The most common liver diseases

The liver – the largest organ inside your body – is a vital organ performing hundreds of tasks associated with food digestion, energy storage and waste filtering. Liver disease, also called hepatic disease, is a general term that refers to any condition affecting your liver. There are many kinds of liver diseases and they can develop for different reasons or causes such as viruses, genetic disorders, or substances such as drugs, alcohol or poisons.

Let’s look at the most common liver diseases affecting patients in the United States.

Hepatitis

Defined as an inflammation of the liver, this condition is caused by exposure to toxins, alcohol misuse, infection or immune disease. Viruses cause the majority of hepatitis cases, and are known as viral hepatitis.

The 3 most common forms of hepatitis are:

Hepatitis A - This highly contagious virus is spread mainly through contaminated food or water. It is an acute, short-term type of hepatitis that usually does not require treatment as it goes away on its own with no long term effects.

Hepatitis B - Infection occurs through the spread of bodily fluids such as blood and semen. It can cause an acute (short-term) or chronic (long-term) infection. Often acute infections require no treatment and improve on their own. Some chronic infections will require treatment to help with the symptom severity.

Hepatitis C - Can also be acute or chronic and is spread through contact with blood from someone with hepatitis C. Chronic infections can lead to permanent liver damage in later stages, but symptoms often don’t show up until this stage. Screening is important if you think you may have been exposed.

Most types of viral hepatitis are contagious, but vaccines for types A and B will help reduce your risk of getting the virus. Preventative steps to protect against type C, such as using a condom during sex and not sharing personal items such as razors, toothbrushes, needles that come in contact with blood, will help protect you from this virus.

Fatty Liver Disease

Fatty liver disease is a condition in which too much fat builds up in your liver, of which there are two main types:

1. Nonalcoholic fatty liver disease (NAFLD)
   • This type of fatty liver disease is not related to heavy alcohol use.
   • When there is fat build up, but before there is any inflammation or liver cell damage, it is called simple fatty liver.
   • When there is inflammation and liver cell damage, it is called nonalcoholic steatohepatitis (NASH) and can cause fibrosis or scarring of the liver known as cirrhosis.
2. Alcoholic fatty liver disease, also called alcoholic steatohepatitis
   • This condition is caused by heavy alcohol consumption
   • The next stage of this disease is called alcoholic hepatitis
   • The third stage is cirrhosis*

*Cirrhosis is defined as a late stage of scarring (fibrosis) of the liver

Both of these conditions typically have few or no symptoms until later stages when the liver damage is more severe. Symptoms of cirrhosis can be managed with medications and procedures, but if the liver scarring damages the liver to the point of failure, a liver transplant will be necessary. Lifestyle changes such as diet and exercise can improve symptoms and reduce your risk for complications from these conditions.

Autoimmune conditions

When the body’s immune system is working correctly, it guards your body against foriegn cells such as bacteria and viruses. When these cells are detected, the body sends out cells to attack these cells. If your body cannot tell the difference between foreign cells and your own cells and mistakenly attacks your healthy cells, this is called an autoimmune disease. There are some autoimmune conditions that involve your immune system attacking the cells in the liver.

Autoimmune hepatitis - inflammation of the liver due to immune cells mistakenly attacking the liver’s normal cells. If not treated, cirrhosis and liver failure can occur.

Primary biliary cirrhosis (PBC) - a buildup of bile in the liver due to damage to the bile ducts. Can also lead to cirrhosis and liver failure.

Primary sclerosing cholangitis - similar to PBC, occurs when inflammation causes gradual damage to the bile ducts which over time leads to a blockage that causes a buildup of bile in the liver.

Genetic conditions

Also called inherited diseases, these conditions are inherited from one of your parents. The most common genetic liver diseases are hemochromatosis, Wilson’s disease and Alpha-1 antitrypsin deficiency.

Hemochromatosis - a disease in which your body absorbs too much iron. When this happens, the body has no natural way to get rid of the extra iron, so it begins to store it in the tissues of your organs. If left untreated, this build up can cause damage and organs can fail.

Wilson’s disease - a very rare disorder that causes your liver to absorb copper instead of releasing it into your bile ducts. Eventually, the liver can become so damaged it can no longer keep storing the copper, which allows it to travel to other organs including the brain.

Alpha-1 antitrypsin deficiency - this disease causes people to have too little or none at all of an important liver protein, alpha-1 antitrypsin. They are often able to produce the protein, but the disease prevents it from entering the bloodstream as it should, instead it accumulates in the liver.

Liver cancer

Cancer is broadly described as a disease that happens when abnormal cells grow too quickly, leaving less space for normal cells. There are two types of liver cancer, primary and secondary. Primary liver cancer starts in the liver and is called hepatocellular carcinoma. Secondary liver cancer, also called metastatic liver cancer, is cancer that started somewhere else in the body and moved to the liver. Secondary liver cancer is far more common than a primary form. Liver diseases are a risk factor for developing liver cancer. Having cirrhosis also increases your risk of developing liver cancer.

Symptoms of liver disease

Though symptoms of liver disease can vary or have none at all, these general symptoms can often indicate severe liver damage:

• Jaundice - yellowing of the skin and eyes
• Swelling in the abdomen and legs
• Color changes in stools and urine
• Easily bruised
• Diarrhea
• Nausea
• Unexplained confusion
• Fatigue and weakness

If you become aware of any of these symptoms, it is advisable to speak with a medical provider as soon as possible to find the source of the symptoms. The sooner liver disease is diagnosed, the better the prognosis.

Liver failure

There are two types of liver failure, chronic and acute. Chronic liver failure usually happens when a large enough portion of your liver becomes damaged and can no longer function normally. In general, liver failure caused by liver disease and cirrhosis occurs slowly. On the other hand, acute liver failure happens suddenly typically as a response to poisoning or overdose. Both of these situations can result in the need for a liver transplant.

The article has been medically reviewed by: Hector Nazario, MD