Liver Disease: Symptoms, Causes, Prevention & Treatment

Worldwide, an estimated 1.5 billion people¹ live with chronic liver disease. Around 1.8%² of the US adult population lives with this disease and cirrhosis (scarring of the liver).

Women are more likely to develop some liver conditions,³ including acute liver failure, autoimmune hepatitis, benign liver lesions, and primary biliary cirrhosis. Women are ten times more likely³ to develop primary biliary cirrhosis, and four times more likely³ to develop autoimmune hepatitis.

However, men are twice as likely³ to die from chronic liver disease than women.

Liver disease can have fatal outcomes, and these conditions are a common factor in worldwide mortality rates. The US records liver disease-related deaths at a rate of 15.7 per 100,000 people.⁴

People with liver disease don’t always display the same symptoms. Liver conditions can manifest in different ways, depending on what causes them.

However, liver conditions do share some general symptoms, including:

Jaundice

The buildup of a waste material called bilirubin may occur when your liver can’t filter toxic substances effectively.

Jaundice occurs when bilirubin levels are high, causing the eyes and skin to yellow.

Bleeding varices

Disease can cause clots or blockages around the liver, reducing the usual flow of blood to the organ. This may cause the veins in your esophagus to carry larger volumes of blood than usual. When this occurs, it may result in blood vessels bleeding or rupturing.

Vomiting blood and bloody stool are common signs of bleeding varices.

Liver dysfunction may also reduce blood clotting, leading to bruising and bleeding.

Ascites

Living with severe liver damage may cause fluid buildup in your abdomen.

Symptoms of ascites include:

• Labored breathing

• Swollen ankles or legs

• Weight gain

• Nausea

• Bloating

• Unexplainable heaviness when moving around

Encephalopathy

A serious consequence of the liver disease is its impact on brain function.

Toxins can build up and collect in your body when your liver cannot filter blood properly. Eventually, these toxins may travel to the brain, causing dysfunction.

Symptoms of encephalopathy include:

• Forgetfulness

• Confusion

• Shaky hands

• Slurred speech

• Disorientation

Several factors may cause you to develop liver disease.

Common types of liver disease and their causes include:

Cirrhosis

Cirrhosis may develop when your liver tries to heal itself when injured. Every time this healing takes place, healthy liver tissue is replaced by scar tissue. This makes it more difficult for your liver to function as it should.

This medical condition is a late-stage development, and will usually cause permanent liver damage. Treating and managing your liver disease early can help limit this damage.

Hepatitis

Hepatitis is a condition where liver inflammation occurs. Viral infections are the most common cause of hepatitis.

Viral hepatitis is usually contagious and may be spread through contact with bodily fluids.

The following five viruses are responsible for liver inflammation:

Hepatitis A

This infection is spread by consuming something contaminated with fecal matter, like food or water. It may also occur following contact with an infected person if you don’t practice appropriate hygiene measures.

Hepatitis B

The liver may become inflamed when viral cells invade normal cells. With hepatitis B, the virus enters the body through contact with an infected person’s blood, semen, or other bodily fluids.

Hepatitis B can be acute (short term) or chronic (long term).

Hepatitis C

Hepatitis C occurs when you come into contact with the blood of someone who is already infected. It is often spread by sharing needles or other tools for injecting drugs.

Like other forms of hepatitis, the infection may be acute or chronic. Hepatitis C rarely causes symptoms until very late in its development.

Hepatitis D

Hepatitis B may develop into a more severe hepatitis D infection through contact with blood. Hepatitis D is a double infection.

You can’t contract hepatitis D without prior exposure to the B variant.

Hepatitis E

Like hepatitis A, you can pick up this infection by drinking contaminated water. It usually clears up on its own within weeks or months without any serious effects.

Hepatitis E is the most common cause of acute hepatitis.¹

Autoimmune diseases

Your immune system is always working to protect you. However, immunity cells sometimes get confused and attack normal cells instead, like liver cells. The reasons for this are unclear.

Women are more likely to be affected by autoimmune conditions² than men.

Most people that live with autoimmune liver diseases have already developed cirrhosis.

Autoimmune liver diseases include:

Autoimmune hepatitis

This condition is caused when a high number of antibodies attack liver cells. It is a chronic illness that leads to liver inflammation.

Primary biliary cirrhosis

Primary biliary cirrhosis (PBC) is a progressive liver disease commonly observed in middle-aged women. This cirrhosis is caused by damage to the hepatic ducts in the liver.

Bile ducts are necessary for transporting digestive bile from the liver and gallbladder to encourage food breakdown. When the ducts suffer damage, bile can build up. This accumulation may cause jaundice and liver fibrosis (scarring).

Primary sclerosing cholangitis

Primary sclerosing cholangitis occurs when inflammation and cirrhosis cause bile ducts in the liver to get smaller. This reduction may cause blockage in the ducts, leading to bile buildup in the liver.

Genetic conditions

Some liver conditions can be passed down through families, including:

Alpha-1 antitrypsin deficiency

This condition is the most common cause of chronic liver disease in children.

Alpha-1 antitrypsin is a protein your body needs to prevent enzyme breakdown. These liver proteins protect the lungs. If Alpha-1 is produced in the wrong shape, it can get stuck in the liver. This is a known cause of liver cirrhosis.

Hereditary hemochromatosis

This is a recessive disorder that builds up when your body can’t properly absorb iron. It is caused by a mutation of the HFE gene which regulates iron absorption from the intestine.

This mutation causes excess iron to be absorbed, leading to high amounts of iron in the body.

Excess iron can cause liver damage, like fibrosis.

Wilson’s disease

Wilson’s disease is an inherited condition where copper accumulates in the body and other organs. 

Copper helps with energy production, iron metabolism, and blood pressure control among other functions.

Your liver usually has the important job of clearing your body of excess copper. However, copper levels can rise when your liver can’t manage them properly, resulting in liver cirrhosis and even brain damage in some cases.

Medication

Damage can occur when the liver comes into continuous contact with certain drugs.

Medications like amiodarone (Pacerone), isoniazid (Nydrazid), methotrexate (Rheumatrex/Trexall), phenytoin (Dilantin), and nitrofurantoin (Macrobid) have been known to cause chronic damage to the liver when taken in high amounts.

Alcoholic liver disease

Heavy drinkers have a high risk of developing alcohol-related liver disease, including alcoholic fatty liver disease, alcoholic hepatitis, and cirrhosis.

Continuously subjecting the liver to high amounts of alcohol can cause fat buildup, known as alcoholic fatty liver disease.

Alcoholic hepatitis is caused when the liver becomes inflamed due to alcohol consumption.

Heavy drinking can also cause cirrhosis.

Non-alcoholic fatty liver disease (NAFLD)

You can also have fat accumulation in your liver without being a heavy drinker. This is known as non-alcoholic fatty liver disease.

NAFLD is associated with metabolic conditions like obesity and diabetes. Patients with these conditions have a higher risk of fat buildup in the liver.

Cancer

Liver cancer is a chronic disease. The most common form of this condition is hepatocellular carcinoma, the fifth most common cancer worldwide.

The disease is associated with serious cases of hepatitis B and C. Cigarette smokers and drinkers also have a higher risk of developing liver cancer.

Outlook

Liver disease can worsen to become a life-threatening condition. It can cause liver failure when left untreated.

Liver failure may be acute when the liver begins to malfunction over a short period. Chronic liver failure is the result of long-term damage to the liver.

A positive liver disease diagnosis can be managed effectively with medication, lifestyle changes, and surgery.

Lifestyle improvements

Your doctor or hepatologist may recommend making changes to your lifestyle and daily habits to help manage and treat your liver condition.

Alcoholics can avoid further liver scarring by abstaining from alcohol. This will also help treat alcoholic fatty liver disease.

Likewise, measures like weight loss and consuming a high-fiber diet¹ show promise for regulating liver inflammation.

People living with non-alcoholic fatty liver disease may also limit calorie intake to improve liver health.

To help treat Wilson’s disease, you should consume a diet with very limited copper intake.

Before making any changes to your lifestyle and diet, speak to your doctor to ensure it’s safe.

Medications

Your doctor may prescribe medication to help manage your liver disease.

You will need to take antiviral medication to treat viral infections like hepatitis B and C, while steroids are useful for controlling diseases caused by inflammation.

Liver transplant

You may need to undergo a liver transplant if your liver damage is too extensive to be managed effectively with medication and lifestyle changes. A transplant can help you return to normal organ function.

The procedure, which is usually a last-resort treatment, may involve all or parts of your liver being removed.

Liver disease can cause serious complications and impact your quality of life. While it may not be possible to prevent inherited liver conditions, you can implement measures to reduce your risk of developing certain forms of the disease.

Preventative measures include:

• Getting regular check-ups with your doctor. Depending on your risk factors, your doctor may recommend carrying out annual blood tests (for example, cholesterol or liver function tests) and can discuss your risk of liver disease with you.

• Receiving treatment for any diseases that increase your chance of developing liver disease.

• Antiviral therapy in people living with hepatitis B or C.

• Implementing the right measures for immunity suppression in autoimmune hepatitis.

• Undergoing treatment for iron overload and the effects of Wilson’s disease.

• Avoiding alcohol can help protect your liver against all forms of liver disease.

Getting a diagnosis

Speak to your doctor at the first signs of liver disease, including yellowing skin, dark urine, and abdominal pain or swelling.

Your doctor may refer you to a hepatologist if they suspect liver disease. A hepatologist is a medical expert that specializes in liver-related diseases and the organs they can affect.

A hepatologist has extensive experience in evaluating, diagnosing, and treating different types of liver disease.

Diagnosing liver disease

The first step in diagnosing the liver disease is your doctor or specialist asking questions about your personal and family medical history and looking at your health records. Your doctor will also review your alcohol and medication use.

During a physical exam, a medical professional will apply a stethoscope to listen to sounds from your abdomen.

A hepatologist can perform various tests to determine how well your liver functions. They can measure your body’s bilirubin levels and the amount of liver enzymes in your blood.

Diagnosing liver disease will also require a complete blood count, clotting blood tests, and finally, virus testing. You may also be tested for autoimmune liver conditions.

Besides blood tests, a hepatologist may perform liver x-rays, ultrasounds, and biopsies to get a picture of your liver health.