The liver is an essential organ responsible for many vital functions, such as detoxifying the body, producing hormones and enzymes, storing nutrients, and aiding digestion. However, due to various factors such as alcohol consumption, viruses, obesity, and genetic disorders, the liver can become damaged and develop diseases.

This blog post will discuss some of the most common liver diseases and their brief descriptions to increase awareness and understanding of them.

Common Liver Diseases

Hepatitis

Hepatitis refers to inflammation of the liver, typically caused by viral infections, but it can also result from excessive alcohol consumption, toxins, or autoimmune diseases.

Hepatitis A is typically transmitted through contaminated food and water, while Hepatitis B and C are usually spread through contact with infected bodily fluids. Symptoms of hepatitis can range from mild, such as fatigue and jaundice, to severe, leading to liver failure or chronic liver disease.

Vaccines are available for Hepatitis A and B, but prevention and management of Hepatitis C rely on antiviral medications and lifestyle modifications.

Fatty Liver Disease (Hepatic Steatosis)

Fatty liver disease, also known as hepatic steatosis, is a condition characterized by an excessive build-up of fat in the liver cells. This can occur due to various reasons, including obesity, diabetes, high cholesterol, and excessive alcohol consumption.

Non-alcoholic Fatty Liver Disease

Non-alcoholic Fatty Liver Disease (NAFLD) is a broad term encompassing a range of liver conditions that affect individuals who consume little to no alcohol. NAFLD is primarily associated with metabolic risk factors such as obesity, type 2 diabetes, and metabolic syndrome. It is characterized by the accumulation of excess fat in liver cells, which can lead to inflammation and liver damage.

In its more severe form, NAFLD can progress to non-alcoholic steatohepatitis (NASH), which increases the risk of developing liver fibrosis, cirrhosis, and liver cancer. Managing NAFLD involves lifestyle changes, including diet modification, increased physical activity, and weight loss, which can significantly improve liver health and reduce disease progression. Regular monitoring and medical interventions may also be necessary for those at higher risk or with more advanced disease stages.

Alcoholic Fatty Liver Disease

Alcoholic Fatty Liver Disease (AFLD) is the result of excessive alcohol consumption, which leads to the accumulation of fat within liver cells. AFLD can be the initial stage of a spectrum of alcohol-related liver conditions, progressing to more severe forms like alcoholic hepatitis and cirrhosis if alcohol consumption continues.

Symptoms might include fatigue, jaundice, and abdominal discomfort, though many with AFLD remain asymptomatic in the early stages. The primary treatment for AFLD is complete cessation of alcohol intake, which can halt or even reverse the disease’s progression.

Cirrhosis

Cirrhosis is a late-stage liver disease characterized by permanent scarring (fibrosis) and loss of liver function.  The scarring disrupts the liver’s standard structure and function, impairing its ability to process nutrients, hormones, drugs, and toxins. Advanced cirrhosis can lead to severe complications like portal hypertension, ascites (accumulation of fluid in the abdomen), hepatic encephalopathy (brain dysfunction), and an increased risk of liver cancer.

Managing cirrhosis involves addressing the underlying cause to prevent further liver damage, such as antiviral treatment for chronic hepatitis, lifestyle changes for fatty liver disease, or alcohol cessation for alcoholic liver disease. Medications may be used to control symptoms and complications, while regular monitoring by healthcare professionals is essential. In severe cases where the liver is extensively damaged, a liver transplant may be necessary. Early diagnosis and proactive management are vital in slowing the progression of cirrhosis and improving the quality of life for affected individuals.

Liver Cancer (Hepatocellular Carcinoma)

Liver cancer, specifically hepatocellular carcinoma (HCC), is a primary malignancy of the liver and is among the most common types of liver cancer.  HCC can develop insidiously, often presenting at an advanced stage due to a lack of early symptoms. When symptoms do occur, they may include weight loss, loss of appetite, upper abdominal pain, jaundice, and worsening liver function.

Diagnosis of HCC usually involves imaging tests such as ultrasound, CT scans, MRI, and blood tests, including alpha-fetoprotein (AFP) levels, which can be elevated in many cases of HCC. Treatment options vary based on the stage of the disease and liver function. They may include surgical resection, liver transplantation, local ablative therapies, and systemic treatments such as targeted therapies or immunotherapy. Regular surveillance and early detection are critical for improving outcomes in patients at high risk for HCC, as early-stage tumors are more amenable to curative treatments.

Hemochromatosis

Hemochromatosis is a genetic disorder characterized by excessive dietary iron absorption, leading to iron overload in various organs, particularly the liver, heart, and pancreas. Over time, excessive iron accumulation can cause significant tissue damage and organ dysfunction, resulting in conditions such as cirrhosis, diabetes, heart disease, and arthritis.

Early symptoms of hemochromatosis can be nonspecific and include fatigue, joint pain, abdominal pain, and skin bronzing. Diagnosis often involves blood tests that measure serum ferritin and transferrin saturation levels, followed by genetic testing to confirm the presence of HFE mutations. Liver biopsy and MRI may also be utilized to assess the extent of iron overload and liver damage.

Management of hemochromatosis primarily involves regular phlebotomy (blood removal) to reduce iron levels in the body and prevent further organ damage. Additionally, patients are advised to avoid iron supplements and vitamin C supplements (which increase iron absorption) and limit alcohol intake due to its potential to exacerbate liver damage.

Wilson’s Disease

Wilson’s disease is a rare inherited disorder that causes excessive copper accumulation in the liver, brain, and other vital organs. When the body cannot correctly remove excess copper, it begins to accumulate and cause organ damage.

Liver-related symptoms may include jaundice, fatigue, abdominal swelling, and signs of chronic liver disease. In contrast, neurological symptoms can range from tremors and poor coordination to more severe issues like psychiatric disturbances and cognitive impairment. Kayser-Fleischer rings, a characteristic feature of Wilson’s disease, can sometimes be seen in the eyes as brownish or greenish rings around the cornea.

Diagnosing Wilson’s disease typically involves a combination of blood tests, including serum ceruloplasmin and copper levels, a 24-hour urinary copper test, and a liver biopsy to measure hepatic copper concentration.

Treatment for Wilson’s disease focuses on reducing copper accumulation through chelating agents like penicillamine or trientine, which help remove excess copper from the body, and zinc, which interferes with copper absorption in the gut. Lifelong adherence to the treatment regimen is crucial, and dietary modifications such as avoiding copper-rich foods (e.g., shellfish, nuts, chocolate) are also recommended.

Primary Biliary Cholangitis (PBC)

Primary Biliary Cholangitis (PBC) is a chronic autoimmune liver disease characterized by progressive destruction of the small bile ducts within the liver. Over time, as these bile ducts are damaged, bile accumulates in the liver, leading to inflammation and eventually fibrosis and cirrhosis. The exact cause of PBC remains unknown, but it is believed to be related to a combination of genetic and environmental factors that trigger an autoimmune response.

Symptoms of PBC can be highly variable, ranging from mild to severe. Early symptoms often include fatigue, pruritus (itching), and dry eyes and mouth. As the disease progresses, patients may develop jaundice, hepatomegaly (enlarged liver), splenomegaly (enlarged spleen), and complications associated with chronic liver disease, such as portal hypertension and liver failure.

Diagnosis of PBC typically involves a combination of blood tests, including liver function tests and the presence of anti-mitochondrial antibodies (AMAs), which are positive in approximately 95% of PBC cases. Imaging studies like ultrasound, MRI, or MRCP (magnetic resonance cholangiopancreatography) may also be performed to assess the bile ducts and liver structure.

The mainstay of treatment for PBC is ursodeoxycholic acid (UDCA), which helps to improve bile flow and reduce liver inflammation. In some cases, the medication obeticholic acid (OCA) can be used as an adjunctive therapy. For symptom management, patients may receive cholestyramine for pruritus and vitamin supplementation to address deficiencies. In advanced cases, liver transplantation may be necessary.

Primary Sclerosing Cholangitis (PSC)

Primary Sclerosing Cholangitis (PSC) is a chronic liver disease characterized by inflammation and fibrosis of the bile ducts inside and outside the liver. Over time, the bile build-up results in liver damage, cirrhosis, and ultimately liver failure. PSC is often associated with inflammatory bowel disease (IBD), especially ulcerative colitis.

Symptoms of PSC can be asymptomatic in the early stages or present with fatigue, pruritus (itching), and jaundice. As the disease progresses, patients may experience more severe symptoms such as abdominal pain, fever, weight loss, and complications related to chronic liver disease, including portal hypertension and liver cirrhosis. Additionally, patients with PSC have an increased risk of developing cholangiocarcinoma (bile duct cancer) and other hepatobiliary malignancies.

Diagnosis of PSC typically involves a combination of blood tests, including liver function tests that may indicate cholestasis, and various imaging studies such as MRCP (magnetic resonance cholangiopancreatography) or ERCP (endoscopic retrograde cholangiopancreatography) to visualize the bile ducts. A liver biopsy may also be necessary to assess the extent of liver damage and fibrosis.

Currently, there is no definitive cure for PSC. Treatment focuses on managing symptoms, slowing disease progression, and addressing complications. In advanced cases with significant liver damage, liver transplantation may be necessary. Regular monitoring and follow-up with healthcare professionals are crucial for managing PSC effectively, and early transplantation consideration is important for patients with end-stage liver disease or cholangiocarcinoma.

If you want more information, please contact your healthcare provider as soon as possible or set up an appointment with the GI Specialists at Gastro Florida.