The liver is one of the most important organs of the body that plays a crucial role in digestion, detoxification, metabolism, and growth. It is located in the right upper quadrant of the abdomen and can be influenced by many different diseases that can be of shorter or longer duration. When the duration of the disease is more than six months, it is called chronic disease. So the chronic disease of the liver includes any disease which affects the liver for more than six months and results in the gradual destruction of the functional liver tissue, which is then replaced by fibrous non-functional tissue over the prolonged period of continuous injury. The liver loses its ability to execute its functions, resulting in loss of appetite, tiredness, weakness, nausea, vomiting, unexplained weight loss. With the progression of the disease, symptoms may include jaundice, itchiness, easy bruising, swelling in the lower legs, and building of fluid in the abdomen. The agents and events leading to chronic liver disease may include viruses, parasites, chemicals, drugs, metabolic products, toxins, autoimmune diseases, and malformations.Chronic liver disease is managed by correcting the underlying disorder, halting further damage, providing symptomatic relief, and offering palliative care and support.
The liver can be affected by many agents and conditions resulting in chronic disease that can be categorized as follows;Infectious agents;
Toxins and drugs;
Chronic liver disease is prevalent worldwide, resulting in serious morbidity and mortality. Around 4.5 million people in the USA are diagnosed with liver disease every year. Alcoholic liver disease is more common in the USA, and according to CDC, the percentage of adults aged 18 and over who had at least one heavy drinking day in 2018 is 25.1%. One heavy drinking day is defined as five or more drinks for men and four or more drinks for women per day. However, recent data has shown an increase in the number of viral liver diseases, among which Hepatitis B and C are the most common. According to CDC, the prevalence of any past or present HBV infection was 4.3% among adults aged 18 and over during 2015–2018. It was higher among men than women. Liver cancer is also a common disease. But it's more common in sub-Saharan Africa and Southeast Asia than in the USA. However, the death rate due to liver cancer has sown a rise of 4.3% in the USA from the year 2000 to the year 2016.
Following are the risk factors that may increase the chances of chronic liver disease.
The signs and symptoms are developed slowly over several days or even years. The initial symptoms are due to hepatic insufficiency; however, later, the symptoms result from complications of the disease process, which involves the fibrosis of the liver structure. Signs and symptoms are as follows;
It takes several years for chronic liver disease to show evidence of fibrosis and the resulting signs and symptoms. Sometimes the disease is diagnosed accidentally by routine liver function tests or ultrasound. People suffering from inherited diseases must be under regular follow-up to check for the severity and progress of liver fibrosis. The diagnosis is made by a detailed history and a thorough physical examination. You may be advised to undergo a few investigations like;
Some other diseases may mimic the presentation of chronic liver diseases.
Chronic liver disease is a progressive disease. It cannot be reversed once the liver is in the fibrosis stage. The goal of treatment is to slow down or halt further damage to the liver. Treatment depends upon the specific cause of cirrhosis, the extent of the damage, patient’s age, overall health, co-morbid diseases, preference, and tolerance for specific therapies and procedures. Abstinence from alcohol is the first and most important intervention for alcoholic liver disease. Some common medicines given for the respective causes are;
Liver transplant: In this procedure, your diseased liver is replaced by a new one. The liver tissue is taken from the deceased person or a living donor. Extensive investigations and medicines are ordered before the transplant to exclude the possibility of tissue rejection.
The course of chronic liver disease progression toto end-stage liver disease is variable in every individual. Some people with significant fibrosis may not show symptoms, but ultimately after a period of compensated liver disease, all will progress to decompensated liver disease with severe risks to health and life.
Once the diagnosis is made, it takes up to 10 years to develop the complications of chronic liver disease, which are:
Chronic liver disease can be prevented by adopting the following precautions;
Our clinical experts continually monitor the health and medical content posted on CURA4U, and we update our blogs and articles when new information becomes available. Last reviewed by Dr.Saad Zia on May 14, 2023.
Chronic Liver Disease - StatPearls - NCBI Bookshelf (nih.gov)
Epidemiology of chronic liver diseases in the USA in the past three decades | Gut (bmj.com)