Knowing How To Recognise The Symptoms Of Liver Disease Can Save Your Life

As with so many illnesses and diseases, liver disease, if spotted early enough, can be arrested and cured (providing the causes have been identified and are avoided in the future) and your liver can fully recover, growing new healthy tissue to replace any that has been damaged, just as long as the disease has not been allowed to progress too far – hence the importance of knowing what the warning signs to look out for.

Deaths from liver disease are on the increase in England, in contrast to other major causes of disease, which have been declining. In 2014 the number of people who died with an underlying cause of liver disease in England rose to 11,597, but liver disease is largely preventable.

Excluding the 5% attributable to autoimmune disorders, most liver disease is due to 3 main risk factors: excessive alcohol consumption, obesity and viral hepatitis.

AN ORGAN AND A GLAND

Your liver is the largest internal organ (and also the largest internal gland) in your body. In a healthy adult, a normal liver will weigh somewhere between 3 to 3.5 pounds and it plays a crucial role in a number of body system functions.

FUNCTIONS OF THE LIVER

The key functions of the liver are to detoxify your blood, and to enhance your digestive system by creating bile, which helps to break down the fats that you consume into small pieces, making them easier for your small intestine to absorb. But that’s not all. Here is a quick summary of what your liver does for you:

It detoxes your blood, filtering out any harmful and unwanted substances like drugs and alcohol.
It produces bile to aid digestion.
It stores some of your body’s vitamins and iron.
It stores glucose.
It converts glucose into sugar that the body can use when the body’s sugar levels become depleted.
It helps blood to clot.
It processes haemoglobin, insulin and a variety of other hormones.
It eliminates old red blood cells, which produces faecal matter which is normally brown in color.

This is why if your stools are discolored (i.e. not brown) it can be an indication there is something wrong with your liver function. Without a healthy liver, health will become severely compromised, and depending on the nature and severity of disease, could prove fatal; which is why it’s so important to be able to detect and interpret the early symptoms of liver disease.

Always consult your doctor if in doubt

There are more than 100 different types of liver disease, which together affect at least 2 million people in the UK. Liver disease is also sometimes referred to as hepatic disease. When any type of hepatic disease affects up to three quarters of your liver tissue, that’s when a significantly increase in liver function can be detected.

CAUSES OF LIVER DISEASE

Liver disease can be brought about in a number of different ways:

Its cells may be inflamed, as with hepatitis.
The passage of bile may become obstructed, as in cholestasis.
A build-up of cholesterol may occur.
The flow of blood to the liver can be damaged.
The tissue of the liver may be attacked and damaged by toxins.

KEY FACTS

Liver disease is the only major cause of death still increasing year-on-year. Liver disease is the fifth ‘big killer’ in England & Wales, after heart, cancer, stroke and respiratory disease: 16,087 people in the UK died from liver disease in 2008, a 4.5% increase since 2007. This includes 13,805 people in England and Wales, 1,903 in Scotland and 379 in Northern Ireland.

Twice as many people now die from liver disease as in 1991 (2009 figures). Liver disease kills more people than diabetes and road deaths combined (Office of National Statistics). Liver disease is on the increase in the UK.

The most frequent and common symptoms of liver disease include:

Bad breath
Black circles beneath the eyes
Bad body odour
Brown blemishes on the skin
Coated tongue
Discolored stools
Flushed facial appearance
Inflamed palms and soles of feet
Swollen eyeballs
Jaundice: the yellowing of the skin which can often also be evidenced in the whites of the eyes
Nausea
Pain – which is felt in the uppermost right hand side of the abdomen, under the ribs
Increased tendency to perspire excessively
Some people also suffer from fatigue and weight loss.

These symptoms of liver disease relate to hepatic disease in general. But there are also many different, specific, illnesses or diseases that affect the liver, and each of these has its own specific symptoms.

ALCOHOL and CIRRHOSIS

The most common cause of liver disease is alcohol abuse. The final stage of liver disease (when the liver sustains severe scarring and cannot regenerate replacement tissue), is known as cirrhosis of the liver and is a major cause of preventable premature death in the UK.

Some Statistics

The cost to the NHS of alcohol misuse has been estimated at £2.7 billion each year.
In 2007 4,580 people died in England and Wales from alcohol related liver disease. There was a 41% increase in the number of deaths from alcohol related liver disease between 1999 and 2005 and in the last 30 years, mortality has risen over 450% in the UK.
Excessive alcohol consumption accounted for 1.4% of all deaths registered in England and Wales in 2012.
In 2007 in total, there were 5,732 alcohol-related deaths in men and 2,992 in women.
The process is silent, but when liver disease has developed it presents as an acute illness with a 25-50% immediate mortality.
Hospital admissions for alcohol related disease, including alcohol related liver disease, have more than doubled since 1995/6 and between 2002/3 and 2006/7 there was a 71% increase
There are over 800,000 hospital admissions directly related and attributable to alcohol each year.
In Scotland, in 2007/8 there was a 400% increase in patients discharged from hospital with alcohol related liver disease (6,817) compared to 1996. In 2006-7, 1,094 children aged under 18 were admitted to hospital with an alcohol-related diagnosis. Treatment for alcohol related conditions in Scotland costs over £1m a day (Office of National Statistics)

As hepatic disease progresses and reaches the stage of cirrhosis, the following symptoms of liver disease may often appear:

A tendency to bruise more easily. This is because the liver is no longer able to efficiently clot the blood.
Itchiness. The result of bile salts being deposited in the skin can cause itching.
Enlarged male breasts. This is a condition known as gynaecomatia and can be brought about by upsetting the balance of sex hormones, and an increase in the hormone oestradiol in particular.
Erectile dysfunction. The upsetting of the balance of sex hormones can also bring about a reduction in sex drive and cause the testicles to shrink.
Feeling confused. Feelings of confusion can arise when the levels of ammonia in the bloodstream become too high. This ammonia is normally removed from the bloodstream by a healthy liver, but when liver health is compromised, the sufferer may experience feelings of confusion.
Feelings of lethargy. This is also potentially brought about by the increase in blood ammonia.
Decrease in muscle tissue. A compromised liver will also reduce its production of proteins, and this can lead to the wasting of muscle.
Swollen stomach veins. Because blood pressure becomes increased with a cirrhotic liver, the blood flow to the liver can become compromised. This may result in a swelling to the veins around the stomach area.

N.B.: It’s important to note that all types of liver disease can cause cirrhosis (scarring of the liver), not just alcohol-related liver disease.

HEPATITIS B

Hepatitis B virus (HBV) is a viral infection carried in the blood causing inflammation (swelling) of the liver and potentially long term damage. The virus is transmitted by contact with an infected person’s blood or body fluids. Hepatitis B is vaccine preventable.

HBV is one of the world's most common and serious infectious diseases and the most common liver infection in the world, affecting more than 2 billion people worldwide.

*** HBV can survive more than a week in dried blood e.g.: blood stains on table tops and razor blades. ***

The average incubation period for hepatitis B is 40 to 160 days. Some people experience flu-like symptoms including sore throat, tiredness, joint pains and nausea. Acute infection can be severe and cause abdominal discomfort and jaundice. There is also a liver-damaging chronic state of hepatitis B that is infectious and may be asymptomatic (without symptoms). Some people with hepatitis B go on to develop cirrhosis or liver cancer.

Acute infectious hepatitis is a notifiable disease in England and Wales.

HEPATITIS C (HCV)

Hep C virus is mainly transmitted through contact with infected blood. Injecting drug use is the most important risk factor for infection within the UK. Those born or brought up in a country with a high prevalence of chronic hepatitis C are also at risk (especially those in Africa and Asia, including Egypt, China and Pakistan).

An estimated 5 out of 6 people with chronic hep C are unaware of their infection.

The World Health Organisation reports that approximately 3% of the world's population are infected with hepatitis C - 170 million are chronically infected and 3-4 million are newly infected each year.

The future burden on the NHS is estimated to reach up to £8 billion by the year 2030.

ABNORMAL METABOLISM OF FATS

Another of the prime symptoms of liver disease is the abnormal metabolism of fats, which can manifest itself in the following ways:

Elevated levels of LDL cholesterol and triglycerides, at the same time as decreased levels of HDL cholesterol.
Hypertension or blood pressure caused by your blood vessels becoming blocked by fatty deposits.
This can also potentially lead to stroke and heart attack.
Fatty tumors and lymphomas developing in the skin.
Significant weight gain that could lead to obesity.
Difficulty in losing weight, even though you may be dieting.
A sluggishly slow metabolism.
Bloated stomach.
The appearance of cellulite.
Developing a roll of fat around the upper abdomen.

The symptoms of liver disease can also be seen in relation to the digestive system and can include things like:

Haemorrhoids
Constipation
Indigestion and/or reflux.
The inability to tolerate alcohol.
The inability to tolerate fatty food.
Irritable bowel syndrome.
Gallstones.

The symptoms of liver disease that are associated with gallstones, include pain in the upper right quadrant of the abdomen; vomiting, (having eaten a fatty or greasy meal); and if the gallbladder itself becomes infected, this may also bring about a fever.

The symptoms of liver damage that relate to blood sugar include:

Developing a craving for sweets things.
Unstable levels of sugar in the blood, also known as hypoglycaemia.
The onset, in later life, of Type II Diabetes.

Poor liver health can also affect your immune system in which case the symptoms of liver disease to watch out for include:

Developing new allergies such as asthma, hay fever, and hives.
Developing skin rashes.
An increased incidence of autoimmune disease.
Developing fibromyalgia.
An increase in the incidence of viral and bacterial infections.

Spot the symptoms of liver damage and give your liver the chance to recover. The continuing health of your liver is essential for a healthy lifestyle. The power of the liver to heal itself from many diseases brought about by alcoholic or non-alcoholic fatty liver is quite amazing; provided that the disease is spotted early; so knowing what the potential symptoms of liver disease are, as discussed above, and keeping a watchful eye out for them, is absolutely crucial.

Knowing how to recognise the symptoms of liver disease can save your life.