What Is Hepatic Liver Disease

Types Of Hepatorenal Syndrome

Hepatorenal syndrome progression may be slow or rapid . Type I disease frequently is accompanied by rapidly progressive liver failure. Hemodialysis offers temporary support for such patients. These individuals are salvaged only by performance of liver transplantation. Exceptions to this rule are the patients with fulminant hepatic failure or severe alcoholic hepatitis who spontaneously recover liver and kidney function. In type II hepatorenal syndrome, patients may have stable or slowly progressive renal insufficiency. Many such patients develop ascites that is resistant to management with diuretics.

What Are The Symptoms Of Cirrhosis

The symptoms of cirrhosis depend on the stage of your disease. In the beginning stages, you may not have any symptoms. If you do have symptoms, some are general and could easily be mistaken for symptoms of many other diseases and illnesses.

Early symptoms and signs of cirrhosis include:

• Loss of appetite.

• Redness in the palms of your hands.
• Spider-like blood vessels that surround small, red spots on your skin .
• In men: loss of sex drive, enlarged breasts , shrunken testicles.
• In women: premature menopause .

Symptoms Of Fatty Liver Disease

With ALD and NAFLD, there are usually no symptoms. Some people may have signs such as tiredness or pain in the upper right side of the belly where your liver is.

If you have NASH or get cirrhosis, you may have symptoms such as:

• Have chronic viral hepatitis, especially hepatitis C
• Have genes that make you more likely to get it
• Are an African-American or Hispanic male
• Age — the older you are, the more likely it becomes.

The reason why some people with NAFLD have simple fatty liver and others get NASH isnât known. Genes may be a reason. NAFLD or NASH is more likely if:

• Youâre overweight or obese
• Your body doesnât respond to insulin as it should or if you have type 2 diabetes
• You have high levels of triglycerides or âbadâ cholesterol, or low levels of âgoodâ cholesterol

There are also some less common reasons why you may get NAFLD or NASH. They include:

• Medical conditions that affect how your body uses or stores fat
• Hepatitis C or other infections
• Taking certain medicines such as glucocorticoids, methotrexate , synthetic estrogen, tamoxifen , and others
• Gallbladder removal. Some people who have surgery to remove their gallbladder are more likely to have NAFLD.

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What Is Liver Encephalopathy

Liver encephalopathy is the deterioration of brain function and damage to the nervous system due to toxic substances building up in the blood, which are normally removed by the liver. Liver encephalopathy is also called portal-systemic encephalopathy, hepatic encephalopathy, or hepatic coma. Symptoms may include:

• Impaired consciousness

Why Is Your Liver Important

The liver is a vital organ responsible for many functions in your body. It is located under your rib cage on your right side. Some of the jobs the liver does include:

• Giving you energy
• Processing what you eat and drink into nutrients your body can use
• Filtering out harmful substances from your blood

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What Is Cirrhosis Of The Liver

Cirrhosis is a late-stage liver disease in which healthy liver tissue is replaced with scar tissue and the liver is permanently damaged. Scar tissue keeps your liver from working properly.

Many types of liver diseases and conditions injure healthy liver cells, causing cell death and inflammation. This is followed by cell repair and finally tissue scarring as a result of the repair process.

The scar tissue blocks the flow of blood through the liver and slows the livers ability to process nutrients, hormones, drugs and natural toxins . It also reduces the production of proteins and other substances made by the liver. Cirrhosis eventually keeps the liver from working properly. Late-stage cirrhosis is life-threatening.

How Common Is Cirrhosis

Scientists estimate that cirrhosis of the liver affects about one in 400 adults in the U.S. It affects about 1 in 200 adults age 45 to 54, the age group most commonly affected by cirrhosis. Cirrhosis causes about 26,000 deaths each year in the U.S. and is the seventh leading cause of death in the U.S. among adults 25 to 64 years of age.

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What Is Liver Disease

Your liver is your bodys second-largest organ . It sits just under your ribcage on the right side and is about the size of a football. The liver separates nutrients and waste as they move through your digestive system. It also produces bile, a substance that carries toxins out of your body and aids in digestion.

The term liver disease refers to any of several conditions that can affect and damage your liver. Over time, liver disease can cause cirrhosis . As more scar tissue replaces healthy liver tissue, the liver can no longer function properly. Left untreated, liver disease can lead to liver failure and liver cancer.

What Causes Liver Failure In Children

Liver failure can happen to children of any age. The liver can fail due to many different types of injury or disease. Often, a cause cannot even be found. Some known causes of acute liver failure include:

• Viruses, such as herpes , Epstein-Barr virus , cytomegalovirus or hepatitis A, B and E. There are many other viruses that can cause acute liver failure, including probably some that have not been discovered or described yet.
• Inherited metabolic disorders, such as galactosemia, tyrosinemia, hereditary fructose intolerance , Wilson disease and mitochondrial diseases
• Toxins, such as certain wild mushrooms, rat poison, insect killer, weed killer and some solvents or cleaners.
• Certain medicines, such as erythromycin, valproic acid or too much acetaminophen
• Immune system problems, such as
• Low blood flow to the liver, such as in heart failure, shock or a blocked blood vessel

Chronic liver failure mostly happens after a child has developed cirrhosis , for example from some of the diseases listed above. Other possible causes include:

• Chronic hepatitis, such as hepatitis C, autoimmune hepatitis, nonalcoholic steatohepatitis
• Inherited conditions, such as hemochromatosis , alpha-1 antitrypsin deficiency or cystic fibrosis
• Heart problems that reduce blood supply to the liver or lead to a backup of blood flow in the liver
• Diseases of the bile ducts, such as biliary atresia or sclerosing cholangitis

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How Is Hepatic Lipidosis Diagnosed

Diagnosis of hepatic lipidosis is made from blood tests that demonstrate poor liver function and from a liver biopsy or fine needle aspirate. The latter may be performed during an exploratory surgery or by inserting a needle into the liver through the skin. The liver sample is sent to a veterinary pathologist for analysis. A cat with hepatic lipidosis will have a large amount of fat in and among the liver cells. Other diagnostic tests may be performed in an effort to determine why the cat originally stopped eating. If the cause for anorexia is treatable or resolved, the prognosis is reasonably good.

“A cat with hepatic lipidosis will have a large amount of fat in and among the liver cells.”

In some cases, a presumed diagnosis may be made without a liver biopsy. If a cats history, clinical signs, and bloodwork are strongly suggestive of the condition and the cat is too unstable to obtain a biopsy, a presumed diagnosis may be considered adequate to proceed with treatment. Further tests may be required however, if your cat develops additional clinical signs or does not follow the expected course of the disease.

What Causes Fatty Liver Disease

Some people get fatty liver disease without having any pre-existing conditions. But these risk factors make you more likely to develop it:

• Having Type 2 diabetes or insulin resistance.
• Having metabolic syndrome .
• Taking certain prescription medications, such as amiodarone , diltiazem , tamoxifen or steroids.

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How Do I Take Care Of Myself

Being confronted with a diagnosis of HE can be overwhelming. HE will affect your quality of life and will impact your whole family. Because HE can affect your memory, concentration and thinking ability, its best to discuss your illness with your family and whenever possible bring a family member with you to your appointments. Keep in mind that sometimes the changes or symptoms of HE are so minimal that your family or friends might notice them before you do. So its good to have someone with you who can help fill in the gaps about your symptoms and medical history.

Taking care of your brain during your illness is extremely important. Some of the symptoms of HE, like anxiety, confusion and forgetfulness may interfere with your ability to keep up and follow your treatment regimen, and you may need to ask a family member to help you. You may also need help communicating with your healthcare providers, keeping your medical appointments, getting the necessary lab tests and eating an appropriate diet.

One thing you can do to stay as healthy as possible is to eat a nutritious diet. Talk to your healthcare provider about specific diet recommendations based on your needs and response to treatment.

Some specific things to keep in mind include the following:

Hepatic Dysfunction And Liver Failure

Hepatic dysfunction is associated with a variety of abnormalities including metabolic abnormalities, malabsorption, maldigestion, anorexia, and early satiety due to ascites. Dietary restrictions also can contribute to malnutrition.

Protein intake in patients with stable chronic liver disease depends on the patients nutritional status and protein tolerance. Nutritionally depleted patients can require as much protein as 1.5 g/kg estimated dry weight. In a minority of patients who have protein-sensitive hepatic encephalopathy, protein intake might need to be decreased to 0.5 to 0.7 g/kg/day and gradually increased to 1.0 to 1.5 g/kg/day, as tolerated. These patients have deranged plasma amino acid profiles, with increased concentrations of aromatic amino acids and methionine and decreased branched-chain amino acids . Randomized, controlled trials that provided parenteral or enteral formulas enriched with branched-chain amino acids have been inconsistent and have had results including no benefit, improved morbidity, no change in mortality, and improvement in encephalopathy. These specialty products should be reserved for patients with disabling encephalopathy who do not tolerate standard proteins and have not responded to other therapies, such as lactulose or neomycin administration.

LOIS L. BREADY M.D., in, 2007

Richard J. Martin MBBS, FRACP, inFanaroff and Martin’s Neonatal-Perinatal Medicine, 2020

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Can Cirrhosis Be Reversed

Generally no. If you have been told you have cirrhosis, you have a late-stage liver disease and the damage that is already done is permanent. There are many liver diseases and complications of liver diseases that can lead to cirrhosis. If your liver disease or complication is caught early and successfully managed, it may be possible to slow or stop the progression of disease.

What Are Esophageal Varices

Esophageal varices are dilated blood vessels within the walls of the lower part of the esophagus that are prone to bleeding. They can appear in people with severe liver disease. A diseased liver can cause portal hypertension, which is high blood pressure in the portal vein. The portal vein supplies the liver with blood. Over time, this pressure causes blood vessels to grow, called collateral blood vessels. These vessels act as channels to divert the blood under high pressure. The extra pressure in these vessels causes them to dilate and become tortuous. These vessels can eventually reach the lower esophagus and stomach and are prone to rupture. The rupture can lead to significant blood loss from vomiting or from lost blood passing through the gastrointestinal tract. Symptoms of esophageal varices may include:

• Painless vomiting of blood
• Black, tarry or bloody stools
• Anemia. A condition that indicates a low red blood cell count.

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Causes Associated With Chronic Liver Failure

Chronic liver failure is the result of long-term inflammation that leads to scarring of healthy liver tissues . The American Liver Foundation explains that when scar tissue takes over the majority of healthy liver tissues, it becomes known as cirrhosis.

A of hepatic cirrhosis notes that, while some of the triggers of hepatic inflammation are linked to underlying health conditions, others can be more difficult to identify. These may include the following:

Hepatitis C infection

If you have hepatitis C, you have a higher risk of developing chronic liver failure or cirrhosis.

This virus often goes undetected, as symptoms are not common. Emory Healthcare reports that, in some cases, people experience significant liver damage before knowing they have a hepatitis C infection.

According to the Centers for Disease Control and Prevention , 5 to 25 percent of people in the United States with chronic hepatitis C develop cirrhosis within 10 to 20 years. The ALF notes that its the most common cause of cirrhosis in the country.

The hepatitis C virus is spread through the blood. If the blood from a person with the infection enters your body, you can catch it. Needle sharing and using unsanitized needles for tattoos or piercings can spread hepatitis C.

Alcohol overuse

Another common cause of cirrhosis and subsequent chronic liver failure is harmful use of alcohol.

Nonalcoholic fatty liver disease

• edema, or fluid buildup in the legs
• ascites, or fluid buildup in the abdomen

Whats The Life Expectancy For People With Cirrhosis

Life expectancy depends on several factors including the cause and severity of your cirrhosis, your response to treatments, the presence of cirrhosis complications, your age and any other existing general health problems. Ask your liver specialist about your life expectancy since every person is unique, with unique overall health issues and specific liver health issues.

If your cirrhosis is advanced, liver transplantation may be an option. You and your doctors will discuss if this is an option for you.

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Causes Associated With Acute Liver Failure

Acute liver failure, also known as fulminant hepatic failure, can occur even if you dont have a preexisting liver disease.

The most common cause of acute liver failure in the United States is acetaminophen overdose.

Acetaminophen is an over-the-counter drug. Always follow the recommended dosage on the label. If you think you may have overdosed, contact a healthcare professional immediately.

Acute liver failure may also be caused by:

• certain prescription medicines

Acute liver failure can be genetic, passed along by genes you inherited from one or both of your parents. If you have a genetic liver disease, youre more susceptible to liver failure.

Symptoms Of Hepatic Encephalopathy

Symptoms are those of impaired brain function, especially reduced alertness and confusion. In the earliest stages, subtle changes appear in logical thinking, personality, and behavior. The person’s mood may change, and judgment may be impaired. Normal sleep patterns may be disturbed. People may become depressed, anxious, or irritable. They may have trouble concentrating.

At any stage of encephalopathy, the person’s breath may have a musty sweet odor.

As the disorder progresses, people cannot hold their hands steady when they stretch out their arms, resulting in a crude flapping motion of the hands . Their muscles may jerk involuntarily or after people are exposed to a sudden noise, light, a movement, or another stimulus. This jerking is called myoclonus Myoclonus Myoclonus refers to quick, lightning-like jerks of a muscle or a group of muscles. Myoclonus may occur normally … read more . Also, people usually become drowsy and confused, and movements and speech become sluggish. Disorientation is common. Less often, people with encephalopathy become agitated and excited. Eventually, as liver function continues to deteriorate, they may lose consciousness and lapse into a coma. Coma often leads to death, despite treatment.

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What Are The Complications Of Liver Disease

Some types of liver disease can increase your risk of developing liver cancer. Others, if left untreated, continue to damage your liver. Cirrhosis develops.

Over time, a damaged liver wont have enough healthy tissue to function. Liver disease that isnt treated can eventually lead to liver failure.

What Are The General Symptoms

Liver disease symptoms vary, depending on the underlying cause. Its also possible for someone to have liver disease and not have any symptoms at all. However, Hepatitis NSW says that a few general symptoms can indicate some kind of severe liver damage.

These include:

Many conditions can affect your liver. Heres a look at some of the main ones.

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Search For A Clinical Trial

Clinical trials are research studies that test how well new medical approaches work in people. Before an experimental treatment can be tested on human subjects in a clinical trial, it must have shown benefit in laboratory testing or animal research studies. The most promising treatments are then moved into clinical trials, with the goal of identifying new ways to safely and effectively prevent, screen for, diagnose, or treat a disease.

Speak with your doctor about the ongoing progress and results of these trials to get the most up-to-date information on new treatments. Participating in a clinical trial is a great way to contribute to curing, preventing and treating liver disease and its complications.

Start your search here to find clinical trials that need people like you.

This information was made possible, in part, with the generous support of, and in collaboration with, Alnylam Pharmaceuticals, Inc. The content was reviewed and approved by ALFs National Medical Advisory Committee in December 2020.