The Therapy

The treatment and therapy of an enlarged liver depends on the cause.

Enlarged liver due to alcohol: The therapy lies in the absolute abstention from alcohol. The fatty liver and alcoholic fatty liver inflammation can be reversed, but cirrhosis of the liver cannot, because it represents irreversible damage to the liver.
Enlarged liver due to incorrect diet: The treatment provides a low-fat and balanced diet.
Enlarged liver due to inflammation of the liver (hepatitis): Hepatitis types A, B, D and E usually heal and do not become chronic.
Hepatitis type C can be treated with antiretroviral drugs. If the hepatitis is very severe and leads to liver failure, liver transplantation is the only possible treatment.
Enlarged liver due to heart disease: If the liver is enlarged due to heart disease, heart medication is given to improve the pumping function of the heart. Typical groups of drugs include ACE inhibitors, AT1 antagonists, beta blockers, diuretics (“water tablets”) or digitalis.
Enlarged liver due to Budd-Chiari syndrome: If the liver is incompletely closed by a blood clot, it is treated with blood-thinning medication. In the case of complete occlusion, a so-called “TIPS”, a transjugular intrahepatic portosystemic shunt is created to guide the blood around the occluded area.
Enlarged liver due to tumors: Benign tumors either do not require treatment at all or the tumor can be removed by surgery. Malignant tumors or metastases require surgery and/or chemotherapy.
Enlarged liver due to bile stasis: A stone in the large bile duct can be removed by endoscopic surgery (ERCP).

The consequences

The most common cause of an enlarged liver is fatty liver. Fatty liver does not affect liver function at first, but can lead to liver inflammation or liver cancer. In many other cases, a decrease in liver function is the result of an enlarged liver.

When the liver is enlarged due to alcohol, inflammation of the liver, tumors or bile stasis, the function of the liver decreases and the liver values in the blood increase. Other consequences are liver cirrhosis and liver cancer. You can find more information about liver cirrhosis here.

Fatty liver is the most common liver damage in industrialized countries. About 70% of patients with overweight and BMI >30 have fatty liver. In Germany about 10 million people are affected.

In addition to an incorrect, excessively fatty diet, regular alcohol consumption, diabetes, high blood pressure and elevated blood lipid levels are risk factors for the development of fatty liver. The intake of some drugs can also promote fatty liver (cortisone, tetracycline, methotrexate). The severity of fatty liver is classified on the basis of a microscopic examination of a tissue sample.

If >5% of the liver cells are fatty, this is called fatty liver. If >50% of the liver cells are fatty, this is referred to as fatty liver. However, the diagnosis of fatty liver is usually made by means of an ultrasound examination.

The liver then appears brighter in the ultrasound than a healthy liver. The consequence of fatty liver can be fatty liver inflammation. If fatty liver persists for a very long time, the connective tissue of the liver is remodeled and the liver fibroses, which increases the risk of liver cirrhosis and liver cancer. The treatment of fatty liver is based on a healthy lifestyle with sports and a balanced diet.