Liver Disease

Basic Facts

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The liver, a football-sized organ in the abdomen, carries out many important functions.
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A wide range of diseases can affect the liver, from chronic illnesses such as cirrhosis to acute conditions such as hepatitis (infection or inflammation of the liver), cancer, or bile duct obstruction.
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Interventional methods can treat liver conditions that previously were inoperable.

The liver processes nutrients and drugs from the digestive system, removes toxins from the body, and produces bile, a greenish-brown fluid essential for digestion. A wide range of diseases can affect the liver, from chronic illnesses such as hepatitis and cirrhosis to acute conditions such as cancer or bile duct obstruction. Millions of Americans suffer from both chronic and acute liver disease, but with many more interventional treatments available, conditions that were previously inoperable are now successfully treated.

 

Liver cancer, portal hypertension, and bile duct obstruction are three of the most common liver diseases.

WHAT ARE THE SYMPTOMS?

Liver Cancer. In its early stages, liver cancer rarely causes symptoms. Symptoms that appear include:

  • Weight loss and loss of appetite;
  • Abdominal pain;
  • Nausea and vomiting;
  • Fatigue;
  • Accumulation of fluid in the abdomen (ascites);
  • An enlarged liver; and
  • Yellowing of the skin and the whites of the eyes (called jaundice).

Portal hypertension. Portal hypertension is high blood pressure in the portal vein, the blood vessel that connects the intestines and the liver. The condition usually develops in people who have liver damage. By itself, portal hypertension has no symptoms. The following symptoms arise from complications of portal hypertension:

  • Bloody vomiting and black, loose stools from varices (bleeding veins at the base of the esophagus and in the stomach);
  • Ascites; and
  • Signs of a brain disease known as encephalopathy, which include neglect of personal appearance, forgetfulness, difficulty concentrating, and confusion.

Bile duct obstruction: The bile duct allows bile, a chemical produced in the liver to aid with digestion, to drain for use in the digestive tract, and storage in the gall bladder. Symptoms include:

  • Pale stools;
  • Dark urine;
  • Jaundice;
  • Abdominal pain;
  • Fever; and
  • Nausea and vomiting.

CAUSES AND RISK FACTORS

Risk factors for liver disease include:

  • Cirrhosis, scarring in the liver usually caused by alcoholism;
  • Chronic viral hepatitis;
  • Blood clots;
  • Exposure to arsenic;
  • Inflammation or tumors of the bile ducts or pancreas;
  • Abdominal trauma;
  • Various congenital disorders; and
  • Primary biliary cirrhosis, an autoimmune disease.

DIAGNOSIS

To diagnose liver disease, a physician may order one or more of the following tests:

  • Blood tests,
  • Computed tomography (CT) scan;
  • Magnetic resonance imaging (MRI);
  • Ultrasound;
  • Endoscopy (physicians insert a viewing tube called an endoscope through the mouth and down into the beginning of the small intestine); or
  • Liver biopsy.

TREATMENT APPROACH

Treatment for liver disease depends on the condition, and may include:

  • Conventional cancer treatments such as chemotherapy and radiation;
  • Chemoembolization (injecting cancer-killing drugs into the liver via a catheter) and other interventional cancer treatments;
  • Bile duct drainage via catheter;
  • Stenting (placement of a tiny mesh-metal tube to support the bile duct or a blood vessel in the liver);
  • Intravenous blood pressure-lowering medications; and
  • Liver transplant.