What You Need to Know About Liver Disease

Your liver is one of your body’s largest organs. It has the important job of turning nutrients from the food you eat into substances that your body can use for energy. It can store these substances and release them when your body needs them, and also helps your body safely remove potentially harmful toxins.

When your liver health is this important to your total well-being, it’s essential you know how to protect it. The most common liver disease, alcohol-related liver disease, is 100% preventable by adopting healthy lifestyle habits.

AdventHealth fellowship-trained gastroenterologist and hepatologist with board certifications in internal medicine, gastroenterology and hepatology, Jason Abdallah, MD, helps explain more about the most common liver diseases, their causes, symptoms and how to keep your liver in top shape.

The Most Common Liver Diseases

“Among many causes of liver disease, the most prevalent that we see today are alcohol-related liver disease due to chronic alcohol use, chronic hepatitis infection caused by hepatitis B or hepatitis C viruses, and non-alcoholic steatohepatitis (NASH), also called fatty liver disease, due to obesity and diabetes,” says Dr. Abdallah.

Some of these causes are preventable and some are not. But there are actions you can take to manage some of the damaging effects.

Alcohol-Related Liver Disease

Dr. Abdallah explains, “Alcohol has a direct toxic effect on the liver cells (called hepatocytes) causing inflammation which is termed alcoholic hepatitis. In the advanced stages, there’s a ballooning of the liver cells from fat accumulation. And it keeps the liver cells from being able to perform their normal functions. Alcohol abuse is one of the most common causes of liver disease in the United States.”

Preventing alcohol-related liver disease is within your control. Avoiding excessive alcohol is one of the simplest ways to protect your liver.

Viral Hepatitis

“Viral hepatitis is the most common cause of both acute and chronic liver injury worldwide,” says Dr. Abdallah. “The hepatitis viruses A, B, C, D and E are responsible for the majority of cases of acute viral hepatitis. However, only the B and C hepatitis viruses can advance to chronic infection, cause chronic liver injury, progressive fibrosis, and lead to cirrhosis and a type of cancer called hepatocellular carcinoma (HCC).”

While most fully recover from acute hepatitis, chronic hepatitis can be a lifelong challenge.

Unlike hepatitis B, there is no vaccine to prevent hepatitis C infection. However, Dr. Abdallah explains, “Newer medications which are generally safe have shown promising results in curing hepatitis C infection. People born between 1945 and 1965 should be tested for hepatitis C antibody in the blood.”

Non-Alcoholic Steatohepatitis (NASH)

Cases of NASH, a form of non-alcoholic fatty liver disease, have been on the rise in the U.S. and are strongly associated with obesity and metabolic syndrome. It is the most common liver disorder in Western industrialized countries.

“This occurs due to fat accumulation within the liver cells, which can lead to liver enlargement and inflammation. The liver cells ultimately lose the ability to perform their functions,” says Dr. Abdallah.

Prevention of NASH is focused on weight loss and maintaining a healthy weight with a healthy lifestyle that includes a balanced diet and regular exercise.

Other Causes of Liver Disease

We’ve reviewed some of the most common causes of liver disease, but other things can affect your liver health.

Dr. Abdallah notes that liver disease can also be caused by the following:

• Autoimmune diseases, including autoimmune hepatitis, primary biliary cholangitis, primary sclerosing cholangitis
• Hereditary causes such as Wilson’s disease, hemochromatosis and alpha 1 anti-trypsin deficiency
• Acetaminophen (Tylenol) overdose and other medications
• Certain herbal medications and supplements

Tips to Prevent Liver Disease

Prevention depends on reducing your risk factors. Overall, here are some things that Dr. Abdallah recommends in keeping your liver healthy and functioning at its best.

• Abstaining from alcohol
• Implementing safe strategies to prevent sexual transmission of hepatitis B
• Avoiding used or non-sterile needles or equipment for IV injections and tattoo and body piercings
• Eating a healthy balanced diet
• Exercising regularly
• Maintaining a healthy weight to prevent NASH
• Avoiding the unnecessary use of over-the-counter medications
• Using personal protective equipment around chemicals, such as proper clothing, masks, glasses and gloves
• Washing eyes and skin immediately if directly exposed to chemicals

Signs and Symptoms of Liver Disease

Signs and symptoms may vary depending upon the exact type of the liver disease; however, there are a few general symptoms, such as:

• Abdominal pain (right side or generalized) and swelling
• Bloody or tarry stools
• Bloody vomiting
• Dark urine
• Easy bruising
• Fatigue
• Itchy skin
• Jaundice (yellowing of skin and sclera of the eyes)
• Loss of appetite
• Malaise
• Nausea and vomiting
• Pale stools
• Weight loss

Diagnosing Liver Disease

Your doctor will use your symptoms, risk factors and unique health history to determine if you might be experiencing liver disease. Some of the tests used to confirm a diagnosis include:

• Complete Blood Count (CBC): CBC shows hemoglobin levels, which may be decreased in liver disease.
  
• Liver Function Tests (LFTs): Testing for enzymes, protein and albumin levels can help determine liver function. INR (blood clotting function) is another important measure of liver function.
  
• Imaging Tests: Ultrasound can show liver texture and also show problems with the gall bladder or bile duct. A CT scan and Magnetic Resonance Imaging (MRI) can give detailed pictures of the liver, too.
  
• Liver Biopsy: A biopsy involves taking a small piece of liver with the help of a long needle and observing it under a microscope. This is an invasive test that is usually reserved as the last resort to confirm a specific diagnosis.

Dr. Abdallah’s Message to You

“If you and your doctor identify risk factors within your control, you can work together to develop a plan to reduce them, which might include eliminating alcohol from your diet, regular exercise, weight loss and proper nutrition,” explains Dr. Abdallah.

It’s also important to be aware of some over-the-counter medications.

“It’s essential to ask your doctor about the correct dosage of medications, especially when you have prescriptions,” says Dr. Abdallah. “Some medication may have a direct toxic effect on the liver; others can cause liver injury through interactions with other over-the-counter or prescribed medications.”

Learn more about digestive health care at AdventHealth Zephyrhills here or contact our Bariatric and Digestive Health Nurse Navigator at Call352-521-1170.