The liver is the second largest organ in the body. It plays an important role in food digestion, energy storage, removal of toxins and production of numerous substances that mediate vital body functions including blood clotting, immunity and homeostasis.
A liver disease which is also known as the hepatic disease can be inherited through genes, such as Wilson disease and hemochromatosis, but this is rare. More frequently liver disease is caused by non-inherited or acquired causes. The commonest cause for liver disease at present is the non-alcoholic fatty liver (NAFLD) which is usually due to being overweight and diseases like diabetes mellitus. Other causes of liver damage may be caused by viruses such as Hepatitis A, B and C as well as diseases caused by alcohol, drug or toxins. Over time, the persistent liver injury caused by these diseases can lead to liver scarring or cirrhosis which can lead to liver failure and death. Apart from these, tumours can arise within the liver and infiltrate other organs.
Liver disease can present in numerous ways. They may present suddenly with acute liver failure which is a life-threatening condition. On the other hand, most liver diseases present insidiously. While the liver disease does not always cause noticeable symptoms and signs, if they do occur, they may include yellowish discolouration of the body (Jaundice), itching, abdominal pain and swelling, loss of appetite, fatigue, nausea or vomiting, dark urine, pale stools, tendency to bruise easily and altered level of consciousness.
Evaluation of liver diseases usually starts with blood investigations which include full blood count, liver enzymes, bilirubin, albumin and coagulation studies. Further investigations will be decided by the clinician depending on clinical evaluation. These include numerous blood serological tests and radiological investigations such as ultrasound scans, CT and MRI studies. Infrequently biopsies from the liver would be sought to make the diagnosis.