Liver Disease:  An Overview of Common Liver Ailments

The liver is one of the largest solid organs in the body. Liver Disease Awareness

It plays a large role in processing the food you consume by converting it into energy that can be utilized by the body, detoxifying your body and blood stream from harmful toxins that enter your body, and producing bile to aid the gallbladder in digesting fats.

Unfortunately, like all parts of our bodies, the liver is susceptible to disease.

Since the liver is responsible for so many critical functions within the body, should it become diseased or injured, the loss of those functions can cause significant damage to the body.

Liver disease is a general term covering all of the potential problems that can cause the liver to fail.  It may be classified as short-lived, acute liver disease, or long-term, chronic liver disease.   An acute liver disease may also turn into a chronic liver disease over time.

The causation of liver disease differs from case to case.  Let’s take a look at some of the most common liver ailments that can affect your liver and its functionality.

 

Hepatitis A

Map of Hepatitis A Risk by GeographyHepatitis A is a liver infection caused by the hepatitis A virus (HAV).

It is extremely contagious and is usually transmitted via the fecal-oral route either through person-to-person contact or consumption of contaminated food or water.

There are several ways in which a person may become infected with hepatitis A:

  • Food or drink consumed that has been contaminated by stools.
  • Fruits, vegetables, shellfish, ice, and water are common sources.
  • Contact with the stool or blood of a person who currently has the disease.
  • Sexual practices that involve oral-anal contact.
  • Other common causes include: overseas travel, IV drug use, and working in a health care, food, or sewage industry where the risk of contact with those infected is higher.

There is no specific treatment for hepatitis A.   After contracting the hepatitis A virus your body produces antibodies in response to the virus to fight future reinfection.  These antibodies provide lifelong protection, however, the best way to prevent Hepatitis A is by getting vaccinated.

 

Hepatitis B

Hepatitis B is a serious liver infection caused by the hepatitis B virus (HBV).

It is contracted by exposure to bodily fluids of someone infected through means such as needles, contaminated blood, and sexual contact.  It can cause an acute infection, but can also progress to cause chronic inflammation that may lead to more damaging liver diseases such as cirrhosis and liver cancer.

Common ways the hepatitis B virus is transmitted include:

  • Unprotected sexual contact with an infected partner.
  • Needle contamination.
  • Sharing intravenous drug paraphernalia puts you at high risk.
  • Accidental needle sticks in a health care setting is a concern for health care workers.
  • Mother to child transmission during childbirth
  • Newborns can be vaccinated to avoid getting infected.

The hepatitis B vaccine can prevent this infection.  If however, you were not previously vaccinated against hepatitis B, there are several treatment options your physician can provide:

  • Acute illness not require treatment.
  • Rest and adequate nutrition and fluids.
  • Antiviral medications fight the virus and slow damage to liver.
  • Liver resection/transplant – If the liver has been severely damaged, surgery may be an option.

 

Hepatitis C

Chart Showing Common Causes of Hepatitis C ContractionHepatitis C is a viral disease that leads to inflammation of the liver.

It is difficult for the human immune system to eliminate hepatitis C from the body and it usually becomes a chronic liver ailment.  If you suffer from years of a hepatitis C infection, damage can result in liver failure.

Below are some of the ways in which you may become infected with the hepatitis C virus:

  • After a needle stick or sharps injury whether from street drug use or in a health care setting.
  • Blood from someone infected contacting a cut on your skin or your eyes/mouth.
  • Engagement in unprotected sexual contact.
  • Passage from mother to child.
  • Tattoo or acupuncture sessions with needles that were not disinfected properly.
  • Sharing of personal items, such as toothbrushes and razors.
  • Blood transfusions with infected blood (this is rare in the U.S. since blood screening became available in 1992).

As of now, there is no vaccine against Hepatitis C.  Common medicines used to attempt to rid the body of the virus include peginterferon and antiviral drugs.  These medicines also reduce the risk of cirrhosis and liver cancer which can result from the long-term presence of hepatitis C in the body.

 

Liver Cancer

The liver can be affected by primary liver cancer, which arises in the liver, or by cancer which forms in other parts of the body and then spreads to the liver.  Most liver cancer is secondary or metastatic, meaning it started elsewhere in the body.

Primary liver cancer tends to occur in livers damaged by birth defects, alcohol abuse, or chronic infection.  Primary liver cancer accounts for about 2% of cancers in the U.S.

Here are some other reasons you may be predisposed to liver cancer:

  • Presence of cirrhosis commonly caused by alcohol abuse.
  • Hepatitis B and C infections or hemochromatosis.
  • Obesity and fatty liver disease.
  • Gender (men have higher risk).
  • Riskier in Asian Americans and Pacific Islanders.
  • Anabolic steroid use.
  • Researchers suggest a link between diabetes and liver cancer.

Benign tumors of the liver are not treated like malignant cancerous tumors.  They may be left untreated or removed by your liver surgeon should they cause significant amounts of pain or bleeding.

Liver cancers include Hepatocellular carcinoma (HCC) and Cholangiocarcinoma.  Treatment for these cancers vary and options should be discussed with your physician based on your personal health history.

 

Cirrhosis

Diagram demonstrating liver with cirrhosisCirrhosis is the scarring of the liver and poor liver function.  It is the last stage of chronic liver disease.

Some common causes of chronic liver disease in the United States are hepatitis B and C, alcohol abuse, autoimmune hepatitis, bile duct disorders, certain medicines straining the liver due to high toxicity, hereditary diseases, nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH).

There are many lifestyle choices you can make to lessen your chances of developing long-term liver disease that may result in cirrhosis:

  • Drink less alcohol.
  • Eat a healthy diet that is low in salt.
  • Vacinnations: influenza, hepatitis A and B, and pneumococcal pneumonia.
  • Discuss all medicines you take with your physician, including herbs, supplements and over-the-counter medicines.
  • Consume “water pills” to get rid of fluid build-up.
  • Take Vitamin K to prevent excess bleeding.
  • As a last resort, should cirrhosis progress to end-stage liver disease, a liver transplant may be necessary.

 

Epstein-Barr Virus (EBV)

Also known to cause the “kissing disease”, the EBV is a member of the herpes virus family.  It is one of the most common human viruses and is found all over the world.  This disease can cause a swollen, infected liver.

Here are the ways in which EBV is transmitted:

  • Most commonly through bodily fluids, primarily saliva, EBV can cause infectious mononucleosis, also called mono, and other illnesses.
  • Through blood and semen during sexual contact, blood transfusions, and organ transplantations.
  • Spread by using objects, such as a toothbrush or drinking glass, which an infected person recently used.

There is no vaccine to protect against an EBV infection.  You can help protect yourself by not kissing or sharing drinks, food, or personal items with people who have an EBV infection.  Drinking plenty of fluids, adequate rest, and over-the-counter medication can help lessen the symptoms of the illness and prevent further damage to the liver and other internal organs.

 

Hemochromatosis

Hemachromatosis is a metabolic disorder that leads to abnormally elevated iron levels in the body. This excess iron can accumulate in the tissues of the liver, among other organs, and can lead to inflammation, cirrhosis, liver cancer, and liver failure.

Hemachromatosis is an inherited disease, meaning it is a genetic disorder passed down through families and occurs at birth.  People affected with hemochromatosis absorb too much iron through their digestive tract causing the iron to build up in the body, especially the liver, causing significant strain and damage to the liver tissue.

The goal of treatment is to remove excess iron from the body and treat any organ damage, usually through a procedure called phlebotomy.  Using this method, one-half liter of blood is removed from the body each week until the body iron level is normal.  This may take many months to do and may require many lifetime sessions to maintain the proper iron levels.

Performing regular phlebotomies helps to prevent the development of cirrhosis and liver cancer by decreasing the damage the “iron overload” does to the liver.  It also improves the symptoms associated with the disease such as weakness, liver pain, joint pain, and fatigue.

 

Liver Failure

Liver LocationDefined as when the liver no longer functions adequately, liver failure is the most severe of all liver diseases.  Often requiring a liver transplantation by a liver surgeon, liver failure can occur suddenly as a result of infection or complications from certain medications, or it can be the end result of a long-term problem.

The following conditions may result in liver failure:

  • Chronic hepatitis with cirrhosis
  • Primary biliary cirrhosis
  • Sclerosing cholangitis
  • Biliary atresia or a malformation of the bile ducts.
  • Alcoholism
  • Wilson’s disease
  • Hemochromatosis
  • Alpha-1 antitrypsin deficiency
  • Liver cancer

Liver failure is a serious medical condition and must be treated immediately.  Additionally, considering a liver transplant is an extremely personal and difficult decision and requires the knowledge and expertise of your specialized liver surgeon to discuss all of your options in order to get your body to regain its health.

 

Final Thoughts

The liver is a vital organ to your body as it performs many important functions.  When it becomes diseased and/or injured, there are options that must be considered to treat the liver ailment that is harming your body and preventing it from functioning correctly.

If you or a loved one is suffering from any of the above-mentioned liver ailments, or even one that was not mentioned, consider contacting Dr. Fraiman.  Since founding the Liver and Pancreas Center at St. Joseph Medical Center in Baltimore, Maryland, Dr. Fraiman has become a leader in comprehensive liver disease treatments and surgeries and can help you outline a plan of action for regaining a healthy liver.

 

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