile-duct obstruction
With cirrhosis, the liver tissue is irreversibly and progressively destroyed as a result of infection, poison or some other disease. Normal liver tissue is replaced by scars and areas of regenerating liver cells.