Chronic liver disease

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Chronic liver disease is a liver disease of slow process and persisting over a long period of time, resulting in a progressive destruction of the liver.

Causes

It can refer to:

• Cirrhosis
• Alcoholic liver disease
• Hepatitis C
• Hepatitis B
• Autoimmune hepatitis
• Liver failure
• Portal hypertension
• Hemochromatosis
• Wilson's disease
• Gaucher disease
• Liver cancer
• Hepatoma
• Primary biliary cirrhosis
• Primary sclerosing cholangitis
• Sarcoidosis
• Zellweger syndrome

Risk Factors

• Health care professionals who are exposed to body fluids and infected blood

• Individuals who get multiple tattoos and body piercing

• Certain prescription medications

• Excessive alcohol use

• Having high levels of fat in the blood

• Sharing infected needle and syringes

• Obesity

• Having unprotected sex and multiple sex partners

• Working with toxic chemicals without wearing safety clothes

Natural History, Complications, Prognosis

Complications

• Portal hypertension
• Hypoalbuminaemia
• Coagulopathy
• Hepatopulmonary syndrome
• Hepatorenal syndrome
• Encephalopathy
• Hepatocellular carcinoma (also called hepatoma)

Prognosis

Prognosis is assessed by

• Model for End-Stage Liver Disease

• Child-Pugh score

Diagnosis

Physical examination

Skin

• Increased pigmentation of the skin
• Tattoos
• Scratch marks

Eyes

• Kayser-Fleischer ring

• Jaundice

Heart

• Signs of right heart failure

Lungs

• Hyperventilation

Abdomen

• Hepatomegaly
• Ascites
• Spider nevi (angiomata)

• Caput medusae

Extremities

• Dupuytren's contracture

• Leukonychia

• Peripheral oedema
• Bruising

• Clubbing

• Palmar erythema

Neurologic

• Peripheral neuropathy
• Cerebellar signs

• Metabolic Flap/Asterixis

• Drowsiness

Other

• Parotidomegally
• Gynaecomastia
• Feminising hair distribution
• Testicular atrophy
• Anaemia

Treatment

The treatment of chronic liver disease depends on the cause. While some conditions may be treated with medications, others may require surgery or a transplant. Transplant is required when the liver fails and there is no other alternative . Because many chronic liver disorders have no cure, many people have been turning to alternative health care. Herbal supplements are widely used by many people with chronic liver disease. None of these herbs have ever been tested in randomized clinical trials and no one knows whether they work. Some common herbs known to be potentially harmful in liver disease include black cohosh, ma huang, chaparral, comfrey, germander, greater celandine, kava, mistletoe, pennyroyal, skull cap and valerian.

See Also

• Hepato-biliary diseases

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