Conditions

Chronic Liver Disease

What is chronic liver disease?

Chronic liver diseases (CLDs) are conditions characterized by elevated liver enzymes, which cause inflammation or scarring to the liver. At advanced stages, patients may progress to cirrhosis, which is defined as irreversible damage of the liver due to scarring. This can occur even in patients who do not drink alcohol in excess. With cirrhosis comes the risk for complications including portal hypertension, accumulation of fluid in the abdomen and liver cancer.

Patients with liver disease require an expert multidisciplinary team to understand and manage the condition to achieve the best outcome. Examples of chronic liver diseases include viral hepatitis (hepatitis A, B, C), autoimmune liver disease (autoimmune hepatitis, primary biliary cholangitis), genetic disorders (hemochromatosis, Wilson’s disease) and fatty liver disease. The latter includes both non-alcoholic fatty liver disease (NAFLD), and non-alcoholic steatohepatitis (NASH).

What are the symptoms of chronic liver disease?

Symptoms of chronic liver disease are many and can be quite varied. These can include fatigue, nausea, vomiting, jaundice, rashes, joint pains, or the patient may have no symptoms. Patients with advanced liver disease or cirrhosis may have ascites (fluid in the belly), jaundice, upper GI bleeding and confusion or difficulty with thought processing (a condition known as hepatic encephalopathy).

How are chronic liver diseases diagnosed?

To diagnose liver disease, your gastroenterologist will review your symptoms and medical history. They will complete a comprehensive physical exam and may use blood tests, a liver biopsy or imaging procedures like CT scans, MRIs or ultrasounds to confirm a diagnosis and develop a treatment plan for you. A newer type of ultrasound, known as a Fibroscan, has become a very useful tool for determining the severity of liver disease with non-invasive technology.

How are chronic liver diseases treated?

The goal of treatment is to restore function to the liver. For mild disease, dietary management and medications are the mainstays of most therapies. For viral hepatitis, specific antiviral therapies are quite effective. For autoimmune hepatitis, a combination of oral medications can control disease. Water pills (diuretics) may be needed to control fluid overload. Another technique for fluid management is paracentesis, which is removal of fluid from the abdomen. Upper endoscopy, or EGD, is needed to screen for varicose veins in the esophagus which can lead to life-threatening GI bleeding episodes. If liver disease is severe, or liver failure occurs, patients may be referred to a transplant center for transplant consultation.