Some parts of your body provide constant reminders that they're on the job. You can feel your heart beating and your lungs filling with air when you take a breath. One of your largest internal organs, however, is more of a silent partner in your health. It's the liver.
Your liver is located behind the lower right area of your ribs. Weighing in at about three pounds, it's the size of a football, but soft and smooth. It is part of the digestive system and is connected to the small intestine by the bile duct.
What does the liver do?
The liver is a multitasking organ, with many functions. Nearly all the blood that leaves the stomach and intestines passes through the liver for processing, according to the American Liver Foundation (ALF).
The liver is a chemical "factory," involved in these myriad body functions:
It produces clotting factors, blood, proteins, bile, and more than a thousand enzymes.
It makes use of cholesterol in the blood.
It stores the energy from the food you eat to provide fuel for your muscles.
It regulates the levels of blood sugar and several hormones in the body.
It removes poisons such as drugs and alcohol from the blood.
What are common liver problems?
Cirrhosis, or scarring of the liver, is one of the most common liver problems. Cirrhosis is a consequence of chronic liver disease, such as hepatitis or alcohol abuse. Liver disease damages normal liver cells, gradually decreasing the amount of normal liver tissue and limiting its function. As the liver disease progresses and cirrhosis worsens, the liver fails.
Many conditions can lead to cirrhosis, the ALF says, but the most common is drinking alcohol to excess. These are other causes of cirrhosis:
Chronic hepatitis infection, brought on by hepatitis B, C or D
Primary biliary cirrhosis, which is an autoimmune disease that affects women
A disease of the bile ducts called primary sclerosing cholangitis
An inherited liver disease, such as Wilson disease, hemochromatosis, alpha1-antitrypsin deficiency, glycogen storage disease, and autoimmune hepatitis
Prolonged exposure to certain toxins
Certain forms of heart disease
Schistosomiasis, a parasitic infection
Nonalcoholic fatty liver disease (NAFLD) may also cause cirrhosis and affects up to 25 percent of people in the United States. The normal liver contains a small amount of fat. A liver affected by NAFLD contains up to 10 percent fat, by weight. This excess fat can cause inflammation, which can lead to scarring and cirrhosis, the ALF says. People at risk for developing NAFLD are those who are obese, or who have diabetes or high levels of triglycerides. Other risk factors include alcohol abuse, rapid weight loss and nutritional deficiencies. The more severe form of NAFLD is called nonalcoholic steatohepatitis (NASH). Up to 25 percent of adults with NASH may have cirrhosis.
What's the biggest threat to liver health?
Hepatitis is a common liver problem that can lead to cirrhosis, or scarring, of the liver. Hepatitis is caused by one of five viruses: A, B, C, D and E:
The hepatitis A virus is found in the feces of people with hepatitis A. It causes an acute infection that does not lead to chronic hepatitis and liver damage. Hepatitis A symptoms are similar to the flu and generally last three to six weeks. Most people recover without long-term health problems, the ALF says. Hepatitis A virus is spread when a person comes in contact with contaminated feces.
Hepatitis B also causes flu-like symptoms, and most healthy adults fight off the virus with no long-term effects. Five percent of infections become chronic, however. Chronic infection can lead to cirrhosis, liver cancer and liver failure. Hepatitis B virus is found in the blood and body fluids of an infected person. It can be spread from an infected person to someone who has no immunity to it by having unprotected sex and by sharing items such as toothbrushes, razors or needles. It also can be spread from mother to child at birth.
Hepatitis C usually causes no symptoms early on, but is a chronic liver disease. When symptoms occur years after the initial infection, the damage has been done. Unlike hepatitis B, which most adults can fend off, infection with the hepatitis C virus becomes chronic in up to 85 percent of cases. It leads to cirrhosis, especially if you drink alcohol. Hepatitis C is the leading reason for a liver transplant and the leading cause of liver cancer. The virus is found in the blood and body fluids of an infected person. It is spread through sharing needles and contaminated blood. It is possible to spread hepatitis C through unprotected sex, but that is uncommon.
Hepatitis D infects people who already have hepatitis B.
What else can affect the liver?
Some medications, including certain cholesterol medicines and the pain reliever acetaminophen, may provide major health benefits, but they may injure the liver. In some cases, taking an especially high dose of acetaminophen or taking high doses for a long time may be bad for the liver.
How can I prevent liver problems?
Keep your weight under control. If you drink alcohol, do so in moderation. Avoid high doses of medications or prolonged use of medications that can cause liver problems, unless you're under direct supervision by your doctor.
To protect yourself from hepatitis B and C, limit the number of sexual partners you have, and always use latex condoms. Don't share razors or toothbrushes. If you inject illegal drugs, seek treatment to help you stop. In the meantime, don't reuse or share needles.
If you are at high risk for hepatitis A or B, you can get a vaccine against these infections. Both vaccines are now part of routine childhood immunizations, recommended by the CDC Advisory Committee on Immunization Practices. Talk to your doctor if you think you need to be vaccinated. There is no vaccine against hepatitis C.
How is liver disease diagnosed?
Blood tests may help your doctor identify a problem. If you're at high risk for infection, it's important to be tested for hepatitis B and C. If you have hepatitis, early diagnosis and treatment are important. It may lower the chance that you'll infect others.
Is a transplant my only hope if I develop liver disease?
Absolutely not. In fact, a liver transplant is the last resort. Many effective medications are available for treating hepatitis B and C and other liver diseases. Taking medications as prescribed and living a healthy lifestyle improve the chance of managing liver disease. It may help you overcome it, too.
Are there symptoms I should watch for?
Unfortunately, the liver can become damaged without your knowledge. By the time severe complications develop, it may be too late to do anything about them. At that point, your only option may be a liver transplant.
These are early symptoms of liver disease:
These are more advanced complications:
Fluid buildup in the abdomen
Bleeding in the stomach or esophagus
Prolonged itching of the skin
Yellow discoloration of the skin or eyes
Very dark urine or pale stools, or bloody or tar-like stools