Liver disease

What is liver disease?

Liver disease includes several conditions that can damage your liver and its ability to function correctly. While the cause of each condition is different, they all damage your liver in a similar, progressive way.

If you want to check your liver health, you can do a liver blood test (formerly known as a liver function blood test or LFT) at home. It's important to note that this test can't diagnose or rule out liver disease on its own.

When doing this blood test, a GP will review your:

• previous liver blood test results (if you have any)
• health profile 
• body mass index (BMI)
• alcohol consumption
• diet

Types of liver disease

Some of the most common types of liver disease are:

• alcohol-related liver disease (ARLD) — caused by damage to your liver from years of alcohol misuse
• non-alcoholic fatty liver disease (NAFLD) — the build-up of fat in your liver
• haemochromatosis — where iron slowly builds up in your body and can damage your liver (also called iron overload)
• hepatitis — inflammation of your liver caused by an infection or alcohol-related damage
• primary biliary cirrhosis (PBC) — an auto-immune disease that damages the tubes that connect your liver to your small intestine (bile ducts)
• chronic liver disease — a long-term liver disease

Liver disease symptoms

Your liver can still function with some degree of damage, so you might not get any liver disease symptoms until the later stages. This is often once severe scarring (liver cirrhosis) and abnormal tissue have developed.

The most common liver disease symptoms include:

• tiredness
• nausea
• irritability and confusion
• yellowing of your skin and eyes (jaundice)

Liver disease stages

Most liver diseases have 4 stages, including:

1. hepatitis — inflammation caused by viral infection or damage caused by alcohol
2. simple fatty liver (steatosis) — caused by too much fat build-up in your liver 
3. fibrosis — scarring of your liver tissue
4. cirrhosis — severe scarring caused by long-term liver damage

End-stage liver disease is the most severe form of cirrhosis. It’s monitored using the Model for End-Stage Liver Disease (MELD) score. 

The MELD score measures your: 

• serum bilirubin
• serum creatinine

What are the causes of liver disease?

There are many different types and causes of liver disease. Managing your weight and not having more than 14 units of alcohol a week (6 pints of beer or 10 small glasses of wine) can help prevent some of them.

Alcohol-related liver disease (ALRD)

ARLD is caused by excessive, long-term alcohol consumption. Most people who drink more than 40 g of alcohol (4 standard drinks) a day will develop stage 2 of liver disease — alcoholic steatohepatitis. But only 10-15% will go on to develop more severe stages of the disease. 

Find out more about the effects of alcohol on your body.

Non-alcoholic fatty liver disease (NAFLD)

NAFLD is caused by fat build up in your liver. It’s linked to carrying excess weight and having insulin resistance — when your cells don’t respond properly to insulin, it causes your blood sugar levels to stay high. This is found in people with type 2 diabetes and often those with PCOS.

Hepatitis 

Hepatitis can be viral, meaning it can be caused by an infectious virus — like hepatitis B or C. There’s also an autoimmune form of hepatitis, a chronic and progressive form of liver inflammation that has unknown causes.

Primary biliary cirrhosis (PBC)

PBC is an autoimmune disease that causes chronic inflammation of the bile ducts in your liver. It’s linked to problems with your immune system, but the exact cause is unknown (like many autoimmune conditions).  

Liver disease treatment

Liver disease treatment depends on what type of liver disease you have. It’s vital to stop or treat whatever is causing the damage to your liver. This will help slow down or stop the progress of the disease so your liver can begin to repair itself. So this could mean antiviral therapy for viral hepatitis or a liver transplant for very advanced and life-threatening stages of liver disease.

As well as stopping further damage to your liver, an essential part of treatment is to manage your liver disease symptoms to avoid complications.

Lifestyle changes

Lifestyle and dietary changes are essential for all types of liver disease treatment. Your liver is vital to digestion, detoxification, and metabolism. So when your liver is damaged, it’s best not to eat or drink anything that might make it worse.

These include:

• reducing how much alcohol you drink to prevent more damage to your liver
• limiting the amount of saturated and trans fats you eat — a damaged liver can’t digest fats less well
• lowering your salt intake and being prescribed diuretics to reduce swelling in your abdomen

Some types of liver disease treatment rely more on lifestyle changes than others. For example, dietary modifications are critical to the initial treatment phase of NAFLD. Aiming to reduce your weight by 4-10% can be beneficial, especially when combined with exercise and dietary changes. 

Like the Mediterranean diet, eating a diet rich in vegetables, whole grains, and unsaturated fats can also improve insulin resistance and reduce fatty deposits in your liver.

Even though these are an essential part of NAFLD treatment, these lifestyle changes also help manage all liver diseases and slow their progression.

When liver disease progresses to advanced stages, lack of proper nutrition (malnourishment) and micronutrient deficiencies can become a concern. 

At this point, your liver disease treatment might include:

• close monitoring of your nutritional levels through regular blood testing
• increased calorie and protein intake
• taking supplements — like vitamin A, vitamin D, vitamin E, vitamin K, and zinc

The good news is that your liver is good at repairing itself. So if the underlying cause is treated, not only are symptoms managed, but the progress of the disease can slow down or stop. This means your liver might even regain some of its previously lost function.

Liver disease complications

There can be many serious liver disease complications depending on which type you have. That’s why acting quickly and getting the right treatment is vital.  

Alcohol-related liver disease complications include:

• infection — due to a weakened immune system
• liver cancer
• portal hypertension — when the blood pressure in your liver rises to a dangerous level. This might result from cirrhosis and sometimes alcoholic hepatitis
• ascites — fluid build-up around your abdomen and intestines. This might result from portal hypertension
• hepatic encephalopathy — your liver is unable to remove toxins from your blood, affecting functions in your brain, including speech and movement

Non-alcoholic liver disease complications include:

• non-alcoholic steatohepatitis (NASH) — advanced NAFLD
• cirrhosis
• hepatocellular carcinoma (HCC) — primary liver cancer