Liver Disease: Top Warning Signs and Symptoms, Causes, Diagnosis, Treatment, and How To Keep a Healthy Liver?

Our liver is the largest abdominal organ and weighs around one and a half kilos (around 3 pounds). Despite its homogenous appearance, it carries more diverse functions than any other organ in the body. It is also a highly regenerative organ that can quickly fix most damage that occurs to its cells -which happens on a daily basis-. The wide variety of liver functions is why liver disease can present a wide range of symptoms and manifestations. According to several studies, over 1% of the US population suffers from chronic liver disease. Several factors contribute to this high prevalence. Liver disease is not only a disabling condition for the patient, managing chronic liver disease patients is costly both to the patient’s family and on the public health level. Avoiding liver disease and detecting it early on can significantly change the lives of those at risk.

Understanding how the liver disease progresses:

The liver disease progresses – Thelifetoday.com

The liver disease starts with acute changes in the cells as inflammation, which can last for up to 6 weeks. Afterward, the inflammation becomes chronic, and more permanent changes take place. The end result of this process is cirrhosis, which means that the intricate architecture of the liver changes to an amorphous mass of cells, causing increased pressure of the blood flowing through the liver, also called portal hypertension.

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The end process of cirrhosis is liver cell failure and death. In general, humans can’t survive for more than 24 hours without a functioning liver. Another possible outcome is the development of liver cancer which is also fatal. However, the time-lapse between the onset of acute liver injury to liver cell failure can be more than 3 decades. This long period reflects the liver’s ability to regenerate until its capacity is reached.

Causes of liver disease:

Owing to the wide variety of functions that the liver performs, several disorders can affect it and cause its failure, including:

Excessive alcohol consumption: Nowadays, it presents the majority of cases of chronic liver disease in Western countries. Alcohol is toxic to liver cells and causes the accumulation of fat within and over them. This causes a condition called alcoholic steatohepatitis, which gradually progresses to cirrhosis.
Viral hepatitis: Five viruses can specifically affect the liver, namely hepatitis viruses A, B, C, D, and E. Other viruses like cytomegalovirus or Epstein-Barr virus can also affect the liver as a part of a multisystemic disorder. Viral hepatitis can be acute or chronic, and chronic cases can progress to cirrhosis. The 2 viruses that commonly cause cirrhosis are Hepatitis B and C viruses. Most of the above viruses are transmitted by blood and to a lesser extent through sexual intercourse and secretions. Hepatitis A and E viruses, however, are transmitted through contaminated food.
Fatty liver disease: Because of the high prevalence of fatty diets in our meals, the prevalence of the fatty liver disease is increasing. Fatty liver has been recognized as one of the commonest causes of liver affection nowadays. The general term used for these cases is Non-alcoholic fatty liver disease (NAFLD).
Autoimmune hepatitis: Several syndromes and conditions can cause autoimmune hepatitis. The body attacks its cells in autoimmune conditions, and in this case, it attacks liver cells. The condition develops in a similar way to viral hepatitis and has a similar outcome.
Drug-induced hepatitis: Any drug that is metabolized by the liver can cause hepatitis. Some drugs are more liable to cause hepatitis than others. Famous drugs that can damage the liver include Paracetamol -in large doses-, antiepileptic drugs, some antibiotics, and steroids.
Rare metabolic diseases: Some rare metabolic diseases can affect the liver. Examples include hemochromatosis, which is the accumulation of iron inside body cells including the liver. Iron becomes toxic and can cause cirrhosis. Another example is Wilson’s disease, which is the defective transport of copper in the body and its accumulation in liver cells.

How to tell if I may have a liver disease:

How to tell if I may have liver disease – Thelifetoday.com

Liver disease has different grades, from mild unnoticeable alteration of function to severe affection and failure. Manifestations differ according to the severity and the cause of the disease. Common symptoms include:

Persistent fatigue and tiredness: Fatigue is a very nonspecific symptom and can result from virtually any disease, but fatigue resulting from liver affection is characterized by being persistent. It doesn’t change from morning to night and is associated with a tendency to sleep for prolonged hours.
Loss of appetite: Liver patients have portal hypertension, which is the congestion of blood vessels connecting the liver to the gastrointestinal system. This causes early satiety and general loss of appetite. You may also feel slight abdominal discomfort following even small meals.
Abdominal pain: Not all causes of liver disease have abdominal pain as a manifestation, but patients who have viral hepatitis or chronic alcoholism can have severe attacks of abdominal pain owing to the associated liver inflammation.
Jaundice: The most well-known of liver disease symptoms is jaundice. Jaundice occurs when the level of a substance called bilirubin rises in the blood and deposits in tissues. Bilirubin is normally produced in the body from the breakdown of hemoglobin, which forms red blood cells. Normally, bilirubin is excreted into the bile. In the case of acute cases of hepatitis, bile channels in the liver are obstructed and liver cells become unable to process bilirubin, causing its accumulation.
Dark urine: When bile channels are obstructed in liver disease, bile regurgitates back to the blood and is excreted in the urine, making its color dark like tea.
Leg and abdominal swelling (ascites): One hallmark of late liver disease is the development of ascites. Ascites are the accumulation of fluid in the abdominal cavity. When the liver becomes severely affected, salt and water accumulate in the body. This overload is seen in the form of leg swelling and abdominal distension.
Vomiting blood: There are many causes for bloody vomiting including stomach ulcers or as a reaction to certain drugs. In liver disease, when portal hypertension occurs, large blood vessels in the esophagus (the tube that leads to the stomach) become distended and can bleed profusely. This is a life-threatening condition that needs immediate treatment.
Easy bruising and prolonged coagulation: The liver produces most coagulation factors, which are proteins that control blood coagulation after injury. When liver impairment occurs, patients can become easily bruised after minor trauma and can bleed profusely after minor injuries.
Palmar erythema: Unusual redness of your hand palm can be a sign of liver disease. It results from an increase in blood estrogen. Estrogen is the female sex hormone and is present in both males and females. Estrogen is normally destroyed by the liver at a constant rate, and when liver functions are impaired, its levels rise. This rise causes the dilatation of blood capillaries in your palm.
Gynecomastia: Because of the rise of blood estrogen levels, some men with advanced liver disease may notice that their breasts enlarge and become tender. Estrogen stimulates breast tissue to enlarge the same way it happens in adolescent females.
Losing muscle mass: The liver is the primary site of protein formation in the body. Many of these proteins are essential for keeping muscle mass across the whole body. Chronic liver disease patients develop a condition called cachexia, where they lose their muscles and fat and appear extremely lean.
Hepatic encephalopathy: Hepatic encephalopathy is a condition seen in patients with acute or chronic liver failure. The liver has an important detoxifying function of ammonia. Ammonia is the byproduct of using proteins by the body and is lethal to the nervous system. It can cross to brain cells and cause a variety of manifestations from lack of concentration and sleepiness to coma.
Hand tremors: Chronic liver disease patients can suffer from severe tremors. It is thought to result as a part of hepatic encephalopathy.

How is the liver disease diagnosed?

How is liver disease diagnosed – Thelifetoday.com

When symptoms of liver disease are apparent, your doctor will diagnose liver affection and its cause using some laboratory investigations and imaging modalities. Laboratory investigations include:

Liver function tests (LFTs): Liver function tests include measuring the levels of liver enzymes, AST, and ALT, which rise when liver damage occurs as well as bilirubin. Other liver function tests include serum albumin, which is the main indicator of the liver’s capacity to produce protein. Prothrombin time (PT) can also be used as an indicator of liver function, as it is the first one to be affected.
Viral markers: Since viral hepatitis is one of the commonest causes of liver disease, detecting hepatitis viruses is routine in all cases of liver disease. This includes testing for Hepatitis A, B, and C.

Abdominal ultrasound is also needed for cases of jaundice and liver disease in general. It helps show what is wrong with the liver and excludes the presence of cirrhosis. Abdominal ultrasound is preferred and sometimes done routinely owing to its lack of side effects and ease of interpretation. A Liver CT scan can be used for cases suspected of having liver cancer.

Is liver disease treatable?

Depending on the cause of liver disease and the stage of a liver cell failure, different treatment modalities are present. The general rule is that the more advanced liver disease is, the more likely it is that the only treatment is liver transplantation. Patients with cirrhosis will eventually develop liver failure and are placed on transplant lists.

Causes like viral hepatitis have specific treatments and antiviral medications. Hepatitis B also has a vaccine and hepatitis A only needs supportive therapy and would go away on its own.
Autoimmune hepatitis can be treated by corticosteroids and immunosuppressive drugs.
Drug-induced hepatitis usually regresses after stopping the causative drug.
Fatty liver disease is usually reversible at its early stages with a good diet and medications to lower blood cholesterol.

How to keep a healthy liver?

The liver is a very robust organ. Being the organ that detoxifies all toxins that enter our bodies, it regenerates at an incredible rate. Therefore, keeping it healthy is an easy task if you follow simple health tips including:

Moderate your alcohol consumption. Alcohol is damaging to the liver, gastrointestinal tract, nervous system, and cardiovascular health. Keeping your alcohol consumption as low as possible ensures that no excess load is placed on the liver.
Eat healthy meals and avoid excessive fatty and carbohydrate-rich food. Fat deposition in the liver is fatal to its cells in the long run.
Never share needles or shaving razors. Hepatitis B, C, and D transmit by blood and can easily pass to you from a minor wound by a used razor.
Avoid street food, especially from unhygienic places. Hepatitis A can easily transmit by flies or the unclean hands of chefs.
Get vaccinated against Hepatitis B. Although the vaccine is widely available and highly effective, treating hepatitis B infection once it occurs is challenging and not always successful.
Do not use medications except as instructed by your physician. Over-medicating can damage your liver and kidneys.

Regarding liver transplantation:

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Liver transplantation is one of the success stories of modern medicine. This organ is now the most successfully transplanted one in the body. Owing to the regenerative nature of the liver, people who donate a lobe of their liver (we have two) can regenerate their lost part within a few months. Liver transplantation is still an operation that has many risks. It is done for patients who have chronic liver failure and in some cases of acute liver failure. Like all organ transplantation, liver transplantation needs compatibility between the donor and the recipient. This means that identical blood grouping, as well as other tests, have to be done to make sure that the recipient body won’t reject the new liver. If the body rejects the new liver, it will fail within a few hours to days and the patient will need a new liver as soon as possible. With that said, patients who get a new liver feel like they have been reborn. Their muscles start to regain their mass, their jaundice disappears, and their bleeding tendency diminishes. Many patients can also recover from hepatic encephalopathy either partially or totally.