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Liver Disease : Symptoms, Causes, Diagnosis and Treatment

What is Liver Disease?

The liver is an organ about the size of a football. It sits just under your rib cage on the right side of your abdomen. The liver is essential for digesting food and ridding your body of toxic substances.

Liver disease can be inherited (genetic). Liver problems can also be caused by a variety of factors that damage the liver, such as viruses, alcohol use and obesity.

Over time, conditions that damage the liver can lead to scarring (cirrhosis), which can lead to liver failure, a life-threatening condition. But early treatment may give the liver time to heal.

Liver Disease belongs under the category of Liver related disease. Acute liver failure (ALF), Alcoholic liver disease, Autoimmune liver disease, Budd-chiari syndrome, cirrhosis, Genetic liver disease, Hepatitis, Infections, Liver cancer and Obstruction of bile ducts are some common types of Liver Disease. Generally Male, Female are the victim of the Liver Disease. Seriousness of this disease is Medium.

Symptoms of Liver Disease are :

  • Pale stool
  • whites of your eyes
  • Yellowing of the skin
  • Dark color urine
  • Abdominal swelling
  • Swelling on feet 
  • itchy skin
  • Itchy skin, also known as pruritus, is an irritating and uncontrollable sensation that makes you want to scratch to relieve the feeling. The possible causes for itchiness include internal illnesses and skin conditions.

  • Bleeding and bruising
  • abdominal pain
  • Abdominal pain has many potential causes. The most common causes ? such as gas pains, indigestion or a pulled muscle ? usually aren't serious. Other conditions may require more-urgent medical attention.

    While the location and pattern of abdominal pain can provide important clues, its time course is particularly useful when determining its cause.

    Acute abdominal pain develops, and often resolves, over a few hours to a few days. Chronic abdominal pain may be intermittent, or episodic, meaning it may come and go. This type of pain may be present for weeks to months, or even years. Some conditions cause progressive pain, which steadily gets worse over time.

  • Loss of appetite
  • Fatigue is a constant state of tiredness, even when you?ve gotten your usual amount of sleep. This symptom develops over time and causes a drop in your physical, emotional, and psychological energy levels. You?re also more likely to feel unmotivated to participate in or do activities you normally enjoy.

    Some other signs of fatigue include feeling:

    • physically weaker than usual
    • tired, despite rest
    • as though you have less stamina or endurance than normal
    • mentally tired and moody

    Loss of appetite means you don?t have the same desire to eat as you used to. Signs of decreased appetite include not wanting to eat, unintentional weight loss, and not feeling hungry. The idea of eating food may make you feel nauseous, as if you might vomit after eating. Long-term loss of appetite is also known as anorexia, which can have a medical or psychological cause.

    It may be a warning sign from your body when you feel fatigue and loss of appetite together. Read on to see what conditions may cause these symptoms.

  • Vomiting
  • Vomiting, or throwing up, is a forceful discharge of stomach contents. It can be a one-time event linked to something that doesn?t settle right in the stomach. Recurrent vomiting may be caused by underlying medical conditions.

    Frequent vomiting may also lead to dehydration, which can be life-threatening if left untreated.

  • Nausea
  • Nausea and vomiting are common signs and symptoms that can be caused by numerous conditions. Nausea and vomiting most often are due to viral gastroenteritis ? often mistakenly called stomach flu ? or the morning sickness of early pregnancy.

    Many medications can cause nausea and vomiting, as can general anesthesia for surgery. Rarely, nausea and vomiting may indicate a serious or even life-threatening problem.

  • Fatigue/weakness
  • Weakness

    Weakness is when strength is decreased and extra effort is needed to move a certain part of the body or the entire body. Weakness is due to loss of muscle strength. Weakness can be a big part of why cancer patients feel fatigue.

    Fatigue

    Fatigue is an extreme feeling of tiredness or lack of energy, often described as being exhausted. Fatigue is something that lasts even when a person seems to be getting enough sleep. It can have many causes, including working too much, having disturbed sleep, stress and worry, not having enough physical activity, and going through an illness and its treatment.

    Causes

    Liver Disease can be caused due to:

    Liver disease has many causes.

    Infection

    Parasites and viruses can infect the liver, causing inflammation that reduces liver function. The viruses that cause liver damage can be spread through blood or semen, contaminated food or water, or close contact with a person who is infected. The most common types of liver infection are hepatitis viruses, including:

    • Hepatitis A
    • Hepatitis B
    • Hepatitis C

    Immune system abnormality

    Diseases in which your immune system attacks certain parts of your body (autoimmune) can affect your liver. Examples of autoimmune liver diseases include:

    • Autoimmune hepatitis
    • Primary biliary cholangitis
    • Primary sclerosing cholangitis

    Genetics

    An abnormal gene inherited from one or both of your parents can cause various substances to build up in your liver, resulting in liver damage. Genetic liver diseases include:

    • Hemochromatosis
    • Wilson's disease
    • Alpha-1 antitrypsin deficiency

    Cancer and other growths

    Examples include:

    • Liver cancer
    • Bile duct cancer
    • Liver adenoma

    Other

    Additional, common causes of liver disease include:

    • Chronic alcohol abuse
    • Fat accumulation in the liver (nonalcoholic fatty liver disease)
    • Certain prescription or over-the-counter medications
    • Certain herbal compounds

    What kind of precaution should be taken in Liver Disease?

    To prevent liver disease:

    • Drink alcohol in moderation. For healthy adults, that means up to one drink a day for women and up to two drinks a day for men. Heavy or high-risk drinking is defined as more than eight drinks a week for women and more than 15 drinks a week for men.
    • Avoid risky behavior. Use a condom during sex. If you choose to have tattoos or body piercings, be picky about cleanliness and safety when selecting a shop. Seek help if you use illicit intravenous drugs, and don't share needles to inject drugs.
    • Get vaccinated. If you're at increased risk of contracting hepatitis or if you've already been infected with any form of the hepatitis virus, talk to your doctor about getting the hepatitis A and hepatitis B vaccines.
    • Use medications wisely. Take prescription and nonprescription drugs only when needed and only in recommended doses. Don't mix medications and alcohol. Talk to your doctor before mixing herbal supplements or prescription or nonprescription drugs.
    • Avoid contact with other people's blood and body fluids. Hepatitis viruses can be spread by accidental needle sticks or improper cleanup of blood or body fluids.
    • Keep your food safe. Wash your hands thoroughly before eating or preparing foods. If traveling in a developing country, use bottled water to drink, wash your hands and brush your teeth.
    • Take care with aerosol sprays. Make sure to use these products in a well-ventilated area, and wear a mask when spraying insecticides, fungicides, paint and other toxic chemicals. Always follow the manufacturer's instructions.
    • Protect your skin. When using insecticides and other toxic chemicals, wear gloves, long sleeves, a hat and a mask so that chemicals aren't absorbed through your skin.
    • Maintain a healthy weight. Obesity can cause nonalcoholic fatty liver disease.

    How it can be spread?

    Spread through blood or semen

    Treatment for the Liver Disease

    Diagnosis:

    If you?re concerned you might have a liver disease, it?s best to make an appointment with your healthcare provider to narrow down what?s causing your symptoms.

    They?ll start by looking over your medical history and asking about any family history of liver problems. Next, they?ll likely ask you some questions about your symptoms, including when they started and whether certain things make them better or worse.

    Depending on your symptoms, you?ll likely be asked about your drinking and eating habits. Make sure to also tell them about any prescription or over-the-counter medications you take, including vitamins and supplements.

    Once they?ve collected all this information, they may recommend:

    • liver function tests
    • a complete blood count test
    • CT scans, MRIs, or ultrasounds to check for liver damage or tumors
    • a liver biopsy, which involves removing a small sample of your liver and examining it for signs of damage or disease

    Other test for liver disease:

    • Abdominal and Pelvic CT
    • Abdominal Ultrasound
    • ERCP (Endoscopic Retrograde Cholangiopancreatography)
    • Lactate Dehydrogenase (LDH) Isoenzymes Test
    • Lactate Dehydrogenase (LDH) Test
    • Liver Biopsy
    • Liver Function Tests
    • Magnetic Resonance Cholangiopancreatography (MRCP)
    • MRI of the Body (Chest, Abdomen, Pelvis)
    • Needle Biopsy

    Treatment:

    Each liver disease will have its own specific treatment regimen. For example, hepatitis A requires supportive care to maintain hydration while the body's immune system fights and resolves the infection. Patients with gallstones may require surgery to remove the gallbladder. Other diseases may need long-term medical care to control and minimize the consequences of their disease.

    In people with cirrhosis and end-stage liver disease, medications may be required to control the amount of protein absorbed in the diet. The liver affected by cirrhosis may not be able to metabolize the waste products, resulting in elevated blood ammonia levels and hepatic encephalopathy (lethargy, confusion, coma). Low-sodium diet and water pills (diuretics) may be required to minimize water retention.

    In those people with large amounts of ascites fluid (fluid accumulated in the abdominal cavity), the excess fluid may have to be occasionally removed with a needle and syringe (paracentesis). Using local anesthetic, a needle is inserted through the abdominal wall and the fluid is withdrawn. The ascites fluid can spontaneously become infected, and paracentesis also may be used as a diagnostic test looking for infection.

    Surgery may be required to treat portal hypertension and minimize the risk of bleeding. Liver transplantation is the final option for patients whose livers have failed.

    Possible complication with Liver Disease

    A number of serious complications can develop if you have alcohol-related liver disease (ARLD).

    Portal hypertension and varices

    Portal hypertension is a common complication of cirrhosis and, less commonly, alcoholic hepatitis.

    It occurs when the blood pressure inside your liver has risen to a potentially serious level.

    When the liver becomes severely scarred, it's harder for blood to move through it. This leads to an increase in the pressure of blood around the intestines.

    The blood must also find a new way to return to your heart. It does this by using smaller blood vessels.

    But these vessels are not designed to carry the weight of blood, so they can become stretched out and weakened. These weakened blood vessels are known as varices.

    If the blood pressure rises to a certain level, it can become too high for the varices to cope with, causing the walls of the varices to split and bleed.

    This can cause long-term bleeding, which can lead to anaemia.

    Alternatively, the bleeding can be rapid and massive, causing you to vomit blood and pass stools that are very dark or tar-like.

    Split varices can be treated by using an endoscope to locate the varices. A tiny band can then be used to seal the base of the varices.

    Ascites

    A person with portal hypertension may also develop a build-up of fluid in their abdomen (tummy) and around the intestines. This fluid is known as ascites.

    Initially, this can be treated with water tablets (diuretics). If the problem progresses, many litres of fluid can build up, which needs to be drained.

    This is a procedure known as paracentesis and involves a long, thin tube being placed into the fluid through the skin under local anaesthetic.

    One of the problems associated with the development of ascites is the risk of infection in the fluid (spontaneous bacterial peritonitis).

    This is a potentially very serious complication and is linked to an increased risk of kidney failure and death.

    Hepatic encephalopathy

    One of the most important functions of the liver is to remove toxins from your blood.

    If the liver is unable to do this due to hepatitis or cirrhosis, the levels of toxins in the blood increase.

    A high level of toxins in the blood due to liver damage is known as hepatic encephalopathy.

    Symptoms of hepatic encephalopathy include:

    • agitation
    • confusion
    • disorientation
    • muscle stiffness
    • muscle tremors
    • difficulty speaking
    • in very serious cases, a coma

    Hepatic encephalopathy may require hospital admission. In hospital, body functions are supported and medicine is used to remove toxins from the blood.

    Infection

    Damage to the liver can weaken the immune system.

    This can make the body more vulnerable to infection, particularly urinary infections and respiratory infections (such as pneumonia).

    Liver cancer

    Liver damage due to heavy drinking over many years can also increase your risk of developing liver cancer.

    Over the past few decades, rates of liver cancer in the UK have risen sharply due to increased levels of alcohol misuse.

    It's estimated 3 to 5% of people with cirrhosis will develop liver cancer every year.

    References:

    1 https://medlineplus.gov/liverdiseases.html#cat_93 2 https://www.medicinenet.com/hepatitis_pictures_slideshow/article.htm 3 https://www.mayoclinic.org/diseases-conditions/liver-problems/symptoms-causes/syc-20374502 4 https://www.webmd.com/hepatitis/liver-and-hepatic-diseases 5 https://liverfoundation.org/for-patients/about-the-liver/the-progression-of-liver-disease/ 6 https://www.healthline.com/health/liver-diseases#symptoms 7 https://www.nhs.uk/conditions/liver-disease/ 8 https://labtestsonline.org/conditions/liver-disease 9 https://liverfoundation.org/5-facts-about-liver-disease/

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