liver that comes and goes

Overview

The liver is a large organ that helps filter your blood, digest food, and store energy. Some people have symptoms like yellow skin or eyes (jaundice), belly pain, or tiredness that come and go. This can be a sign of a liver condition that flares up from time to time, such as inflammation, infection, or a problem with bile flow.

Yes, it is fairly common for chronic liver conditions to have periods where symptoms appear and then improve for a while.

It can affect anyone, but it is more common in people who are overweight, drink too much alcohol, have diabetes, or have had a hepatitis infection.

Symptoms

Common symptoms

• Yellowing of the skin or the whites of the eyes (jaundice) that comes and goes
• Pain or discomfort in the upper right side of the belly
• Feeling very tired or weak
• Dark urine or pale stools
• Nausea or loss of appetite

Symptoms in children

• Poor weight gain or slow growth
• Yellow skin that appears and disappears
• Fussiness or abdominal swelling

Symptoms in older adults

• Confusion or forgetfulness (when the liver is not clearing toxins well)
• Loss of appetite leading to weight loss
• Yellowing of the skin may be harder to notice on darker skin

Causes

Main causes

• Hepatitis (inflammation of the liver) caused by a virus (hepatitis B or C) or the immune system attacking the liver (autoimmune hepatitis)
• Fatty liver disease (buildup of fat in the liver cells)
• Alcohol-related liver damage
• Gallstones or other blockages that stop bile from leaving the liver
• Certain medications or herbal supplements that can irritate the liver

Risk factors

• Being overweight or having type 2 diabetes
• Drinking too much alcohol
• Sharing needles or having unprotected sex (risk for viral hepatitis)
• Family history of liver disease
• Taking medications that can harm the liver (such as high doses of paracetamol/acetaminophen)

When to see a doctor

See a doctor urgently if:

• If you have jaundice (yellow skin or eyes) that goes away but keeps coming back
• If you have severe belly pain or vomiting
• If you notice confusion, severe drowsiness, or swelling in your belly or legs

Book a routine appointment if:

• If you feel tired all the time or have mild belly discomfort that does not go away
• If you have risk factors for liver disease (like being overweight or drinking alcohol) and want a check-up

Diagnosis

Your doctor will ask about your symptoms, lifestyle, and family history. They will examine your belly and check for yellowing of your skin or eyes.

Tests that may be done

• Blood tests to check liver enzymes and function
• Imaging tests like an ultrasound or CT scan of your abdomen to look at the size and condition of the liver and bile ducts
• Sometimes a small sample of liver tissue (biopsy) to look for damage or disease

What to expect at your appointment

Most tests are quick and painless. If a biopsy is needed, you will be given a local anaesthetic to numb the area. The doctor will explain each step and answer your questions.

Treatment

Treatment depends on what is causing your symptoms. The aim is to stop the liver damage, manage the underlying condition, and reduce flare-ups.

Self-care at home

• Avoid alcohol completely if your liver is inflamed or damaged
• Maintain a healthy weight with a balanced diet and regular exercise
• Avoid over‑the‑counter medications that can harm the liver (always check with your doctor or pharmacist)

Medical treatments

Your doctor may prescribe medicines to treat the underlying cause. For example, antiviral drugs for hepatitis B or C, steroids or other immune‑suppressing medicines for autoimmune hepatitis, or medicines to help with fatty liver disease. Never take any medicine without a doctor’s advice.

When is surgery considered?

Surgery is rarely needed for liver conditions. It may be considered if a gallstone or other blockage is causing repeated attacks of jaundice or pain, or in severe liver failure when a liver transplant is necessary.

Living with this condition

Pay attention to your body. If you notice symptoms returning, contact your doctor early. Keep all your appointments and take any prescribed medicines exactly as directed.

Lifestyle tips

• Avoid alcohol and recreational drugs
• Get vaccinated for hepatitis A and B if you are at risk
• Manage stress with relaxation techniques or talking to someone you trust

Diet and exercise

Eat a well‑balanced diet with plenty of fruits, vegetables, and whole grains. Limit foods high in sugar, salt, and unhealthy fats. Stay active with walking, swimming, or other moderate exercise for 30 minutes most days.

Mental health and emotional wellbeing

Living with a chronic health problem can be worrying or stressful. It is normal to feel anxious or frustrated at times. Talking to your doctor, a counsellor, or a support group can help you cope.

Prevention

Many cases of intermittent liver symptoms can be prevented or improved by keeping a healthy weight, limiting alcohol, avoiding risky behaviours like sharing needles, and getting vaccinated against hepatitis B.

Vaccines

Vaccines are available for hepatitis A and hepatitis B. Ask your doctor if these are right for you.

Screening programmes

If you have risk factors (such as a family history of liver disease, diabetes, or obesity), your doctor may recommend regular blood tests to check your liver health.

Complications

If left untreated

• Scarring of the liver (cirrhosis) that can lead to permanent damage
• Liver failure, where the liver stops working properly
• Increased risk of liver cancer

Long-term outlook

For most people, liver conditions that cause symptoms to come and go can be managed well with the right treatment and lifestyle changes. Many people live full, healthy lives for many years. Even if some liver damage has occurred, stopping further damage can prevent serious complications.

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