Liver Pathophysiology - All You Need to Know

What Is the Liver?

The liver is a large organ present on the abdomen's right side. It is brown and is essential for digesting food and getting rid of toxins from the body.

What Is Liver Pathophysiology?

The combination of pathology and physiology is called liver pathophysiology. Pathology studies the cause and effect of a disease or an injury. Physiology deals with the study of the way the organ functions. Liver pathophysiology is the study of functional changes that occur due to an injury or a liver disease. Liver diseases can be inherited from parents or close family members, or they can also be caused by various other factors such as viruses, alcohol use, and obesity. Some conditions damage the liver when left untreated, leading to scarring, inflammation, and liver failure. So recognizing it early and treating it will help in healing the liver.

What Are the Symptoms of an Abnormal or Diseased Liver?

Liver disease, most of the time, does not show any symptoms. However, if it does, it includes the following:

• Yellowish discoloration of the skin and eyes, which is also known as jaundice.

• Abdominal pain and swelling.

• Swelling in the leg and ankles.

• Dark-colored urine.

• Itchy skin.

• Pale-colored stool.

• Chronic fatigue (a feeling of tiredness over a long period).

• Nausea.

• Vomiting.

• Loss of appetite.

• Tendency to get bruised easily.

What Can Be the Causes of Liver Diseases?

Liver diseases can be caused due to various reasons. Some of the causes include

• Infections: Viruses and parasites can cause infections in the liver, which can reduce its function and cause inflammation. Viruses cause liver damage by spreading through blood or semen, contaminated food or water, and coming in close contact with someone who has already been infected. Hepatitis is the most frequently occurring infection of the liver. It is classified into hepatitis A, B, and C.

• Hepatitis A Virus: It can be present in the stool or blood of someone with that virus. It spreads through close contact with someone infected with the virus. The various modes through which a person comes in close contact are the following:

• Taking care of someone already infected with the virus.

• Physical contact, like sexual intercourse with a person who is infected with the virus.

• A person can become infected by eating food prepared by someone who has not washed their hands properly after defecating or drinking infected water.

• Hepatitis B Virus: It is caused when someone comes in close contact with the blood or fluids of a person infected by the hepatitis B virus. The incubation period for the hepatitis B virus ranges between 60 to 150 days. However, not everyone with the hepatitis B virus will experience those symptoms.

• Hepatitis C Virus: It is also transmitted in the same way as the hepatitis B virus.

• Autoimmune Hepatitis: The liver's inflammation occurs when the body's immune system turns against the liver cells.

• Primary Biliary Cholangitis: It is a chronic condition in which the bile ducts present in the liver are slowly destroyed.

• Primary Sclerosing Cholangitis: It is also a long-term disease in which the bile ducts present inside and outside of the liver get inflamed and scarred, which eventually gets narrowed and obstructed. When this happens, bile accumulates in the liver, causing further damage.

• Genetics: Inheriting an abnormal gene from one or both parents can cause substances to build up in the liver, resulting in liver damage. Some examples of genetic liver diseases include:

1. Hemochromatosis: It is a condition that causes too much iron to get built up in the body, where the body absorbs excessive amounts of iron from the food an individual eats.

2. Wilson's Disease: It is a rare genetic disorder of copper metabolism. It is characterized by the accumulation of copper in the hepatocytes (liver cells).

3. Alpha 1 Antitrypsin Deficiency: A genetic disorder raises the risk of liver disease. It is a protein that protects the lungs. The liver produces this protein. If these proteins are not in the correct form, they get stuck in the liver and will not reach the lungs. This condition can lead to cirrhosis (scarring) of the liver.

• Cancer is a disease in which the cells of the body grow uncontrollably and advance to other parts of the body. The conditions which can occur in the liver include:

1. Liver Cancer: This type of cancer originates in the liver cells. Hepatocellular carcinoma is the most common type of liver cancer.

2. Bile Duct Cancer: It is otherwise called cholangiocarcinoma. This cancer forms in the bile ducts, which are thin tubes that carry the digestive liquid called bile. The gall bladder and the small intestine are connected to the liver via the bile duct.

3. Liver Adenoma: It is also called hepatocellular adenomas. It is a rare but benign (not cancerous) epithelial tumor of the liver frequently associated with contraceptives.

Some other causes of liver diseases include:

• Chronic Alcohol Abuse: Intake of alcohol over prolonged periods can lead to liver damage.

• Fat Accumulation in the Liver: Excessive fat storage can cause this condition. A healthy liver contains small amounts of fat. It becomes a problem when the fat weighs 5 % to 10 % of the liver weight. It can damage the liver over time, eventually leading to liver cirrhosis.

• Certain Over-the-Counter Medications: Some over-the-counter medications like Acetaminophen and nonsteroidal anti-inflammatory drugs can cause toxic liver disease leading to liver failure.

What Are the Risk Factors of Liver Disease?

The risk factors of liver disease include:

• Heavy alcohol use.

• Obesity.

• Type 2 diabetes.

• Tattoo or body piercings.

• Exposure to certain medications or toxins.

• Family history of liver disease.

• Exposure to bodily fluids of other people.

What Are the Preventive Measures That Can Be Taken to Prevent Liver Disease?

• Consume Moderate Amounts of Alcohol: In healthy adults, one peg a day for women and up to two pegs for men is considered moderate.

• Avoid Risky Activities: Use a condom during sexual intercourse. If the patient has tattoos or body piercings, the individual should be picky about cleanliness when selecting the tattoo parlor. Avoid sharing needles for any injections.

• Get Vaccinated: If the patient is at an increased risk of getting hepatitis, the patient should consult the doctor to get the vaccinations done.

• Use Medications Only When Necessary: Take medications only when needed and at recommended doses. Avoid taking drugs and alcohol at the same time. Consult a doctor before using any over-the-counter drugs or herbal supplements because unnecessary use of medications can damage the liver.

• Maintain Good Hygiene: Make sure to wash your hands more frequently and practice brushing teeth at least twice daily.

• Maintain a Healthy Weight: Obesity can cause non-alcoholic fatty liver disease.

What Diagnostic Methods Can Be Employed to Detect These Conditions?

1. Blood Test: A set of liver function tests can be used to diagnose liver diseases.

2. Imaging Tests:

• Ultrasound uses sound waves to obtain images of the structures within the body.

• Computed Tomography uses specialized x-ray equipment to create detailed images of the body.

• Magnetic Resonance Imaging uses magnetic fields and computer-generated radio waves to create detailed images and organs within the body.

3. Liver Biopsy (checking the tissue sample):

Removing a tissue sample from the liver can help diagnose liver disease and help look for signs of liver damage. A liver biopsy is carried out using an extended needle pushed through the skin to take a tissue sample which will then be sent to the lab for examination.

Conclusion

Thus, the treatment for liver disease depends on the diagnosis. Some liver problems can be addressed through small lifestyle modifications like cessation of alcohol use, losing weight, and monitoring liver functions. Medications or surgery can treat other liver problems, such as liver failure necessitating a liver transplant.