Catherine Frenette, MD, a gastroenterologist and hepatologist at Scripps Clinic, discusses the different types of liver disease, their causes, symptoms and treatment, including liver transplant. Dr. Frenette is medical director of the liver transplant program at Scripps.
Liver disease is anything that causes irritation or inflammation in the liver that can then result in scar tissue formation in the liver. As more and more scar tissue forms in the liver, you can develop cirrhosis. This basically means end-stage scar tissue in the liver where the liver is no longer smooth and nice and red. It’s sort of lumpy, bumpy, and gravely almost, and that prevents it from functioning properly.
There are many causes of liver disease. We all think of alcohol as the cause but that’s only one of a multitude of causes and it’s not even the most common cause. There are viruses called hepatitis or hepatitis B, hepatitis C that cause liver disease.The most common liver disease right now is fatty liver, where patients can actually get fat in the liver. That can result in irritation and inflammation and then scar tissue development.
I always think of the liver as being a very forgiving organ and the problem with that is that people don’t often get symptoms until the liver is very advanced. Once people have more advanced liver disease, they can develop symptoms like yellow eyes or yellow skin. They can develop swelling in their legs or swelling and fluid buildup in their abdomen that’s called ascites fluid. They also can have toxins build up in their body that can actually get into their brain and make them confused or forgetful or shaky as some of the advanced symptoms.
Treating liver disease really centers on treating whatever it is that’s irritating the liver. For instance, if someone has Hepatitis C, we want to treat Hepatitis C. If someone drinks alcohol, we want them to stop drinking alcohol. Whatever the cause of the liver disease is, we first attack the cause, which then will allow the liver to start to heal itself because the liver can be a very forgiving organ and actually repair some of the damage that’s done. If the liver gets too much damage with the cirrhosis and lumpy bumpy scar tissue in the liver, then it can get to a point where it no longer is going to heal itself and at that point, we may need to think about a liver transplant or replacing the liver with a healthy one.