A football-sized organ under your ribcage, the liver is your largest internal organ. It performs many vital tasks, including filtering your blood and helping with digestion.
The liver is one of the only organs that can regenerate or regrow damaged or missing tissue. But over time, continued damage can affect your liver’s ability to work.
What Causes Liver Disease?
Common causes of liver disease include:
- Acute reactions to medications, poisons, or drugs.
- Alcohol use.
- Autoimmune disease.
- Genetics.
- Obesity.
- Viruses.
Liver disease can progress quickly over weeks (acute liver disease) or slowly over years or decades (chronic liver disease). How quickly your liver disease progresses depends on your diagnosis.
Stages of Liver Disease
Regardless of your diagnosis, liver damage occurs in predictable stages or steps.
Stage 0: Healthy liver
According to the American Liver Foundation, your liver performs more bodily functions than any other organ except your brain. Your liver helps keep you healthy by:
- Breaking down medications and other drugs.
- Controlling blood clotting.
- Fighting infections.
- Helping to digest food.
- Removing toxins from the blood.
- Storing energy.
Because your liver has so many jobs, liver damage can affect your whole body.
Stage 1: Beginning of liver damage
The first stage of liver disease is usually inflammation of the liver, or hepatitis. When the body tries to heal an infection or injury, the healing process causes inflammation (swelling).
Hepatitis is a stage of liver disease, but it’s also the name of a virus. Viral hepatitis is a virus that causes liver inflammation and damage. Common types of viral hepatitis include hepatitis A, hepatitis B, and hepatitis C.
People with hepatitis often have no symptoms, so they may not seek medical attention. Mild symptoms at this stage can include abdominal pain and swelling.
Your doctor will treat hepatitis based on its type. To help yourself heal from any form of hepatitis:
- Stop drinking alcohol immediately.
- Ask your provider or pharmacist if any of your current medications increase the risk of bleeding, like preventive aspirin. Your doctor may tell you to discontinue such drugs.
Liver damage from early-stage liver disease is likely to be temporary. That’s because the liver can often heal itself before serious damage has occurred.
Stage 2: Moderate liver damage
The second stage of liver disease typically involves fibrosis, the formation of scar tissue in the liver. As scar tissue crowds out healthy liver tissue, your liver may not work as well over time.
As with the first stage of liver disease, people with stage two liver disease may not feel any symptoms. At this stage, the liver should still be able to heal itself.
Stage 3: Significant liver damage
In stage three liver disease, significant damage has occurred. Fibrotic scar tissue has crowded out more of the healthy tissue, making it much harder for the liver to function.
By this time, people with stage three liver disease may notice more symptoms. These include:
- Diarrhea.
- Itchy skin.
- Joint pain.
- Jaundice (yellowed eyes or skin).
- Loss of appetite.
- Low-grade fever.
- Nausea.
Left untreated, moderate-to-severe fibrosis can lead to cirrhosis and liver cancer. But it still may be possible for the liver to heal at this stage.
Stage 4: Severe liver damage (cirrhosis)
In the cirrhosis stage, liver damage happens faster than healthy liver cells can regenerate. People with cirrhosis have much more scar tissue than healthy tissue in their livers, and their liver scarring is likely permanent. At this point, the liver can barely function.
People with cirrhosis may have a variety of symptoms, including:
- Abdominal pain.
- Fatigue.
- Loss of appetite.
- Nausea.
- Severe itching.
- Spider-like blood vessels on the skin.
- Weight loss.
Cirrhosis often leads to serious complications, including:
- Cognitive impairment or change in brain function due to ammonia buildup in the bloodstream (hepatic encephalopathy).
- Damage to other organs, especially the kidneys.
- Excessive bruising and bleeding.
- Fluid buildup in the abdomen (ascites).
- Fluid buildup in the legs (edema).
- Internal bleeding.
- Gallstones.
Liver cancer is much more likely when you have cirrhosis. Because of this, people with cirrhosis should have regular liver cancer screenings.
Goals for treating cirrhosis include preventing more liver damage and managing complications.
Liver failure (end-stage liver disease)
Liver failure, or end-stage liver disease, occurs when the liver can no longer function. Early symptoms of liver failure can include any or all symptoms from the previous stages.
As liver failure progresses, health complications may include:
- Coma.
- Extreme tiredness.
- Kidney failure.
UPMC Center for Liver Care
The experts at the UPMC Center for Liver Care can provide full-spectrum care for all liver-related conditions. We’re here to support people at every stage of liver disease.
To schedule an appointment, call 412-647-1170.
Editor's Note: This article was originally published on , and was last reviewed on .