What Causes Liver Damage?

Instructor: Amanda Robb
In this lesson we'll be looking at the main causes of liver damage. We'll go over infections of the liver, alcohol abuse, genetics, and cancer as the four main causes of liver damage.

What is the Liver?

Think about the organs in your abdomen that make up your digestive system. Which one do you think takes up the most space? Many people assume this is the stomach, since we often refer to our abdomen as our 'stomach'. However, you might be surprised to learn that it's the liver, the second largest organ in your body.

The liver is one of your largest organs
liver

The liver is often viewed as an accessory organ to the digestive system, but your liver is incredibly important! The liver does help with digestion, but it also removes toxins from your body, regulates metabolism and blood sugar, and helps clear out old red blood cells.

So what happens if your liver gets sick? Many times, it's able to repair itself. You can actually remove 2/3 of your liver and it will grow back! This regeneration is pretty amazing, but sometimes the liver can become damaged beyond its capacity for repair. In these cases, toxins don't get cleared from the body and can build up. Metabolism and digestion also suffer.

Today, we're going to look at the four major causes of liver damage: infections, alcohol, genetics, and cancer.

Infections

A drug user comes to your clinic complaining of abdominal pain, fever, nausea, and recently a yellow tingle to his skin, called 'jaundice'. These are telltale signs of liver inflammation, called hepatitis. Since your patient has been injecting drugs for many years, you decide to test for hepatitis C, one virus in a group that are a common cause of hepatitis.

These viruses attack the liver, damaging tissue and causing liver disfunction. Due to the liver's awesome healing powers, sometimes the body can fight off the virus on its own. However, in untreated cases, the viruses can severely damage the liver, eventually leading to liver failure.

There are five main types of hepatitis viruses: hepatitis A, B, C, D and E. Hepatitis B and C are especially harmful as they can develop into chronic conditions causing liver cirrhosis, or scarring of the liver that permanently inhibits its function. Unlike hepatitis B, hepatitis C has no vaccine. Although today hepatitis C is most common in drug users, prior to 1992, blood supplies were not adequately screened for hepatitis C in the United States, and infection through a blood transfusion or surgery was common.

Alcohol

Fahren comes into your clinic for a routine exam. She works in a marketing agency downtown and is chronically stressed by her clients and deadlines. She explains that at night she comes home and unwinds with a glass of wine but, when you press her she admits it's more like three glasses. She also drinks at client meetings, social events after work, and even more on the weekend. Concerned about Fahren's alcohol intake, you explain the risks associated with alcohol and alcoholic liver disease, where alcohol damages the liver.

Patients don't have to be alcoholics or even get drunk to get alcoholic liver disease. The biggest factor is heavy, chronic drinking. It's your liver's job to clear toxins (like alcohol) from the blood. When you drink too much, you put your liver into overdrive, causing alcoholic liver disease.

Chronic drinking can cause alcoholic liver disease
alcohol

In the earliest stages of alcoholic liver disease, patients develop fatty liver disease, where increased amounts of fats are deposited in the liver. These increased fats decrease liver function. Many heavy drinkers have fatty liver disease, although most don't have symptoms and may not even know that the liver damage is occurring.

Alcoholic hepatitis is a progression from fatty liver disease. More fat is deposited in the liver and is accompanied by inflammation of the liver, as well as visible symptoms like fever, nausea, jaundice, and abdominal pain. If alcoholic hepatitis is left untreated with further drinking it can develop into alcoholic cirrhosis, which causes scarring and extreme disruption of liver function and structure. This occurs in about 10-20% of heavy drinkers.

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