The Progression of Liver Disease
There are many different types of liver disease. But no matter what type you have, the damage to your liver is likely to progress in a similar way.
Whether your liver is infected with a virus, injured by chemicals, or under attack from your own immune system, the basic danger is the same – that your liver will become so damaged that it can no longer work to keep you alive.
Cirrhosis, liver cancer, and liver failure are serious conditions that can threaten your life. Once you have reached these stages of liver disease, your treatment options may be very limited.
That’s why it’s important to catch liver disease early, in the inflammation and fibrosis stages. If you are treated successfully at these stages, your liver may have a chance to heal itself and recover.
Talk to your doctor about liver disease. Find out if you are at risk or if you should undergo any tests or vaccinations.
Your liver helps fight infections and cleans your blood. It also helps digest food and stores energy for when you need it. A healthy liver has the amazing ability to grow back, or regenerate, when it is damaged. Anything that keeps your liver from doing its job – or from growing back after injury – may put your life in danger.
In the early stage of any liver disease, your liver may become inflamed. It may become tender and enlarged. Inflammation shows that your body is trying to fight an infection or heal an injury. But if the inflammation continues over time, it can start to hurt your liver permanently.
When most other parts of your body become inflamed, you can feel it – the area becomes hot and painful. But an inflamed liver may cause you no discomfort at all, and people with inflammation generally do not feel it.
If your liver disease is diagnosed and treated successfully at this stage, the inflammation may go away.
If left untreated, the inflamed liver will start to scar. As excess scar tissue grows, it replaces healthy liver tissue. This process is called fibrosis. (Scar tissue is a kind of fibrous tissue.)
Scar tissue cannot do the work that healthy liver tissue can. Moreover, scar tissue can keep blood from flowing through your liver. As more scar tissue builds up, your liver may not work as well as it once did. Or, the healthy part of your liver has to work harder to make up for the scarred part.
If your liver disease is diagnosed and treated successfully at this stage, there’s still a chance that your liver can heal itself over time.
Cirrhosis is the scarring of the liver – hard scar tissue replaces soft healthy tissue.
As cirrhosis becomes worse, the liver will have less healthy tissue. If cirrhosis is not treated, the liver will fail and will not be able to work well or at all.
Cirrhosis can lead to a number of complications, including liver cancer. In some people, the symptoms of cirrhosis may be the first signs of liver disease.
- You may bleed or bruise easily.
- Water may build up in your legs and/or abdomen.
- Your skin and eyes may take on a yellow color, a condition called jaundice.
- Your skin may itch intensely.
- In blood vessels leading to your liver, the blood may back up because of blockage. These blood vessels may burst.
- You may become more sensitive to medications and their side effects.
- You may develop insulin resistance and type-2 diabetes.
- Toxins may build up in your brain, causing problems with concentration, memory, sleeping, or other mental functions.
Once you’ve been diagnosed with cirrhosis, treatment will focus on keeping your condition from getting worse. It may be possible to stop or slow the liver damage. It is important to protect the healthy liver tissue you have left.
End-Stage Liver Disease includes a subgroup of patients with cirrhosis who have signs of decompensation that is generally irreversible with medical management other than transplant. Decompensation includes hepatic encephalopathy, variceal bleed, kidney impairment, ascites, lung issues. The decompensated liver disease allows these patients to be prioritized on the transplant list
Cancer that starts in the liver is called primary liver cancer. Cirrhosis and hepatitis B are leading risk factors for primary liver cancer. But cancer can develop in the liver at any stage in the progression of liver disease. Read more.
Liver failure means that your liver is losing or has lost all of its function. It is a life-threatening condition that demands urgent medical care.
The first symptoms of liver failure are often nausea, loss of appetite, fatigue, and diarrhea. Because these symptoms can have any number of causes, it may be hard to tell that the liver is failing.
But as liver failure progresses, the symptoms become more serious. The patient may become confused and disoriented, and extremely sleepy. There is a risk of coma and death. Immediate treatment is needed. The medical team will try to save whatever part of the liver that still works. If this is not possible, the only option may be a liver transplant.
Liver failure is a life-threatening condition that demands urgent medical care.
When liver failure occurs as a result of cirrhosis, it usually means that the liver has been failing gradually for some time, possibly for years. This is called chronic liver failure or End-stage Liver Disease (ESLD).
Chronic liver failure can also be caused by malnutrition. More rarely, liver failure can occur suddenly, in as little as 48 hours. This is called acute liver failure and is usually a reaction to poisoning or a medication overdose.
- What is the extent of the damage (if any) on my liver?
- Do I have fibrosis or do I have cirrhosis?
- Should I have routine labs and/or imaging studies?
- Are there other lifestyle changes I should make to slow the progression of the liver disease?
- Are there any over the counter medications or prescribed medications which should be reduced or stopped?
- Will I need a liver transplant?
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