What is liver disease?
The liver is a vital organ in our body. Broadly, after the blood crosses the stomach and intestines it goes into the liver. Here, the liver clears it of toxins, metabolises drugs (in the bloodstream) into a form that makes them more effective, and forms nutrients. Therefore, if there is an issue with the functioning of the liver, it can lead to a lot of problems.
In this article, we will talk about the different forms and types of liver diseases and some of their common symptoms and causes.
Some common signs and symptoms that you might notice in someone having liver function troubles include:1
- Yellowing of skin & eyes – most commonly Jaundice
- Bleeding in the oesophagus and/or stomach is caused by swollen blood vessels because of pressure build-up from the damaged liver – this condition is known as Bleeding Varices, and it is a life-threatening situation
- Swelling up of the abdominal area due to excess pressure in the liver leads to breathlessness and in some cases, malnutrition – This phenomenon is known as Ascites
- Sometimes issues in the liver can immediately affect the brain too. This happens when the liver is not able to filter toxins and hence, they remain in the blood supply eventually reaching the brain causing symptoms such as changes in mood, difficulty in maintaining concentration, memory problems, etc. This disease is known as hepatic encephalopathy
There are multiple causes behind liver diseases:2
- Undiagnosed hepatitis infection
- Excess consumption of alcohol
- Genetic Issues
- Autoimmune disease
We will discuss this further in the article.
Now we will briefly look at some key snippets about infections causing liver disease:3
Lasting from just a few weeks to several months, this disease spreads through ingestion of faecal matter (even if microscopic) for example through objects, food, or drinks that are infected by the stool/faeces of a contaminated individual, and it can be prevented using hep A vaccines. Treatment is usually in the form of supportive care.
This infection occurs through the exchange of bodily fluids (such as blood or semen) between an infected and non-infected individual, and can be acute and mild or chronic and potentially life-threatening. For acute forms of Hep B, there are no medications available, and supportive care is the best option. In the chronic version, patients are regularly observed for signs of worsening liver function and are sometimes treated with anti-viral medications. There is, however, an effective vaccine available for Hep B.
An infection with no vaccines currently available, it can range from acute to chronic and is usually transmitted through blood-to-blood contact between an infected and non-infected individual. It can also be transmitted through the usage of contaminated equipment such as syringes.
Damage to the liver
Above in the article, we discussed some of the causes of liver diseases. Let’s expand on that a little bit:
Liver fibrosis occurs when there is continuous or repetitive damage to the liver. Normally, when the liver is damaged, it repairs itself by making new liver cells. However, upon continuous injury, when liver cells attempt to fix the damage, what results is scar tissue4 [defined as the connective and fibrotic tissue that results after the occurrence of injury, disease, or surgery].5
When this fibrosis becomes severe and spreads throughout the organ due to recurring damage, it can prevent it from regenerating its function – this is known as Cirrhosis. As a result of this, the liver is unable to break down toxins and bile (digestive fluid) and produce essential substances that aid in survival. This leads to symptoms such as itchy skin, bloody vomit, swollen legs (known as oedema), and/or stomach (ascites), etc.6
Non-alcoholic fatty liver disease
As the name suggests, this occurs due to the buildup of fat in the liver. What begins as a harmless buildup of fat can eventually lead to inflammation further causing fibrosis and cirrhosis. Symptoms of NAFLD include fatigue, weakness, sudden and unexplained weight loss, and pain in the upper right stomach. Diagnosis involves a blood test known as a liver function test and treatment is usually done through changes in lifestyle habits.7
Abbreviated as AIH, this is a chronic condition lasting more than 6 months, usually a lifetime, and as the name suggests it is autoimmune (meaning the body’s immune system attacks its cells). Symptoms are similar to other liver diseases and range from mild to severe including fatigue, weakness, joint or muscle aches, itchiness, nausea, etc. Treatment generally involves the prescription of immunosuppressants (medications that reduce the activity of your immune system and reduce its ability to fight infections).8
Liver cancer can be classified into two types – primary and secondary. Primary liver cancer is the result of a malignant tumour. Malignant is a term often used in conjunction with cancer to describe cells that have rapidly divided in an uncontrolled manner and can invade nearby tissues and hence spread quickly.9
There are three types of primary liver cancer:
- Hepatocellular carcinoma – cancer that originates in the liver cells (referred to as hepatocytes)
- Cholangiocarcinoma a.k.a bile duct cancer – cancer starting in the walls of bile ducts (tube connecting the liver to the bowel and gallbladder)
- Angiosarcoma – a rare type of liver cancer, this originates in the blood vessels and often occurs in the elderly (those aged above 70)
Secondary liver cancer means that cancer originated in another part of the body but has spread to the liver.
Liver cancer has a multitude of causes which include Hepatitis B & C Viruses, obesity, smoking tobacco, excessive alcohol consumption, and type 2 diabetes. In terms of symptoms, one can expect weakness, abdominal swelling, right shoulder pain, fever, weight loss, etc.10
Summarising what we have discussed above, it is important to understand that the liver is an extremely vital organ. Obesity or fatty buildup and alcohol/drug abuse can often cause severe damage to the liver in the long term and since these are factors that we may be able to control we should keep them in check. To prevent infections such as Hep A, B, or C we can ensure that we make the maximum effort to stay sanitary and hygienic. There are also liver diseases such as AIH and liver cancer that are not really in our control, but regardless if you are suffering through symptoms such as weakness, fatigue, fever, achiness, etc, it is pertinent that you seek advice and clarity from a healthcare provider.
- Signs & Symptoms of Liver Damage or Disease | Liver Health [Internet]. Hepatitis NSW. Available from: https://www.hep.org.au/liver-health/signs-and-symptoms-of-liver-damage-or-disease/
- NHS. Liver disease [Internet]. NHS.uk. 2017. Available from: https://www.nhs.uk/conditions/liver-disease/
- Centres for Disease Control and Prevention. What Is Viral Hepatitis? [Internet]. CDC. 2020. Available from: https://www.cdc.gov/hepatitis/abc/index.htm
- Fibrosis of the Liver - Liver and Gallbladder Disorders [Internet]. MSD Manual Consumer Version. Available from: https://www.msdmanuals.com/home/liver-and-gallbladder-disorders/fibrosis-and-cirrhosis-of-the-liver/fibrosis-of-the-liver
- NCI Dictionary of Cancer Terms [Internet]. National Cancer Institute. Cancer.gov; 2019. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/scar-tissue
- Cirrhosis of the Liver - Liver and Gallbladder Disorders [Internet]. MSD Manual Consumer Version. Available from: https://www.msdmanuals.com/home/liver-and-gallbladder-disorders/fibrosis-and-cirrhosis-of-the-liver/cirrhosis-of-the-liver
- NHS Choices. Non-alcoholic fatty liver disease (NAFLD) [Internet]. NHS. 2019. Available from: https://www.nhs.uk/conditions/non-alcoholic-fatty-liver-disease/
- Autoimmune Hepatitis [Internet]. British Liver Trust. [cited 2022 Aug 12]. Available from: https://britishlivertrust.org.uk/information-and-support/living-with-a-liver-condition/liver-conditions/autoimmune-hepatitis/#symptoms
- https://www.cancer.gov/publications/dictionaries/cancer-terms/def/malignant [Internet]. www.cancer.gov. 2011. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/malignant
- Liver cancer | Causes, Symptoms & Treatments [Internet]. www.cancer.org.au. Available from: https://www.cancer.org.au/cancer-information/types-of-cancer/liver-cancer\