Liver disease is any disturbance of liver function that causes illness. The liver is responsible for many critical functions within the body and should it become diseased or injured, the loss of those functions can cause significant damage to the body.
Classic symptoms of liver disease include:
- Skin and eyes that appear yellowish (jaundice)
- Abdominal pain and swelling
- Swelling in the legs and ankles
- Itchy skin
- Dark urine color
- Pale stool color, or bloody or tar-colored stool
- Chronic fatigue
- Nausea or vomiting
- Loss of appetite
- Tendency to bruise easily
However, since there are a variety of liver diseases, the symptoms tend to be specific for that illness until late-stage liver disease and liver failure occurs.
Examples of liver disease symptoms due to certain conditions or diseases include:
- Infection. Parasites and viruses can infect the liver, causing inflammation and that reduces liver function. The viruses that causes liver damage can be spread through blood or semen, contaminated food or water, or close contact with a person who is infected. The most common types of liver infection are hepatitis viruses, including: Hepatitis A, B, and C.
- Immune system abnormality. Disease in which your immune system attacks certain parts of your body can affect your liver. Examples include: Autoimmune hepatitis, Primary biliary cirrhosis, Primary sclerosing cholangitis
- Genetics. An abnormal gene inherited from one or both of your parents can cause various substances to build up in your liver, resulting in liver damage. This includes: Hemochromatosis, Hyperoxaluria and oxalosis, Wilson’s disease.
- Cancer. Cancers such as Liver cancer, Bile duct cancer, and Liver adenoma.
Liver disease can have physical findings that affect almost all body systems including the heart, lungs, abdomen, skin, brain and cognitive function, and other parts of the nervous system. The physical examination often requires evaluation of the entire body.
Blood tests are helpful in assessing liver inflammation and function.
Specific liver function blood tests include:
- AST and ALT ( transaminase chemicals released with liver cell inflammation);
- GGT and alkaline phosphatase (chemicals released by cells lining the bile ducts);
- bilirubin; and
- protein and albumin levels.
Other blood tests may be considered, including the following:
- complete blood count (CBC), patients with end stage liver disease may have bone marrow suppression and low red blood cells, white blood cells and platelets. As a result, patients with cirrhosis may have bleeding;
- INR blood clotting function may be impaired due to poor protein production and is a sensitive measure of liver function;
- lipase to check for pancreas inflammation;
- electrolytes, BUN and creatinine to assess kidney function; and
- ammonia blood level assessment is helpful in patients with mental confusion to determine whether liver failure is a potential cause.
Imaging studies may be used to visualize, not only the liver, but other nearby organs that may be diseased. Examples of imaging studies include:
- CT scan (computerized axial tomography),
- MRI (magnetic resonance imaging), and
- ultrasound (sound wave imaging, which is especially helpful in assessing the gallbladder and bile ducts.
Liver biopsy may be considered to confirm a specific diagnosis of liver disease. Under local anesthetic, a long thin needle is inserted through the chest wall into the liver, where a small sample of liver tissue is obtained for examination under a microscope.