Living with liver

Overview

The liver is a large organ in the upper right side of your belly. It helps filter your blood, break down food, store energy, and fight infection. Liver disease happens when the liver becomes damaged and cannot work as well as it should.

Liver conditions are fairly common. In the UK, around 1 in 10 people have some form of liver disease, and rates are rising.

Anyone can develop liver problems. You are more at risk if you drink alcohol heavily, have obesity or diabetes, have hepatitis B or C, or have a family history of liver disease.

Symptoms

Common symptoms

• Feeling very tired or weak
• Loss of appetite
• Slight yellowing of the skin or eyes (jaundice)
• Swelling in the belly or legs
• Dark urine or pale stools
• Nagging discomfort in the upper right side of the belly

Symptoms in children

• Ongoing tiredness and poor weight gain
• Jaundice that doesn't go away
• Belly swelling
• Very itchy skin

Symptoms in older adults

• Confusion or memory problems (when the liver can't filter toxins)
• Falls or weakness
• Loss of appetite and unintentional weight loss

Causes

Main causes

• Drinking too much alcohol over many years
• Fat building up in the liver (fatty liver disease)
• Viral infections like hepatitis A, B, or C
• Genetic or inherited conditions, such as hemochromatosis
• Some medicines, supplements, or toxins

Risk factors

• Heavy alcohol use
• Obesity or type 2 diabetes
• High cholesterol or high blood pressure
• Past or current hepatitis infection
• Family history of liver disease
• Sharing needles or having unprotected sex

When to see a doctor

See a doctor urgently if:

• Symptoms above – seek same-day care or call your local emergency number if they are severe.
• Pain that doesn't go away or stops you from doing normal activities.

Book a routine appointment if:

• If you feel unusually tired for more than two weeks.
• If you notice changes in appetite, nausea, or itchiness.
• If you have risk factors like past hepatitis infection or heavy alcohol use.

Diagnosis

A doctor will take a detailed history, ask about alcohol and medicines, and feel your belly. Blood tests check liver enzymes and how well your liver is working.

Tests that may be done

• Liver blood tests (liver function tests)
• Ultrasound, CT or MRI scans of the liver
• Fibroscan – a special ultrasound that measures liver stiffness
• Liver biopsy – a tiny sample of liver tissue removed with a needle

What to expect at your appointment

Most of these tests are painless or cause only mild discomfort. You can usually go home the same day. Ask your healthcare team to explain what each test is for.

Treatment

Treatment depends on the cause and how advanced the disease is. The goal is to stop damage, manage symptoms, and let the liver heal as much as possible.

Self-care at home

• Stop drinking alcohol completely, or follow your doctor's advice on limits.
• Keep a healthy weight with gentle daily activity.
• Eat a balanced diet and limit processed foods, salt, and sugar.
• Stay up to date with recommended vaccines, especially hepatitis A and B.
• Avoid mixing medicines or supplements without checking with your pharmacist.

Medical treatments

Your doctor may suggest medicines to slow liver inflammation, clear certain hepatitis viruses, or manage complications. Some treatments are given as tablets; others are injections. If you have portal hypertension, a doctor may recommend a procedure to reduce pressure in the blood vessels around the liver. Never stop or change prescribed medicines without discussing it with your care team.

When is surgery considered?

If the liver is severely scarred and cannot work, a liver transplant may be considered. This is major surgery, and your team will weigh the risks and benefits with you.

Living with this condition

Living with a liver condition means being consistent with check-ups and taking small steps every day to protect your liver. Keep a diary of symptoms, take medicines exactly as prescribed, and tell your care team about any changes.

Lifestyle tips

• No alcohol or very little – ask your doctor what is safe for you.
• Move your body each day, even a short walk.
• Get enough sleep and manage stress with breathing or talking to someone.
• Ask about vaccines and avoid things that can harm the liver, like raw shellfish.

Diet and exercise

Eat mostly plant-based meals with plenty of vegetables, fruits, whole grains, and lean proteins. Limit fried foods, added salt, and sugary drinks. Doing at least 30 minutes of moderate activity most days can help reduce fat in the liver.

Mental health and emotional wellbeing

It can be stressful to live with a long-term condition. You might feel anxious, low, or afraid. That's normal. Talking to a psychologist or counsellor, joining a support group, and staying connected with loved ones can make a big difference.

Prevention

Many liver problems can be prevented by staying at a healthy weight, drinking alcohol in moderation (or not at all), getting vaccinated, and avoiding illegal drugs or sharing needles.

Vaccines

Ask your local health service about hepatitis A and B vaccines. These protect against two viruses that can cause liver inflammation.

Screening programmes

If you have a family history of liver disease, diabetes, or if you have hepatitis B or C, your doctor may recommend regular liver blood tests and an ultrasound scan.

Complications

If left untreated

• Scarring of the liver (cirrhosis) that can worsen over time
• Fluid buildup in the belly (ascites) which can become infected
• Internal bleeding from enlarged veins in the food pipe
• Liver failure, where the liver stops working
• Increased risk of liver cancer

Long-term outlook

The outlook depends on the cause and how early it's found. With good care, the liver can often repair itself, and many people live well for years. Even with cirrhosis, treatment can slow the damage and manage symptoms. Staying engaged with your care team gives you the best chance for a full life.

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