Your liver is a vital organ for everything from digesting and absorbing nutrients, to building important bodily proteins, to filtering toxic substances from your blood. When it starts acting up, there are a variety of liver disorders and conditions that may be to blame.
- One of the most common liver conditions is non-alcoholic fatty liver disease (NAFLD) that can progress to non-alcoholic steatohepatitis (NASH) and subsequently lead to liver scarring and progressive loss of function (cirrhosis). The features of these conditions can be very difficult to distinguish from another common liver disorder, alcoholic fatty liver disease (AFLD).
- Chronic viral hepatitis is also quite common, especially hepatitis C. Many have it for a long time without their knowledge before finally being diagnosed. Viral hepatitis A and B are less commonly seen in the United States.
- Women are more likely to have primary biliary cirrhosis, an autoimmune disorder that is an irritation and swelling of the bile ducts inside the liver that eventually block the flow of bile. In general, autoimmune disorders are more common in women than men.
- Pregnant women can sometimes have pregnancy associated liver disorders such as cholestatis, when the flow of bile from the liver slows or stops. While it doesn’t harm the mother, it can be dangerous to the fetus and close monitoring of mother and baby is necessary. Sometimes the baby requires an emergency delivery.
While liver disorders often have no symptoms, you may experience fatigue, right upper quadrant abdominal pain or itchy skin. When liver conditions are more advanced, you may develop jaundice, a yellow discoloration of the skin and eyes.
If you suspect that you have a liver disorder, the first step is to see your family practice provider. If a liver condition is discovered, you will then be referred to a gastroenterologist or a hepatologist.
Liver disorders can frequently be diagnosed with routine lab work during an annual physical exam. Blood tests, imaging tests and liver tissue tests (biopsy) can also assist in diagnosing problems.
Treatment for liver disorders depends on the nature of the diagnosis.
Medications such as interferon, ribavirin and protease inhibitors are used in combination triple therapy to treat hepatitis C, but it is an expensive treatment with many side effects. A wide range of research is currently underway to discover better, more affordable treatment options for hepatitis C.
For non-alcoholic liver disease, the best treatment is often a lifestyle change through nutrition and exercise.
Autoimmune liver conditions are often treated with prednisone or immune suppressants. Still, some patients with these conditions will eventually need a liver transplant.
While there are many types of hepatitis viruses, the five listed below are considered to be of greatest concern due to the severity of illness caused and their potential for outbreak and epidemic.
Hepatitis A virus (HAV) is most often transmitted through consumption of contaminated water or food in areas of the world with poor sanitation. While the majority of HAV infections are mild, some can be severe or even life threatening.
Safe and effective vaccines are available to prevent HAV infection.
Hepatitis B virus (HBV) is transmitted through exposure to infective blood, semen or other body fluids. Transmission may also occur through transfusions of HBV-contaminated blood, injections during medical procedures and through injection drug use. HBV is a cause of concern for infected mothers, who can transmit the virus to their infants at birth or in early childhood, and for health care workers who may sustain needle stick injuries while caring for HBV-infected patients.
Safe and effective vaccines are available to prevent HBV.
Hepatitis C virus (HCV) is most often transmitted through exposure to infective blood. This includes transfusions of HCV-contaminated blood and contaminated injections during medical procedures or drug use. Sexual transmission is also possible, but is much less common.
While there is no vaccine, HCV treatment is getting faster, simpler and more effective through new medications such as Harvoni®, which is curing some patients in as little as eight weeks with just one pill per day.
Hepatitis D virus (HBD) infections only occur in those who are also infected with Hepatitis B, possibly resulting in a more serious disease and worse outcome. Hepatitis B vaccines also provide protection from HBD.
Hepatitis E virus (HEV) is most commonly transmitted through the consumption of contaminated water or food in developing parts of the world, but is also becoming increasingly recognized as an important cause of disease in developed countries as well.
Safe and effective vaccines have been developed to prevent HEV, but they are not widely available.
Of these, types B and C lead to chronic disease in hundreds of millions of people worldwide and, together, are the most common cause of cirrhosis and cancer.