Various diseases of the liver are summarized under the generic term liver diseases. Often these are caused by toxins, with whose degradation the organ is overtaxed. Once damage has been caused by liver disease, it may not be possible to reverse it.
What are liver diseases?
Infographic on the anatomy and structure of the liver. Click to enlarge. The term liver diseases refers to all diseases that can occur in connection with the liver. The organ is significantly involved in metabolism in the human body and in this context is responsible, among other things, for the breakdown of toxins. Excessive intake of toxins, for example from alcohol or viruses, can cause the liver to become diseased and no longer perform its important functions, or only to a limited extent. If the diseases and thus the functional impairment continue to progress, irreparable damage and/or life-threatening conditions may result. Since liver diseases are not manifested by specific symptoms and the organ itself has no nerves, i.e. cannot cause pain, they are often noticed quite late. Statistics state that approximately 5 million Germans suffer from liver disease.
Causes
Liver disease can have quite different causes. Often it is an excessive consumption of luxury toxins such as alcohol or too greasy food, which overload the liver and thus promote the development of sometimes serious diseases. Overeating in general and the resulting excess weight can also contribute to the development of liver disease. The long-term use of certain medications can also put a strain on the liver and lead to liver disease. However, liver disease is not always caused by an individual’s lifestyle. Viral infections such as the hepatitis virus in various forms cause many liver diseases. Metabolic or autoimmune diseases such as fatty liver or autoimmune hepatitis can also cause or be accompanied by diseases of the liver, as can cancers of the organ itself.
Symptoms, complaints, and signs
Symptoms of liver disease are not always clear-cut. Often, only several signs allow a suspicion of this organic disease. Complaints also occur in many cases only after a prolonged course of the disease. Recognizable effects of a fatty liver, cirrhosis (shrinking liver) or hepatitis (liver inflammation) can occur in different versions. This is also true for liver cancer disease. It also happens that the detection of liver disease does not occur due to lack of signs. This is mainly due to the fact that there are no nerve fibers in the tissue of a liver that are equipped with a conduction function for pain. Inflammation is therefore difficult to detect. Basically, a distinction is made between specific and non-specific symptoms. The following non-specific signs may occur, which individually or in combination are considered indications of liver disease: Poor performance, listlessness, fatigue and intolerance of alcohol or/and fat. Frequent feeling of fullness after eating, diarrhea, flatulence and loss of appetite and excessive sweating. Typical symptoms of liver disease occur predominantly when the disease has already progressed to an advanced stage. In addition, it plays a role how severely the liver is currently affected. A specific symptom of liver damage is a yellowish skin coloration, which also occurs in the conjunctiva of the eyes. This phenomenon is colloquially known as jaundice. Dyes from bile acid entering the blood cause the yellowing. Color changes can therefore also be detected in the urine and feces of people affected by severe liver damage.
Diagnosis and course
If liver disease is suspected, a detailed discussion should first be held with the patient. The patient’s circumstances and medical history are just as important in the diagnosis as a comprehensive blood test. The latter may reveal elevated liver values that indicate a disease and/or malfunction of the organ. In addition, an ultrasound examination of the liver itself is useful to determine whether it is enlarged or shows other changes.In case of doubt, a tissue sample can be taken, which provides more precise information about the condition of the organ. If liver disease is left untreated, it can lead to complete failure of the organ, among other things. Cirrhosis of the liver often develops, particularly as a result of increased alcohol consumption. This final stage of numerous diseases leads to a slow poisoning of the body, which can end in a comatose state.
Typical and common liver diseases
- Cirrhosis of the liver
- Fatty liver
- Hepatitis
- Liver failure
Complications
A fatty liver can become inflamed, and if left untreated, this acute hepatitis often progresses to a chronic form. This also increases the risk of developing cirrhosis (shrunken liver) or liver cancer. Complications of cirrhosis often include varicose veins in the esophagus, which can rupture and cause severe bleeding. Water often accumulates in the abdomen (ascites), and brain function can also be impaired (hepatic encephalopathy). If cirrhosis of the liver is detected early, secondary diseases can be avoided in many cases or their occurrence can be delayed. Without therapy, the disease leads to liver failure. Jaundice, severe weight loss, nausea and upper abdominal pain are evident in the advanced stages of liver cancer. If the organ can no longer adequately fulfill its detoxification function, toxins enter the brain and damage the brain cells, which becomes noticeable through impaired consciousness and personality changes. In the worst case, the gradual poisoning of the body leads to hepatic coma or kidney failure. As another complication of liver cancer, metastases can form in other organs or the skeletal system. Some autoimmune liver diseases are associated with inflammation of the bile ducts, as a result of which bile duct carcinoma may develop. Surgical removal of part of the damaged liver carries the risk of rebleeding or infection. Liver transplantation may be followed by rejection, thrombosis, or narrowing of the bile ducts.
When should you see a doctor?
Liver disease often goes unnoticed in the early stages because it causes no symptoms or only very nonspecific symptoms: Anyone suffering from chronic fatigue and a significant drop in performance should therefore also think of liver disease and consult a doctor for clarification of liver values. In the case of unwanted weight loss, which is often accompanied by nausea and loss of appetite, a medical examination is also recommended. Headaches, itching, a tendency to bruising, intolerance of fatty foods and a feeling of pressure in the right upper abdomen can also indicate liver disease: A visit to the doctor should no longer be postponed, especially if several of the above symptoms occur in combination. Serious alarm signs are a yellow discoloration of the skin and eyes (jaundice) and an accumulation of water in the abdomen (ascites) – in this case, advanced liver damage must be assumed, which requires immediate medical treatment. The first point of contact is usually the family doctor, who can rule out or confirm a liver function disorder on the basis of liver-specific laboratory values. If there is a well-founded suspicion of liver disease, further examinations by a specialist are necessary, such as sonography, computer tomography or a liver biopsy. Even without presenting symptoms, people who are overweight, frequently consume large amounts of alcohol, or come into contact with harmful substances that damage the liver should have their liver values checked regularly.
Treatment and therapy
Treatment of liver disease depends on the actual cause of the symptoms. There is no “cure-all” for all liver diseases; in contrast, what is beneficial in one disease may cause great harm in another. Viral diseases such as hepatitis are treated with virus-inhibiting drugs. In addition, the immune system is strengthened to counteract the viruses. If an autoimmune disease is the cause of the liver complaints, on the other hand, the immune system must be suppressed with the aid of suitable drugs (immunosuppressants). In this way, the body’s excessive reaction is prevented, which can also cure or at least alleviate the liver disease in question.Liver diseases caused by alcohol consumption require strict renunciation of the pleasure poison. Consistent withdrawal is often the only way to avoid further damage to the organ. Due to obesity and/or the excessive consumption of fatty foods, weight reduction and a change in dietary habits are advised.
Outlook and prognosis
The prognosis for liver disease must be individualized. It depends on the existing disease, the patient’s general health, and the options for treatment. In the case of fatty liver, the affected individual can contribute significantly to improvement or freedom from symptoms by changing his or her lifestyle habits. In the case of cirrhosis of the liver, there is also the possibility, depending on the cause, of achieving relief through a change in lifestyle. Hepatitis can be treated well with current medical treatment methods. Although the disease is challenging for the organism to manage, there is a good chance of recovery in most cases due to advanced treatment options. If there is irreparable damage to the tissue, many patients can be cured by transplanting the organ. A donor organ is often the last option for improving health. Transplantation is associated with numerous risks. The surgical procedure is complex and can cause complications. In addition, it is necessary to wait and see whether the donor organ will be accepted by the organism in order to determine the prognosis. In the case of cancer, the stage of diagnosis is decisive for the further course of the disease. Cancer therapy is accompanied by numerous side effects and risks. There is a strong restriction of the quality of life. Nevertheless, in the management of liver cancer, it can lead to a cure.
Prevention
Some liver diseases can be prevented to some extent by a healthy lifestyle and moderate consumption of luxury and fatty foods. Some forms of hepatitis result from poor hygiene or direct contact with infected individuals. In these cases, particularly detailed information can help to prevent further infections and spread of the infectious disease. Regular check-ups with a doctor are advisable in order to detect and treat any liver diseases in good time.
Follow-up care
Follow-up care for liver disease is highly dependent on the particular clinical picture. It is coordinated with the primary care physician, the internist, and, if necessary, with an oncologist or radiologist. Checking that a treated finding does not flare up again or worsen is an essential part of follow-up care. The more serious the findings, the more closely the follow-up examinations are usually arranged. However, all liver diseases have something in common when it comes to follow-up care. The liver should be optimally protected as part of a healthy lifestyle. This includes, in particular, not drinking alcohol. Drugs and dispensable medications are also broken down via the liver and are not recommended in connection with aftercare or in general. Fatty foods often have an unfavorable effect on the liver and bile. Smoking is also always a risk factor for the development of internal diseases and should therefore also be avoided. Jaundice is a sign of liver dysfunction. In the course of follow-up care, therefore, attention should be paid to yellowing of the skin or eyes, as well as to nausea or digestive disorders. If the liver disease is related to another disease (e.g. metastases from cancer), the causative disease should of course be the focus of follow-up care. If a change in diet is prescribed due to chronic liver disease, nutritional counseling can help. What is learned must then be put into practice at home.
What you can do yourself
In all liver diseases, it is extremely important to avoid liver-damaging substances as much as possible. Alcohol is best avoided completely, and medications should only be taken after consultation with the attending physician. If an addiction exists, weaning therapy is recommended. High-fat foods also put a strain on the liver; a balanced diet with plenty of fresh fruit and vegetables, whole-grain products, lean meat and fish is more gentle.Cirrhosis of the liver is often accompanied by a protein deficiency, which requires a special diet adapted to the severity. In addition to the therapy prescribed by the doctor, numerous home remedies can stimulate liver activity. Artichoke leaves, which can be eaten as a vegetable or drunk as a juice or tea, have proved particularly effective. Milk thistle, drunk as an infusion two to three times a day, supports the formation of new liver cells, while dandelion, drunk as a tea or in salad, promotes bile flow and thus relieves the liver. Other medicinal herbs that can be used are sage, yarrow, chicory, gentian and wormwood as a tea preparation – not all of these medicinal plants, however, are suitable for use in every type of liver disease. A doctor should therefore be consulted before self-treatment. Furthermore, a healthy lifestyle with sufficient exercise, as well as rest and relaxation breaks, promotes the healing process in liver disease.
