The Many Faces of Liver Disease

People of all ages face liver disease. Both children and adults are diagnosed with hepatic diseases caused by viruses, substances or the body's own immune system. If caught early on, the liver can often heal itself and recovery. But when liver disorders aren't diagnosed quickly, the damage may be irreversible, thus requiring a liver transplant.

What is the liver?

Located on the upper right side of your abdomen, the liver filters impurities from your blood, assists in digestion, fights infection, and stores energy from food. In this way, the liver is vital to your health. Humans cannot live without a healthy liver. Fortunately, the organ is unique in that it can often repair itself from illness or injury.

Progression of liver disease

No matter the exact illness, liver disease progresses in much the same way for everyone. In the earliest stages, your liver will become inflamed as the body attempts to fight off infection. Unlike other parts of your body though, you won't know your liver is inflamed. Even though your liver is roughly the size of a football, you'll experience no pain.

If the inflammation is left untreated, scarring (fibrosis) will begin to occur. Fibrosis, or scar tissue, doesn't work like healthy liver tissue. That means the healthy tissue that remains must work harder to get the job done. At this point, liver disease can still be treated.

If treatment doesn't happen, progression to severe scarring or cirrhosis of the liver occurs. This is when much of the liver becomes hard from extensive scarring. Unfortunately, this is when many people first begin to experience symptoms of liver disease. Symptoms may include:

- Easy bleeding or bruising,

- Yellowed eyes,

- Fluid retention in your legs or abdomen,

- Skin itching,

- Medication sensitivity,

- Problems concentrating, sleeping or with memory.

People with cirrhosis have increased risk of developing liver cancer. It can also occur in the liver at any time. A few other liver diseases can also further increase the risk of liver cancer, including hepatitis B (with or without cirrhosis), hepatitis C to name a few.

Once cirrhosis is diagnosed, the disease can be managed, but often not reversed. At some point, the liver may deteriorate further leading to end-stage liver disease. Patients at this stage typically go to the top of the transplant list.

Fatty Liver

Since many people often don't experience symptoms until it's too late, it's important to know if you have risk factors for fatty liver disease. This condition is caused by a buildup of fat in the liver, or steatosis, which occurs when the liver contains 5-15% fat. It can be caused by drinking alcohol or by other factors not related to alcohol or non-alcoholic fatty liver disease (NAFLD, see below risk factors).

In many cases, fatty liver disease does no harm. However, for some, the condition causes liver damage, scarring, and even cirrhosis. Risk factors include:

- Obesity,

- Type 2 diabetes

- Metabolic syndrome, which includes excess body weight, insulin resistance, high blood pressure and high triglyceride levels

- Some genetic metabolic conditions,

- Some prescription medications.

While symptoms aren't always evident, they do sometimes include:

- Abdominal pain or a feeling of fullness in the middle or upper right portion of the abdomen,

- Loss of appetite or weight loss,

- Nausea,

- Weakness or extreme fatigue,

- Yellowing of the skin and the whites of the eyes,

- Abdominal and leg swelling,

- Mental confusion.


Roughly 100 million people are diagnosed each year with non-alcoholic fatty liver disease. Of those, a portion develop nonalcoholic steatohepatitis (NASH), a more severe form that causes liver swelling and damage. While many people do have risk factors including obesity, rapid weight loss or poor eating habits, some have no risk factors at all. A high number of liver enzymes on a blood test is often the only way to diagnose the disease. Your doctor will help you find ways to lower the fat content of your liver, which may include:

- Weight loss,

- Eating a nutritious diet,

- Lowered triglycerides and cholesterol,

- Alcohol avoidance.


Three kinds of viral hepatitis cause liver damage.

Hepatitis A is caused by a virus, which goes away on its own, but the virus can cause some severe damage to people with existing liver disease or those over the age of 60. A vaccine is available to prevent people from contracting the virus.

Hepatitis B is a virus that often clears up on its own after about six months. However, about 5% of adults who contract the virus develop chronic symptoms that lead to liver damage. Unlike adults, 90% infants under the age of 2, who acquires hepatitis B, will keep it for life. Bodily fluids pass the virus between people.

Hepatitis C usually doesn't go away on its own. This virus becomes chronic for many people, leading to liver cancer, liver failure and cirrhosis. Treatment is now available and hepatitis C is considered curable, but it's vital to diagnosis the virus early.