When diagnosing liver disease, the physician looks at the patient's symptoms and conducts a physical examination. In addition, the physician may request a liver biopsy, liver enzyme tests, an ultrasound, or a CT scan (computed tomography scan).
Some common liver disease symptoms include the following, each of which are described briefly below:
Jaundice is a yellow discoloration of the skin and whites of the eyes due to an abnormally high level of bilirubin (bile pigment) in the bloodstream, which is then excreted through the kidneys. High levels of bilirubin may be attributed to inflammation or other abnormalities of the liver cells, or blockage of the bile ducts. Sometimes jaundice is caused by the breakdown of a large number of red blood cells, which can occur in newborns. Jaundice is usually the first sign, and sometimes the only sign, of liver disease.
Cholestasis is reduced or stopped bile flow. "Chole" refers to bile and "stasis" means "keeping at the same level." Bile flow may be blocked inside the liver, outside the liver, or in both places. Symptoms may include the following:
Some causes of cholestasis include:
Liver enlargement (hepatomegaly) is usually an indicator of liver disease. There are usually no symptoms associated with a slightly enlarged liver. Symptoms of a grossly enlarged liver include abdominal discomfort or "feeling full."
Portal hypertension is abnormally high blood pressure in the portal vein, which brings blood from the intestine to the liver. Portal hypertension may be due to increased blood pressure in the portal blood vessels or resistance to blood flow through the liver. Portal hypertension can lead to the growth of new blood vessels (called collaterals) that connect blood flow from the intestine to the general circulation, bypassing the liver. When this occurs, substances that are normally removed by the liver pass into general circulation. Symptoms of portal hypertension may include:
Ascites is fluid build-up in the abdominal cavity caused by fluid leaks from the vessels on the surface of the liver and intestine. Ascites due to liver disease usually accompanies other liver disease characteristics such as portal hypertension. Symptoms of ascites may include a distended abdomen, which causes discomfort and shortness of breath.
Liver encephalopathy is the deterioration of brain function due to toxic substances building up in the blood which are normally removed by the liver. Liver encephalopathy is also called portal-systemic encephalopathy, hepatic encephalopathy, or hepatic coma.
Symptoms may include:
Liver failure is severe deterioration of liver function. Liver failure occurs when a large portion of the liver is damaged due to any type of liver disorder. Symptoms may include: