Liver Diseases
The liver is the largest solid organ in the body and one of its most metabolically active, performing over 500 known functions including filtering the blood, producing bile for digestion, synthesising proteins and clotting factors, metabolising drugs and alcohol, and storing energy. Liver disease is therefore a broad term encompassing any condition that impairs the liver's ability to carry out these essential functions.
Common conditions
The most prevalent liver diseases include non-alcoholic fatty liver disease (NAFLD) — closely linked to obesity, type 2 diabetes, and metabolic syndrome — and its more aggressive form, non-alcoholic steatohepatitis (NASH); alcohol-related liver disease; viral hepatitis caused by hepatitis B and C viruses; autoimmune hepatitis; and primary biliary cholangitis. In advanced stages, many of these conditions can progress to cirrhosis — irreversible scarring of the liver tissue — and ultimately to liver failure or liver cancer (hepatocellular carcinoma).
Symptoms
In its early stages, liver disease is often silent. As it progresses, symptoms may include fatigue, loss of appetite, nausea, abdominal discomfort (particularly in the right upper quadrant), and unexplained weight loss. Jaundice — a yellowing of the skin and whites of the eyes — is a hallmark of significant liver dysfunction. More advanced disease may produce abdominal swelling due to fluid accumulation (ascites), easy bruising and bleeding, confusion (hepatic encephalopathy), and darkened urine or pale stools.
Diagnosis
Liver function tests — a set of blood tests measuring enzymes and proteins produced by the liver — are the standard initial investigation. Imaging with ultrasound, CT, or MRI helps assess the structure of the liver. Liver biopsy may be required to determine the severity of inflammation and fibrosis. Non-invasive alternatives such as transient elastography (FibroScan) are increasingly used to assess liver stiffness.
Treatment
Management varies by cause. Viral hepatitis B and C are now highly treatable; direct-acting antiviral therapy can cure hepatitis C in over 95% of cases. Alcohol-related liver disease requires complete abstinence. NAFLD is managed primarily through weight loss, dietary change, and exercise. Autoimmune conditions are treated with immunosuppressive medications. In cases of end-stage liver disease, liver transplantation may be the only definitive option.
Choosing where to be treated
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