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Enlarged Liver: Causes, Symptoms, and Treatment

The liver is the largest gland present in the body and performs some of the most critical tasks to make it function smoothly. Enlarged liver, also known as hepatomegaly, is a consequence of some underlying health condition. This article will give you information regarding the possible causes, symptoms, and treatment of this condition.
Bidisha Mukherjee
Last Updated: Mar 19, 2018
The normal size of the liver depends on various parameters, such as age and sex. The liver grows to its complete size by age 15. Usually, males have a larger liver compared to females. The liver carries out several vital functions of the body. It is responsible for synthesizing cholesterol, fatty substances, and carbohydrate metabolism. It secretes an essential digestive juice called bile that helps in the breaking down of fats in the intestines to aid proper digestion. It also removes all the toxic substances that enter the body because of activities including drugs and alcohol consumption.
The normal size of the liver in an adult male body is 8-12 cm, while a female may have a size within the range of 6-10 cm. These values are considered normal when the technique known as percussion is used to measure the liver. 
Note: Please note that the normal values may differ depending upon the technique of measurement. Please check with your physician for the same.
An enlarged liver is not a disease in itself. However, it acts as a significant sign of some underlying health condition that has led an increased liver size. Most people do not even realize that they have an enlarged liver!
An enlarged liver or hepatomegaly, as it is medically termed, can have various causes that may not necessarily be related to the liver directly. The causes may include problems related to the heart, the immune system, illnesses like cancer, usage of certain herbal supplements, and liver-related diseases. Below is a list of some of the causes for hepatomegaly, listed according to the aforementioned categories.
Related to the Liver

☞ Cirrhosis: It is the eventual outcome of chronic liver disease causing the scarring of the liver, thereby hampering its functionality.
☞ Hepatitis: It is a viral infection in the liver caused by hepatitis A, B, or C viruses. However, it can also occur due to other reasons such as alcoholism, excessive intake of certain medications, bacterial infections, autoimmune disorders, etc.
☞ Alcoholic fatty liver disease: It is a result of excessive alcohol consumption that enables deposition of fatty substances in the liver. It can further aggravate to a condition known as alcoholic hepatitis.
☞ Nonalcoholic fatty liver disease: It occurs in people who do not drink alcohol at all, or drink moderately. People with problems like obesity, diabetes, high cholesterol levels, etc., are prone to this disease.
☞ Blockage in the bile duct or the gallbladder: The liver produces a fluid known as bile which is stored in the gallbladder and released during the digestion of fats present in food. Any obstruction in this process can cause liver damage.
☞ Tumors and cysts: Liver cysts are the pockets in the liver which are filled with fluid. Abnormal growth of tumors in the liver can either be malignant or benign in nature.
☞ Disorders: There are various disorders that enable accumulation of substances like fats, protein, copper, and iron in the liver. Amyloidosis is a condition when abnormal protein deposits are found in the liver. When accumulation of copper is found in the liver, the condition is known as Wilson's disease. Gaucher's disease is when accumulation of fatty substances are found in the liver, while the accumulation of iron leads to a condition called hemochromatosis.
Related to Blood Supply

☞ Heart failure: It occurs when the heart's capacity to pump out enough blood to supply the body decreases. This can happen due to various factors like narrowing of arteries due to fat deposits, hypertension, impairment of the heart valves, etc.
☞ Budd-Chiari syndrome: This condition affects the hepatic vein. This vein is responsible for draining blood from the liver to the heart. If there is a blockage in this vein, it leads to decreased blood flow from the liver, resulting in liver enlargement.
☞ Liver cancer: There are many cancer types that originate elsewhere but affect the liver. However, liver cancer is when the cancer cells are originated within the liver cells itself.
☞ Leukemia: It is a type of cancer that affects the tissues that form the blood. When a person has leukemia, growth of abnormal white blood cells (WBCs) is observed in the bone marrow. These WBCs are incapable to function and support the immune system as they ideally should.
☞ Carcinoma: It is another type of cancer which originates from the membranous tissue covering the internal organs and surfaces of the human body.
☞ Lymphoma: As the name suggests, it is the cancer that affects the lymphocytes. Lymphocytes are the white blood cells that form an integral part of the immune system.
☞ Other cancer types: According to National Cancer Institute, liver is among the most common sites where metastatic cancer is found. Meaning the cancer originates in one area of the body and slowly spread towards the other parts. For example, cancers of the breast, colon, stomach, and lungs can spread to the liver.
Other Causes

☞ Malaria: It is a disease caused by a mosquito bite that transmits the malaria parasite into the human body. In a rare scenario, malaria can also result in liver enlargement.
☞ Reye Syndrome: It is an inflammation of the brain and liver, affecting children and teenagers. Its cause is typically associated with consuming too much aspirin.
☞ Certain medications and herbal supplements: Consumption of these can affect the health of the liver. For example, excessive intake of acetaminophen, retinol, etc., can cause hepatomegaly. As far as herbal supplements are concerned, the usage of herbs like mistletoe, black cohosh, kava, chaparral, valerian, etc., can prove to be harmful for the liver. Tell your doctor about the supplements and medications you use.
☞ Autoimmune diseases: These are disorders that enable the immune system to attack the healthy cells in the body, misidentifying them as a threat. Conditions such as autoimmune hepatitis and autoimmune lymphoproliferative syndrome can cause swelling and enlargement in the liver.
☞ Other causes: Other reasons including Q fever, glycogen storage disease, tuberculosis, toxins, jaundice, etc., are also associated with hepatomegaly.
Risk Factors
☞ Being overweight aids the accumulation of fat deposits in the liver, heart, and other areas of the body, which not only puts one at the risk of liver disease, but can also trigger conditions like heart failure, diabetes, etc. Maintaining cholesterol levels and blood sugar levels is also a must to avoid being in the risk zone.
☞ Alcohol consumption is associated with fatty liver disease which can further aggravate to conditions like alcoholic hepatitis and cirrhosis. Heavy drinkers are at higher risk. However, liver disease has also been observed in moderate drinkers.
☞ Excessive intake of over-the-counter medications, which may include vitamin or dietary supplements can put the consumer under the risk of liver disease.
☞ Sharing of needles, injecting or snorting narcotic drugs may contribute towards this problem.
Usually, there are no symptoms observed for hepatomegaly because the liver does not have any nerves. However, some symptoms can be observed when the liver span increases considerably. These are listed as under.
☞ Some pain and discomfort arises as the liver puts pressure on the surrounding organs and nerves because of the swelling.
☞ In case the liver enlargement is due to a liver-related disease, one may experience symptoms like - yellowing of the skin and white part of the eyes (jaundice), nausea, lethargy, pain in the abdomen, and vomiting.
The liver has the inbuilt capacity to renew cells that get damaged by any disease, injury, or other harmful substances. If the destruction of liver cells continues for a long time, then the glandular organ fails to regenerate those damaged cells. As a result, the impairment becomes permanent, and there is a collapse in the functioning of the liver, which is why early diagnosis and treatment is a must.
The doctor can estimate the approximate size of the liver by touching it. Physical examination would also reveal if any lumps have formed inside it. X-ray, CT scan, MRI, and ultrasound techniques are used to confirm the diagnosis. If required, blood tests and a biopsy are also conducted.
Treatment can start only after the identification of the exact cause. Anyone who has developed an enlarged liver due to alcoholism should cease the intake of alcohol immediately, or else it could be fatal. A patient who is suffering from hepatitis is given medication to bring down the inflammation in the liver. In case it is a nonalcoholic problem caused by obesity, the patient must opt for a proper weight loss program that includes regular exercise. Diabetic patients must control their blood sugar and cholesterol levels. For liver cancer and leukemia, the treatment involves chemotherapy or radiation.
Early diagnosis can lead to early treatment wherein the damage could be reversed. However, any delay in the diagnosis and treatment may prove fatal. Most of the aforementioned causes are serious in nature, therefore, it is important to get treated as soon as possible under the supervision of a trusted practitioner only.
Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a replacement for expert medical advice.