Liver disease: Warning signs and the importance of lifestyle changes in treatment

Although many patients with liver disease don’t experience symptoms, there are some key indications of the onset of liver failure to look out for as revered consultant gastroenterologist and hepatologist Dr Marek Czajkowski reveals in this informative article. The leading specialist also reveals the importance of key lifestyle changes in preventing and managing liver problems.

What are the different stages of liver disease?

Liver disease is best thought of like an iceberg. Most of it happens below the surface, and you won't notice it until your blood tests show abnormalities. By that point, 80 per cent of your liver function may already be lost. This can happen suddenly from certain types of conditions or infections, or it can be slower and more insidious.

Although many stages of liver disease are hidden and symptomless, some patients show signs of the onset of liver failure, including jaundice, swelling and bleeding from the stomach. Patients can also present with confusion caused by toxin buildup as the liver is unable to clear the toxins from the bloodstream. These are more advanced stages, but the majority of liver disease is asymptomatic.

Are there any warning signs for patients to watch out for?

Yes, in addition to the symptoms I mentioned earlier, it’s important to watch out for weakness, sleepiness and confusion. The biggest warning signs are muscle wasting, severe weight loss, abdominal swelling, and occasional bleeding.

How is liver disease diagnosed?

Liver diseases are often diagnosed through blood tests, where the liver tests are picked up as being abnormal, although there are some limitations.

FibroScan, a non-invasive scan that measures liver stiffness, has revolutionised diagnosis. A healthy liver, much like you might see in a supermarket, is nice and squishy, whereas an unhealthy liver becomes more rubbery and hard. We can tell how stiff or rubbery a person’s liver is with this little scan that vibrates the liver through the skin. In addition, ultrasounds and endoscopic procedures are sometimes used to diagnose liver disease.

Are liver diseases treatable?

Overall, liver disease is highly treatable. The majority of liver disease (95 per cent) is related to lifestyle factors, although people often mistakenly think that alcohol is the only cause of liver disease. Treating liver disease involves managing these risk factors. Some specific conditions may also require antiviral or immunosuppressive treatments.

How important are lifestyle changes in treating liver disease?

Given that 95 per cent of liver disease is caused by lifestyle factors, whatever the cause or the stage of liver disease you have, lifestyle management is absolutely vital.

In our modern lives, we spend a lot of time sitting and often eat the wrong kinds of very high energy foods. There has been also marked increase in cases of diabetes worldwide. This is lifestyle related, involving calorie intake, alcohol consumption, and to a certain extent, other lifestyle issues that can cause us to develop a range of health problems including liver problems.

As liver disease progresses, we find that the biggest issue that affects patients and their ability to live well is muscle weakness. We also know that actual prognosis of a patient with liver disease and how their quality of life will be impacted is very much dependent on muscle bulk. As such, introducing lifestyle changes and explaining the importance of them to patients is really key at every stage of liver disease, whether it's at the beginning as a cause of liver problems or later on as a part of the treatment for the liver disease.

Therefore, a huge part of my work is not only learning about lifestyle factors and their effects but also how to make it easier for patients to change and adapt their behaviour accordingly through understanding their condition and what they can do to improve their quality of life, even if the underlying liver disease is advanced.

Can the liver repair itself?

Yes, the liver has remarkable regenerative abilities. The vast majority of liver problems can get better, particularly if whatever factor which has caused them is eliminated. If this relates to lifestyle related liver disease, making key behavioural changes typically results in an improvement in liver function. This is even possible when patients develop cirrhosis, an advanced scarring of the liver. Although the liver does change at that point, it can still repair itself to a certain extent, where the scar tissue remains but liver function can improve with further treatments.




If you are concerned about your liver health and wish to schedule a consultation with Dr Czajkowski, you can do so by visiting his Top Doctors profile.