What is liver disease?
Your liver is a large, triangle-shaped organ found in the upper right side of your tummy.
It has lots of functions, including:
- making proteins to help your blood clot properly
- making a liquid called bile, which helps to break down fats
- breaking down food for energy
- making certain hormones and controlling their levels
- helping your body fight infections
- controlling levels of nutrients, like fat, protein and glucose in the blood
- removing toxins (including medication) from your body
- storing essential vitamins, minerals and chemicals
When it’s working properly, your liver carries out these functions, day in and day out. But sometimes, it stops working as it should. This is known as liver disease.
Types of liver disease
There are lots of different types of liver disease, each with different causes. The most common include:
- alcohol-related liver disease
- non-alcoholic fatty liver disease
- hepatitis – viral or alcohol-related hepatitis
- primary biliary cirrhosis
- liver cancer
Read more about the causes of the different types of liver disease.
Liver disease symptoms
If you have liver disease, you usually won’t notice any symptoms in the early stages. But when the condition progresses to a later stage, where your liver has become seriously damaged, you may develop symptoms.
Symptoms of liver damage include:
- yellowing of the whites of your eyes and your skin (jaundice)
- loss of appetite
- losing weight without meaning to
- feeling very tired
- itchy skin
- feeling sick (nausea) and being sick (vomiting)
- tummy swelling (ascites), pain or general discomfort
- dark coloured pee
- light coloured and/or foul-smelling poo
When to see a doctor about liver disease
You should see a doctor as soon as possible if you have any of the symptoms listed above, as they suggest you may have liver damage. But as liver disease doesn’t always cause symptoms, you should also see a doctor if you feel OK, but think you may have liver disease, or you drink a lot of alcohol, or have a family member with an inherited liver condition.
In serious cases, liver disease can cause complications that need emergency medical treatment. Call an ambulance or go to the emergency department if:
- you feel confused or drowsy
- you’re vomiting blood or something that looks like coffee grounds
- your poo looks bloody or dark and like tar
- you’re bleeding from any part of your body and you can’t stop the bleeding
What causes liver disease?
Different types of liver disease have different causes. Here are the causes of some of them.
Alcoholic liver disease
This is usually caused by drinking too much alcohol – otherwise known as alcohol misuse. There are 2 key ways you can drink too much alcohol: binge drinking (drinking a lot of alcohol over a short period of time) or regularly drinking more than the recommended amount over many years.
While both habits can lead to alcoholic liver disease – also known as alcohol-related liver disease (ARLD) – it’s thought that the risk of this is higher if you regularly drink more than the recommended amount of alcohol.
Read more about how much alcohol is too much.
Non-alcoholic fatty liver disease (NAFLD)
NAFLD is a build-up of fat in your liver. It’s not clear why it happens to some people and not to others, but it’s more likely if you have risk factors like:
- being overweight or obese
- being older than 50
- type 2 diabetes
- high cholesterol
- high blood pressure
- high blood fat levels
- taking certain medications, like methotrexate
- losing weight very quickly
Read more about the causes and symptoms of nonalcoholic fatty liver disease (NAFLD).
Hepatitis is liver inflammation and it’s usually caused by 1 of 2 things: a viral infection or drinking too much alcohol.
Less commonly, hepatitis can be caused by your immune system accidentally attacking your liver cells. This is known as autoimmune hepatitis.
Read more about the different types of hepatitis and their causes.
Haemochromatosis is an inherited condition that causes liver damage when iron builds up in your liver. It’s caused by inheriting a faulty gene from both of your parents.
Primary biliary cirrhosis
Most cases of primary biliary cirrhosis are thought to be caused by a problem with your immune system – it accidentally attacks and damages small channels (called bile ducts) in your liver. But it’s not clear why this happens, although it’s often seen in people who have other autoimmune conditions.
Liver cancer can be caused by an abnormal growth that starts in your liver (primary liver cancer) or that spreads from elsewhere in your body (secondary liver cancer). Primary liver cancer can affect anyone and risk factors include:
- being male
- being older than 60
- having a parent or sibling (brother or sister) who has had primary liver cancer
- having some medical conditions, like liver cirrhosis, hepatitis, gallstones, diabetes or HIV
You can only get secondary liver cancer if you have another type of cancer – although you may not always know you have the first cancer.
How is liver disease diagnosed?
If a doctor suspects you have liver disease, they’ll usually ask you about your symptoms and do a physical exam.
If you’re being checked for a type of liver disease that affects the bile ducts, you may also need a procedure called an endoscopic retrograde cholangiopancreatography (ERCP) to take a closer look at these ducts. It involves having an X-ray and an endoscopy of your gullet, stomach and upper gut.
In some cases, a doctor may recommend a liver biopsy to confirm or rule out a type of liver disease.
Liver disease treatment
The specific treatment you’re likely to need for liver disease will usually depend on the type of liver disease you have. However, because most cases of liver disease are caused by drinking too much alcohol, being obese or catching a hepatitis infection, you can help to reduce your risk of liver disease in general by making some lifestyle changes. These may include:
- not drinking too much alcohol – if you drink a lot of alcohol, don’t suddenly stop or cut down as this can be dangerous for your body. Instead, speak to a doctor for advice on how to safely cut down
- eating a healthy, balanced diet – read more about what a balanced diet looks like and which foods are good for your liver
- exercising often and losing weight if you’re overweight or obese – speak to a doctor or dietitian for advice on how to safely do so
- avoiding dirty or used needles
- using barrier contraception, like condoms, when having sex
- not sharing personal hygiene items, like toothbrushes and razors
- having a vaccine to protect you from hepatitis A and B
What to expect after having liver disease
There are many different types of liver disease and some types, like early-stage fatty liver, are common, often cause no symptoms and can be managed with simple lifestyle changes. Other types may have a bigger impact on you, causing obvious symptoms and needing medical treatment.
In some cases, ongoing liver disease can lead to irreversible damage, known as liver cirrhosis. This is a serious type of liver damage that can lead to liver failure. Read more about liver cirrhosis.
Your health questions answered
How do you know if something is wrong with your liver?
It’s not always possible to know if something is wrong with your liver because many types of liver disease don’t cause any symptoms – especially at an early stage. But, you can sometimes develop symptoms of liver disease, such as yellowing of your skin or the whites of your eyes, and loss of appetite and itchy skin. See a doctor if you think you’ve got a liver problem, even if you have no symptoms, especially if you have risk factors, such as drinking too much alcohol or a family member with an inherited liver condition. A doctor will be able to do some tests to check how well your liver is working.
What does a stool look like with liver problems?
Liver problems don’t always affect your stool (poo). But they can if they affect the normal flow of bile from your liver. When this happens, your poo may look very light and smell really bad. Some types of liver disease can also cause complications that make you bleed more easily or bleed into your gut. If that happens, your poo may look very dark like tar or bloody.
What is the first stage of liver disease?
In general, inflammation is the first stage of liver damage, but this isn’t the first type of change that happens in all types of liver disease. If you have fatty liver disease, for example, a build-up of fat in your liver, known as hepatic steatosis, is the first stage.
- your liver has many functions, including making proteins to help your blood clot properly and breaking down food for energy
- liver disease happens when your liver stops working normally
- there are many types of liver disease, including hepatitis, cancer and alcohol-related liver disease
- liver disease doesn't always cause symptoms, but if it does, these symptoms may include yellowing of your skin and the whites of your eyes, loss of appetite and feeling weak and tired
- many things can cause or increase your risk of liver disease, including being overweight, your genes and drinking too much alcohol