Causes of Liver Disease

• Infections: Hepatitis A, B, C and E viruses
• Alcohol Abuse: Major cause of liver damage and liver cancer
• Fatty Liver: Associated with obesity, diabetes and high cholesterol
• Autoimmune Disorders: Autoimmune hepatitis, primary biliary cirrhosis and sclerosing cholangitis
• Other Causes: Drugs, toxins and genetic disorders

Risk Factors

• Alcohol abuse
• Diabetes
• Obesity
• Exposure to toxins
• Unprotected sexual contact
• Sharing infected needles
• Unsafe blood transfusion

Symptoms of Liver Disease

• Yellow discoloration of eyes and skin (Jaundice)
• Nausea and vomiting
• Chronic fatigue
• Itching (Pruritus)
• Abdominal swelling (Ascites)
• Leg swelling
• Dark urine
• Pale stools
• Loss of appetite
• Vomiting blood (Hematemesis)
• Blood in stool or black stool

Treatment Options

Treatment depends on the cause and severity of liver disease.

• Lifestyle modification
• Alcohol cessation
• Weight reduction
• Diabetes control
• Medications
• Liver transplant in advanced disease

Prevention

• Maintain healthy weight
• Regular exercise
• Control diabetes
• Avoid alcohol and smoking
• Hepatitis B vaccination
• Avoid unsafe injections
• Safe blood transfusion

Fatty liver disease is expected to become one of the leading causes of liver failure in the future if lifestyle risk factors are not controlled.

Hepatocellular Carcinoma (Liver Cancer)

Hepatocellular carcinoma is the most common primary liver cancer and usually occurs after the age of 50 years. It is more common in men.

Around 80% of cases develop in patients with chronic liver disease, while about 20% occur in normal liver.

Early prevention is the most effective way to reduce liver cancer risk.

Common Causes

• Alcohol-related liver disease
• Hepatitis B infection
• Hepatitis C infection
• Fatty liver disease

Prevention

• Hepatitis B vaccination
• Treatment of hepatitis infections
• Avoid alcohol
• Healthy weight maintenance
• Regular exercise

Symptoms

• Right upper abdominal pain
• Loss of appetite
• Weight loss
• Jaundice
• Ascites

Diagnosis

• Triple phase CT Scan
• Alpha-fetoprotein blood test
• MRI if required

Biopsy is usually avoided in cirrhotic patients due to the risk of tumor spread.

Treatment of Liver Cancer

Treatment planning depends on both tumor characteristics and liver function.

• Liver transplantation in cirrhotic patients
• Surgical liver resection
• Radiofrequency ablation (RFA)
• Trans-arterial chemoembolization (TACE)
• Targeted therapy

Liver transplantation treats both liver failure and cancer in selected patients.

Liver Abscess

Liver abscess may be of two main types:

• Pyogenic abscess
• Amoebic abscess

Patients usually present with fever and right upper abdominal pain.

Diagnosis

• Ultrasound abdomen
• CT Scan when required

Treatment

• Antibiotics
• Percutaneous drainage
• Laparoscopic drainage in ruptured abscess