The liver is one of the largest and most vital organs in the body — and for many, also one of the most mysterious. A common perception is that the liver filters waste, and while it does break down harmful substances, it also absorbs and stores nutrients and produces proteins essential to health. In addition, the liver is important to immune function and helps the body fight off infections.
In this video, San Diego Health host Susan Taylor talks with Julio Gutierrez, MD, a hepatologist and liver transplant specialist with Scripps Clinic Torrey Pines about common liver diseases and how liver damage affects health.
A damaged liver can no longer perform the functions essential to good health. Liver damage is caused by chronic inflammation from various diseases.
“The liver is able to recruit stem cells to replace damaged cells, and this process occurs throughout our life, as the liver is repairing itself,” says Dr. Gutierrez. “But eventually those stem cells run dry and scar tissue starts to form and replace normal liver cells.”
Advanced scarring, a condition called cirrhosis, creates changes in liver shape and function and can cause severe muscle loss, weight loss and inability to fight off infections. End-stage liver disease can be fatal.
One of the most common causes of scarring is fatty liver disease related to excess weight. Once patients gain about 20 extra pounds, they start to store more fat in their liver than is normal, which can lead to permanent scarring.
Hepatitis is a group of viral infections that cause inflammation of the liver. Hepatitis A spreads through contaminated food or water or contact with someone who is infected. Hepatitis A is entirely preventable with a vaccine, but if a person does not get the vaccine and gets infected with hepatitis A, there is about a 5 to 10% chance of death.
Hepatitis B is transmitted through blood and bodily fluids, and hepatitis C through contaminated blood. Fortunately, all three can be treated or prevented. Hepatitis B, if found early, can be easily controlled with oral medications that patients take for life. Hepatitis C is curable with medications taken for eight to 12 weeks.
Many signs of liver disease are hidden, and most patients will have no symptoms until the disease has reached an advanced stage.
“Probably the most common symptom I see is dull, nagging pain in the lower part of your chest in the right side,” says Dr. Gutierrez. “Another sign is yellowing of the skin or whites of the eyes, a condition called jaundice. Other very concerning symptoms are vomiting blood or swelling of the abdomen. Any of those are signs of end-stage liver disease.”
If you are concerned about liver disease, talk with your primary care physician about running a simple, comprehensive metabolic panel that will measure liver enzymes and function. The results can help determine if you should see a liver specialist.
Liver disease treatments depend on the type and severity of disease. Medications, including steroids, antiviral drugs and immunosuppressants, can help manage some liver disorders including hepatitis B and C and fatty liver disease. In severe cases, a liver transplant may be needed.
While some liver diseases are not preventable, lifestyle habits can help ward off some conditions. Fatty liver disease can be prevented by maintaining a healthy weight. Alcohol use is the leading cause of cirrhosis. Alcoholic hepatitis is a severe form of alcoholic liver damage that tends to happen in people 30 to 50 years old. Severe acute alcoholic hepatitis can be fatal for 30 to 80% of patients.
“If patients can reduce or eliminate alcohol, that can also improve their liver health,” says Dr. Gutierrez. “We’re building a program at Scripps that allows patients to receive not only the alcohol rehabilitation needed to stay away from alcohol, but potentially even a life-saving liver transplant should they need it.”