Chronic liver disease
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] ; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
Overview
Chronic liver disease is a liver disease of slow process and persisting over a long period of time, resulting in a progressive destruction of the liver.
Causes
Common Causes
- Cirrhosis
- Alcoholic liver disease
- Hepatitis C
- Hepatitis B
- Autoimmune hepatitis
- Portal hypertension
- Hemochromatosis
- Wilson's disease
- Gaucher disease
- Hepatoma
- Primary biliary cirrhosis
- Primary sclerosing cholangitis
- Sarcoidosis
- Zellweger syndrome
Causes by Organ System
| Cardiovascular | Right heart failure |
| Chemical / poisoning | No underlying causes |
| Dermatologic | No underlying causes |
| Drug Side Effect | Methotrexate, Nitrofurantoin |
| Ear Nose Throat | No underlying causes |
| Endocrine | No underlying causes |
| Environmental | No underlying causes |
| Gastroenterologic | Autoimmune hepatitis, Cirrhosis, Hepatitis B , Hepatitis C, Hepatoma, Non-alcoholic fatty liver disease, Portal hypertension, Primary biliary cirrhosis , Primary sclerosing cholangitis, Sarcoidosis, Wilson's disease |
| Genetic | Gaucher disease, Hemochromatosis, Sarcoidosis, Wilson's disease, Zellweger syndrome |
| Hematologic | No underlying causes |
| Iatrogenic | No underlying causes |
| Infectious Disease | Cytomegalovirus (CMV), Epstein Barr virus (EBV), Hepatitis B , Hepatitis C |
| Musculoskeletal / Ortho | No underlying causes |
| Neurologic | Wilson's disease |
| Nutritional / Metabolic | Gaucher disease, Hemochromatosis, Zellweger syndrome |
| Obstetric/Gynecologic | No underlying causes |
| Oncologic | Hepatoma |
| Opthalmologic | Wilson's disease |
| Overdose / Toxicity | No underlying causes |
| Psychiatric | No underlying causes |
| Pulmonary | Sarcoidosis |
| Renal / Electrolyte | No underlying causes |
| Rheum / Immune / Allergy | Autoimmune hepatitis, Primary biliary cirrhosis , Primary sclerosing cholangitis, Sarcoidosis |
| Sexual | No underlying causes |
| Trauma | No underlying causes |
| Urologic | No underlying causes |
| Dental | No underlying causes |
| Miscellaneous | Alcoholic liver disease |
Causes in Alphabetical Order
- Alcoholic liver disease
- Autoimmune hepatitis
- Cirrhosis
- Cytomegalovirus (CMV)
- Epstein Barr virus (EBV)
- Gaucher disease
- Hemochromatosis
- Hepatitis B
- Hepatitis C
- Hepatoma
- Metabolic
- Methotrexate
- Nitrofurantoin
- Non-alcoholic fatty liver disease
- Portal hypertension
- Primary biliary cirrhosis
- Primary sclerosing cholangitis
- Right heart failure
- Sarcoidosis
- Wilson's disease
- Zellweger syndrome
Risk Factors
- Health care professionals who are exposed to body fluids and infected blood
- Individuals who get multiple tattoos and body piercing
- Certain prescription medications
- Excessive alcohol use
- Having high levels of fat in the blood
- Sharing infected needle and syringes
- Having unprotected sex and multiple sex partners
- Working with toxic chemicals without wearing safety clothes
Natural History, Complications, Prognosis
Complications
- Portal hypertension
- Hypoalbuminaemia
- Coagulopathy
- Hepatopulmonary syndrome
- Hepatorenal syndrome
- Encephalopathy
- Hepatocellular carcinoma (also called hepatoma)
Prognosis
Prognosis is assessed by
Diagnosis
Physical examination
Skin
- Increased pigmentation of the skin
- Tattoos
- Scratch marks
Eyes
Heart
- Signs of right heart failure
Lungs
Abdomen
- Hepatomegaly
- Ascites
- Spider nevi (angiomata)
Extremities
Neurologic
- Peripheral neuropathy
- Cerebellar signs
Other
Treatment
The treatment of chronic liver disease depends on the cause. While some conditions may be treated with medications, others may require surgery or a transplant. Transplant is required when the liver fails and there is no other alternative [1]. Because many chronic liver disorders have no cure, many people have been turning to alternative health care. Herbal supplements are widely used by many people with chronic liver disease[citation needed]. None of these herbs have ever been tested in randomized clinical trials and no one knows whether they work. Some common herbs known to be potentially harmful in liver disease include black cohosh, ma huang, chaparral, comfrey, germander, greater celandine, kava, mistletoe, pennyroyal, skull cap and valerian.
Prevention
Some chronic liver diseases cannot be prevented but one can reduce the risk by adopting the following measures:
- Do not drink excessive alcohol. Alcohol is one of the most common causes of chronic liver disease in North America.
- Avoid high risk behaviour. If you do use intravenous drugs, do not share needles or syringes. Never have sex without a condom with a stranger and avoid multiple sex partners. If you plan to have tattoos or have your body pierced, choose a place which has a reputation for cleanliness and safety.
- Get vaccinated against epatitis A and B. it is highly recommended that one get vaccinated against hepatitis B. This chronic infection is highly contagious and one of the complications is liver cancer.
- Do not use multiple medications or illicit drugs unwisely. Never mix alcohol with medications. Always talk to your physician about your medications and get your liver enzymes checked to make sure that the liver is functioning fine.
- If you have any member of the family of friend who is sick, avoid contact with blood or bodily fluids. Many infections can be transferred through body fluids include HIV, hepatitis and even herpes. Do not make it a habit of sharing personal care products with anyone, even household members.
- If you work in an environment where there are chemicals, wear a mask. Take protective measures when spraying weed killers, insecticides or using other toxic chemicals. If you work with hazardous chemicals, change clothes before you go home. If you work in the garden and use chemicals, wear long sleeve shirts, gloves and a hat.
- Eat healthy exercise and keep your weight down. Obesity is a well known cause of chronic fatty liver disease [2].
See Also
References
- ↑ Liver Disease Gastro.com - 27/01/2007/
- ↑ The Progression of Liver Disease American Liver Foundation - 27/01/2007/