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Inflamed Liver

Inflamed Liver

Inflamed liver is often the first reaction that occurs in almost every type of liver disease, and is manifested through symptoms like nausea, loss of appetite and fatigue. Described in the current article, are the various factors that lead to an inflamed liver, as well as the diagnostic and treatment options available.
Bidisha Mukherjee
Last Updated: Apr 20, 2018
Did You Know?
Although inflammation forms a part of the wound-healing and regenerative processes of the liver, its persistence may lead to scarring and tissue damage.

Liver is the largest gland in our body, and is the only organ that has regenerative capacity. This endocrine organ plays a vital role in several cellular processes of the body. It is the site for synthesis of bile, enzymes, clotting factors and many other useful molecules that facilitate various metabolic, endocrine, and immunity-related processes. It is also responsible for the detoxification and removal of metabolic wastes.

Inflammation of the liver is a condition characterized by the migration of phagocytic immune cells to the liver, which may lead to enlargement and tenderness. It is often the early stage of several liver disorders. Most individuals with an inflamed liver remain asymptomatic, but symptoms like mild to moderate abdominal pain, nausea, fatigue, and malaise may be experienced by some. The etiological factors and the corresponding symptoms of inflamed liver, as well as the diagnostic and therapeutic methods have been described below.

Inflammation in the liver tissue occurs as a response to the presence of foreign agents like toxins and pathogens, as well as in case of hepatocellular damage. However, the persistence of such an agent or cellular damage leads to chronic inflammation and further tissue damage, which may culminate into liver failure. Some of the etiological factors that lead to an inflammatory response have been described below.

  • Mood disturbances
  • Memory impairment
  • Increased thirst
  • Edema
  • Aggressiveness
  • Abnormally dark or light skin
It has been about 200 years, that alcohol has been identified as a major causative factor for several diseases. Nevertheless, it continues to be the leading cause for liver damage and death.

Regular consumption of excessive amounts of alcohol leads to alcoholic hepatitis characterized by persistent inflammation and irreversible damage of the liver cells. Acute alcohol intake or binge drinking leads to alcoholic fatty liver disease (FLD) characterized by abnormal retention of lipid molecules in the liver cells. The progression of this condition leads to cirrhosis and liver failure.

  • Jaundice
  • Diarrhea
  • Fever and chills
  • Abdominal pain and discomfort
  • Vomiting
  • Anemia
Liver inflammation may occur as a part of the immune system response, in the event of several viral, bacterial, and parasitic infections. The common examples of infectious agents (and the resultant diseases) that lead to liver inflammation include:

Viral: Hepatitis viruses (A, B, C, D, E), yellow fever virus, adenoviruses, herpesviruses, etc.
Bacterial: Mycobacterium tuberculosis (tuberculosis); Treponema pallidum (syphilis); Salmonella typhimurium (typhoid); Leptospira spp. (leptospirosis); Yersinia pestis (plague)
♦ Protozoan: Entamoeba histolytica (amoebiasis and amoebic liver abscess); Leishmania donovani (visceral leishmaniasis); Plasmodium spp. (malaria); Toxoplasma gondii (toxoplasmosis)
Parasitic: Roundworms like Ascaris lumbricoides (ascariasis); Liver flukes like Fasciola hepatica (fasciolosis), blood fluke or Schistosoma spp. (schistosomiasis)

Autoimmune Disorders
  • Dark-colored urine
  • General malaise
  • Abdominal distension
  • Itchy skin
These include disorders of the immune system that involve destruction of healthy liver cells. It involves a failure in one or more processes of the immune system that are responsible for distinguishing foreign bodies from healthy body tissue.

The resultant self destructive action in liver leads to inflammation, and is termed as autoimmune hepatitis. It may occur in conjunction with Graves disease, rheumatoid arthritis, inflammatory bowel disease, systemic lupus erythematosus (SLE), Sjögren syndrome, type 1 diabetes, etc.

  • Limb edema
  • Vomiting
  • Tinnitus
  • Headache
  • Diarrhea
  • Blurred vision
  • Severe abdominal pain
This term refers to hepatic injury occurring due to chemical agents, especially drugs and their metabolites. Drug overdose (acute or chronic) and even a therapeutic dose of certain drugs leads to the death (necrosis) of hepatocytes.

Certain drugs alter lipid metabolism and lead to fatty deposition in the liver cells which is known as non-alcoholic fatty liver disease (NAFLD). These conditions lead to an inflammatory response in the liver tissue. The severity of damage depends on the type of drug and its amount. Examples include aspirin, diclofenac, isoniazid, phenytoin, some chemotherapeutic medicines, few anti-HIV medicines, as well as antibiotics like erythromycin, oxacillin, etc.

Hepatic Ischemia
  • Abdominal pain and discomfort
  • Dizziness in case of prolonged low blood pressure
Reduction in the supply of blood, and hence oxygen and nutrients, to the liver is termed as hepatic ischemia. The resulting lack of oxygen and nutrients leads to cell death and tissue injury. This leads to an inflamed liver, and is known as ischemic hepatitis or shock liver. Reduction in blood to the liver can occur due to low blood pressure or blockage and narrowing of hepatic artery due to cholesterol and fat deposition.

Diagnosis and Treatment
The diagnosis of liver inflammation involves blood investigation to determine the levels of albumin, bilirubin, certain hepatic enzymes, blood clotting tests, etc. These tests are indicative of liver damage, and help to identify the precise etiology.
Inflamed Liver and Cancer
Chronic liver inflammation and cirrhosis are the most common reasons behind primary liver cancers. It is known as the silent killer, and generally gets diagnosed in the advanced stages, which presents a poor prognosis. Hence the need for early diagnosis and prompt treatment.

Imaging techniques like abdominal ultrasound, CT (computed tomography) scan and MRI (magnetic resonance imaging) may be advised to examine the liver size and morphology. Liver biopsy may be advised to identify malignancy, if any unusual growths are observed during the imaging tests. Stool samples and urine samples may be investigated for infectious agents and fluke eggs.

The precise treatment prescribed depends on the stage of liver damage. In the early stages, that are characterized by liver inflammation alone, dietary modifications and analgesics are recommended in addition to the cause-specific treatment. In the advanced stages, that involve scarring of tissue and cirrhosis, liver resection and liver transplant surgery may be advised.

Disclaimer: This HealthHearty article is for informative purposes only, and should not be used as a substitute for professional medical advice.