Benign Liver Diseases: An Overview

Introduction:

The liver is the largest organ of the human body with regenerative properties. Unfortunately, some of the common diseases associated with the liver are heart decompensation, alcohol-induced liver cirrhosis, and hepatic infections.

What Are Some of the Basic Injuries Damaging the Structure of the Liver?

The liver is one of the most vulnerable organs of the human body. Hence, any damage to it affects the metabolic activity of other organs. Some of the common injuries seen in the liver are:

• Inflammation: The swelling of liver cells is also known as hepatitis. These hepatocyte cells destroy, and scavenger macrophages engulf the dead remains. Other factors, like foreign body infections to liver cells, can also lead to an inflammatory reaction.

• Degeneration: Destruction of hepatic cells due to toxins can lead to liver degeneration. It gives a swollen, diffuse, and foamy appearance. In addition, the deposition of toxins such as fat, also known as steatosis, including iron, copper, and retained biliary hepatocytes, can cause degeneration of liver cells.

• Cell Death: Certain isolated hepatic cells undergo cell death via apoptosis. These cells become shrunken, eosinophilic, and gradually raptures. Injury to the liver can also lead to cell death or necrosis.

• Fibrosis: As a result of liver injury, fibrous tissue deposition is seen in the hepatic cells. Such deposition of collagen interferes with blood flow and cellular diffusion functions. Most of the time, liver injury caused due to fibrosis has irreversible after effects.

• Cirrhosis: Injury caused to the parenchymal cells of the liver leads to liver cirrhosis. This can be due to excessive fat deposition in alcoholic and non-alcoholic individuals. In alcoholic patients, fat deposition does not alter the position of the nucleus and is known as microvesicular steatosis. In pregnant women, excessive fat deposition leads to Reye syndrome. It is commonly seen during the third trimester. In obese or diabetic, or chronic alcoholic patients, the nucleus of hepatic cells undergoes displacement. This is known as macrovesicular steatosis.

What Are the Symptoms of Liver Disorders?

Liver dysfunction rarely shows symptoms. If exhibited, they are:

• Fatigue.

• Loss of appetite.

• Weight loss.

• Dark urine.

• Pale stool.

• Vomiting and nauseating.

• Icterus of eyes or yellow-colored sclera.

• Pale skin texture.

• Abdominal pain.

• Ascites or swelling of the abdomen.

• Swelling of the legs and ankles.

• Tendency to bruise easily.

What Causes Liver Diseases?

The liver disease could be a multifactorial or locally induced lesion. Some of the causes are:

• Infections: Viral infections can be caused by contaminated food or the spread of infection, causing damage to the liver cells. For example, Hepatitis A, B, and C infections.

• Genetic: Certain liver conditions are inherited, like Wilson disease and hemochromatosis.

• Weakened Immunity: Poor immune system can kill its own cells, also known as autoimmune liver disease. For example, primary biliary cholangitis and autoimmune hepatitis.

• Toxins: Consumption of toxins like alcohol and other systemic disorders like diabetes and obesity causing fat deposition can lead to liver dysfunctions.

• Tumors: Pathological conditions can be acute or chronic. In malignant conditions, tumors can be life-threatening due to the abnormal multiplication of cells inducing cancer.

What Is Cholestasis?

Excessive bile production can lead to inflammation of liver cells, also known as cholestasis. This can also cause jaundice. The plasma bile acids are elevated, leading to cholesterol deposition or hyperlipidemia. During the lab investigation procedure, the serum alkaline phosphatase shows high values.

What Causes Jaundice?

Increased production of unconjugated bilirubin and bilirubin glucuronides leads to their deposition in tissues. This leads to yellow discoloration of excreta like urine or icterus seen in the eyes. In newborn infants, the hemolytic disease leads to jaundice.

The normal serum bilirubin levels are 0.3 to 1.2 mg/dL. Among the various causes of jaundice are hemolytic anemia, hepatitis, and obstruction of bile flow.

What Is Liver Cirrhosis?

Diseases caused due to hyperbiliary production leads to liver cirrhosis. This could be due to alcohol-induced or non-alcoholic individuals. Liver cirrhosis is considered to be an end-stage condition. Scarring of liver tissue does not cause cirrhosis. Instead, diseases of the liver are caused due to cell death and fibrosis of tissue. Liver cirrhosis is manifested as weight loss, anorexia, and weakness. In rare cases, the development of hepatocellular carcinoma occurs. Alcohol-induced liver cirrhosis constitutes about 60 to 70 % of the population. Factors leading to non-alcoholic-induced liver cirrhosis are viral hepatitis, biliary disease, genetic predisposition, syphilis, drug-induced cirrhosis, and cryptogenic cirrhosis.

What Is Ascites?

It is a hepatic disorder leading to excessive fluid deposition in the peritoneal cavity. It is clinically detectable when the fluid accumulates in the peritoneal cavity and extends beyond 500 mL. Individuals suffering from ascites have enlarged abdomens. The liquid can seep into surrounding tissues like hydrothorax. Sinusoidal hypertension caused by excessive fluid in conditions like hypoalbuminemia can cause ascites.

What Are the Risk Factors for Liver Disease?

Certain factors can aggregate liver dysfunction. Such as:

• Unhealthy lifestyle.

• Continuing with adverse habits like intaking alcohol.

• Uncontrolled diabetes.

• Multiple system failures.

• Intaking toxins like lead, copper, rat poison, and farm pesticides can lead to liver toxicity and cell death.

How Is Liver Disease Diagnosed?

Tests conducted to check for liver disease are:

• Liver Function Test (LFT): The function of liver enzymes is checked, and serum creatine level is monitored. Normal creatinine level is 0.6 to 1.3mg/dL.

• Imaging Tests: Tests conducted to check the internal structure such as ultrasound, magnetic resonance imaging (MRI), and computed tomography (CT).

• Biopsy: A tissue sample is collected using fine needle aspiration to detect any malignancies.

How To Manage or Treat Liver Disease?

Depending on the progression and severity, liver disorders can be managed. Such as:

• Quitting Adverse Habits: Cessation of alcohol and controlling the body weight in obese patients.

• Medications: Taking medicines for fatty liver and infections like hepatitis can control and reverse the disease.

• Liver Transplant: When the disease progresses to complete liver failure, a liver transplant from a suitable donor is advised.

Conclusion:

The liver has the largest functional activity in the human body with the regenerative property. In chronic liver-damaged patients, where removal of 75 percent of the liver still leads to its regeneration process. However, chronic liver conditions have serious consequences leading to death.