The liver can withstand substantial damage and continue to perform its many functions. A large percentage of people with moderate to severe liver disease experience no symptoms. With overwhelming acute damage or chronic disease, however, liver-related problems often ensue. Medical problems associated with significant liver abnormalities commonly involve the digestive, nervous and cardiovascular systems. Treatment of the underlying liver condition may help to alleviate problems in other organs caused by liver disease.
Ascites
People with chronic liver disease typically develop progressive liver scarring, or fibrosis. Early-stage fibrosis usually causes no symptoms. With continued liver damage, scarring distorts the normal structure of the liver, causing impaired function. This advanced stage of liver disease is called cirrhosis.
With cirrhosis, scar tissue impedes normal blood flow through the liver, explains the National Institute of Diabetes and Digestive and Kidney Diseases. Blood backs up in the digestive system blood vessels, causing increased pressure in the abdominal circulation, or portal hypertension.
Portal hypertension and decreased protein production by the failing liver commonly lead to fluid leakage into the abdomen, a condition known as ascites. Patients with significant ascites experience increased abdominal size, tense stretching of the abdominal skin and an early feeling of fullness with eating. Profound ascites can cause shortness of breath as the bloated abdominal cavity encroaches on the lungs.
Gastrointestinal Bleeding
Increased pressure in the digestive system circulation can cause areas of dilation and thinning of the veins called varices. Varices can burst, causing profuse and potentially life-threatening bleeding. In a September 2006 article published in "American Family Physician," Drs. Joel Heidelbaugh and Marryann Sherbondy report that approximately five out of every 10 patients with cirrhosis develop varices. The food pipe, or esophagus, proves the most common site for portal hypertension-induced varices. Varices may also occur in the stomach and, less frequently, in the intestines.
Hepatic Encephalopathy
Liver failure causes chemical imbalances in the body that can adversely affect brain function. Impaired brain function in the setting of liver failure--and not caused by another condition--is called hepatic encephalopathy. The American College of Gastroenterology practice guideline for hepatic encephalopathy states that common symptoms of the condition include poor concentration, sleep disturbances, hand tremors, apathy, depression or unexplained exuberance, confusion, slurred speech and bizarre or inappropriate behavior. Patients with severe encephalopathy may become lethargic and fall into a coma. Approximately eight out of 10 people with hepatic encephalopathy who lapse into a coma die, reports the National Library of Medicine medical encyclopedia MedlinePlus.
References
- National Institute of Diabetes and Digestive and Kidney Diseases: Cirrhosis
- "American Family Physician"; Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment; Joel J. Heidelbaugh, M.D., Maryann Sherbondy, M.D.; September 2006
- "American Journal of Gastroenterology"; Practice Guidelines, Hepatic Encephalopathy; Andres T. Blei, M.D., et al.; July 2001
- MedlinePlus: Hepatic Encephalopathy
- "Harrison's Principles of Internal Medicine, 16th Edition"; Dennis L. Kasper, M.D., et al., Editors; 2004
