17179 Liver Disease

Overview

Liver disease is the name for a group of conditions that damage the liver and stop it working as well as it should. The liver is a large organ that cleans the blood, helps digest food, stores energy, and makes substances the body needs. When the liver is damaged over time, it may become scarred and can stop working properly.

Liver disease is becoming more common around the world. Many people have early fatty liver disease without feeling ill, and they may not know their liver is affected until a routine blood test or scan.

Liver disease can affect anyone at any age. It is more likely in people who drink a lot of alcohol, are overweight or living with diabetes, have been exposed to certain viruses, or have a family history of liver problems.

Symptoms

Common symptoms

• Feeling unusually tired or weak
• Losing your appetite or feeling sick
• Losing weight without trying
• Pain or discomfort in the upper right side of the belly
• Yellowing of the skin or the whites of the eyes
• Dark urine or very pale stools
• Itchy skin
• Swelling in the legs, ankles, or belly

Symptoms in children

• Yellow skin or eyes
• Poor weight gain or slow growth
• Feeding poorly in babies
• Pale or chalky stools
• Dark urine
• Being unusually sleepy or irritable

Symptoms in older adults

• Yellow skin or eyes
• Confusion, memory problems, or becoming more sleepy than usual
• Falls or feeling very weak
• Swelling in the legs or belly
• Loss of appetite and weight loss
• Nausea or vomiting

Causes

Main causes

• The build-up of fat in the liver, called fatty liver disease
• Long-term heavy alcohol use
• Viral hepatitis, such as hepatitis B or hepatitis C
• Autoimmune hepatitis, where the immune system attacks the liver by mistake
• Certain rare genetic conditions
• Some medicines, herbal remedies, or toxins that can harm the liver

Risk factors

• Drinking a lot of alcohol over a long time
• Being overweight or living with type 2 diabetes
• Having high cholesterol or high triglycerides
• Being exposed to contaminated blood, such as through unsterile needles
• Having a family history of liver disease
• Taking medicines or supplements that can strain the liver

When to see a doctor

See a doctor urgently if:

• Your skin or eyes look yellow
• Your belly is painful or swollen
• Your urine is dark or your stools are very pale
• You keep vomiting and cannot keep fluids down
• You have a fever with chills

Book a routine appointment if:

• You have felt unusually tired for weeks
• You are losing your appetite or losing weight without meaning to
• You have nausea, discomfort, or a dull ache around your upper belly
• You notice changes in your skin or your bathroom habits

Diagnosis

Liver disease is diagnosed through a combination of your medical history, a physical examination, blood tests, and often scans of your liver. Your GP may refer you to a liver specialist if there are signs that your liver is not working normally.

Tests that may be done

• Blood tests, including liver function tests
• A full blood count
• An ultrasound scan of your liver
• A scan that measures how stiff the liver is, as stiffness can mean scarring
• A liver biopsy, where a tiny sample of liver tissue is removed and examined

What to expect at your appointment

Your doctor will ask about your symptoms, alcohol use, medicines, family history, and any risks you may have for liver problems. They may press gently on your belly to feel for tenderness or swelling. You may need one or more follow-up visits and tests before a clear picture is formed.

Treatment

Treatment for liver disease depends on what is causing it and how much damage has already happened. The goals are to stop further damage, reduce symptoms, and prevent complications. In many cases, early treatment can allow the liver to heal and work better.

Self-care at home

• Avoid alcohol completely, especially if your liver is already damaged.
• Maintain a healthy weight gradually by eating well and moving more.
• Take only medicines and supplements that your doctor or pharmacist has confirmed are safe for your liver.
• Keep all medical appointments and complete any tests your doctor recommends.
• Follow any specific diet or fluid advice you are given.

Medical treatments

Your doctor may recommend medicines to treat the underlying cause of liver disease, such as antiviral treatments for viral hepatitis or medicines that reduce inflammation in autoimmune liver disease. Other medicines may be used to control symptoms, lower blood pressure in the liver, or help the body remove extra fluid. Your doctor will explain the options and the expected benefits and risks, and you should always take prescribed medicines exactly as directed.

When is surgery considered?

In advanced liver disease, surgery may be needed to manage complications or, in severe cases, a liver transplant may be considered. This is a major operation, and doctors will only suggest it if other treatments are no longer controlling the condition. Your specialist team will help you understand whether any surgical option is right for you.

Living with this condition

Living with liver disease means making the liver a priority in your daily choices. Some days you may feel tired or unwell, and that is okay. Pace yourself, rest when you need to, and keep your care team informed about how you are feeling.

Lifestyle tips

• Stop alcohol completely, or ask for help to stop drinking.
• If you smoke, ask your GP for support to stop.
• Try to reach or keep a healthy weight.
• Sleep well and take breaks during the day if you need them.
• Ask your doctor before trying any new medicine, herbal product, or supplement.

Diet and exercise

Eat a balanced diet full of fruits, vegetables, whole grains, and lean proteins such as chicken, fish, beans, and lentils. Limit salt, fried foods, sugar, and very processed foods. Gentle activity, such as walking, swimming, or cycling, can help with energy and mood, but check with your doctor before starting anything new.

Mental health and emotional wellbeing

Being diagnosed with liver disease can bring up worry, sadness, or anger. These feelings are normal, and you deserve support. Speak to your GP about counselling or mental health services if you are struggling. If you ever have thoughts of harming yourself, contact your local emergency number or a mental health crisis helpline immediately.

Prevention

In many cases, liver disease is preventable. Limiting alcohol, keeping to a healthy weight, eating well, staying active, and avoiding unnecessary medicines or toxins are the best ways to protect your liver.

Vaccines

Vaccines are available to protect against some viruses that cause liver disease, including hepatitis A and hepatitis B. Ask your doctor, nurse, or pharmacist whether these vaccines are recommended for you.

Screening programmes

Simple blood tests can check how well your liver is working. If you have a strong family history of liver disease, diabetes, obesity, or long-term alcohol use, ask your GP whether regular liver checks are a good idea.

Complications

If left untreated

• Cirrhosis, or permanent scarring of the liver
• Liver failure, when the liver can no longer do its jobs properly
• A build-up of fluid in the belly, called ascites
• Internal bleeding from swollen veins in the food pipe or stomach
• Liver cancer

Long-term outlook

The outlook for liver disease is better than many people think. With early detection and the right care, many people live well for many years. Even when some scarring has happened, treatment and healthy habits can slow or stop further damage and greatly improve your quality of life. Your healthcare team will help you understand your own outlook and what steps will help you most.

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