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Liver diseases - What causes the damage

Updated: Mar 27, 2023

The liver is a vital organ that performs some of the most important functions. It is related to metabolism, energy storage and body purification. It aids digestion and filters toxic substances from the blood.


Liver damage is caused by factors that damage liver cells, causing inflammation and liver failure. These include viruses (causing viral hepatitis, i.e., hepatitis A, B or C), alcohol, excess fat in the diet, drugs and immunological factors. A significant number of people may develop fatty liver or cirrhosis.


The most recognisable symptom of liver cell damage is jaundice, which is yellowing of the skin and mucous membranes. Liver cancer is now the sixth most common cancer in the world.

Is there any way to know that the liver is not functioning properly?

In many cases, chronic liver disease causes no symptoms. In most cases, a damaged liver shows no symptoms until it is seriously damaged. Therefore, diagnostic tests play a key role in liver damage prevention. That is why prophylactics at least once a year is extremely important, and you can do it yourself with the LIVER-Screen® quick test.


Jaundice

Jaundice is the most common symptom of liver damage. The characteristic yellowing of the skin, whites of the eyes and mucous membranes is associated with the accumulation of excessive amounts of bilirubin. Bilirubin is one of the bile pigments and is formed mainly from the breakdown of heme, which is a component of red blood cells (erythrocytes).

The normal concentration of bilirubin in the blood serum is 03-1.0 mg/dl. An elevated level of bilirubin is called hyperbilirubinemia. Jaundice most often occurs when serum bilirubin is higher than 2-2.5 mg/dl.


Chronic and acute liver failure

Liver failure is a disturbance in the proper functioning of the liver. Failure occurs when hepatocytes (liver cells) are so damaged that they are unable to perform the liver's basic functions. This leads to an impaired metabolic function and suppression of the production of proteins necessary for the proper functioning of the entire organism.


The consequences of liver damage are:

  • Impaired blood coagulation (deficiency of the proteins responsible for this process, decrease in the number of platelets)

  • Encephalopathy (disease of the brain, most often of a degenerative nature)

  • Gastrointestinal bleeding

  • Brain swelling

  • Hemodynamic disorders, i.e. disorders of blood flow through the organs

  • Electrolyte disorders

  • Metabolic disorders - alkalosis, acidosis and hypoglycaemia

  • Kidney failure

Particularly dangerous is the situation in which sudden, acute liver failure occurs. This may be due to:

  • Drug poisoning - very high doses of drugs, e.g., paracetamol

  • Poisoning by toxins - most often this is phalloides toxin

  • Bacterial shock or sepsis – systemic bacterial infections

  • Viral infection – HBV (hepatitis B), HCV (hepatitis C), HAV (hepatitis A)

Liver damage from drugs

A special case of liver failure is drug poisoning. Since the liver is mainly responsible for the metabolism of drugs in the body, it is exposed to their toxic effects. More than 800 drugs, chemicals, toxins or other (non-infectious) agents can cause liver damage or dysfunction.


Toxic effects can result from:

  • Poisoning (taking too much medicine)

  • Allergic reaction (in this case, even a very small dose of a substance or drug can cause very severe symptoms)

Acute liver failure after taking a large dose of paracetamol accounts for 50% of all cases.


Hepatitis and autoimmune diseases

Viral infections

Viruses can cause necrosis and inflammation of hepatocytes (liver cells). Viruses that can damage the liver:

  • Hepatitis A, B, C, D, E, G (HAV, HBV, HCV, HDV, HEV, HGV) viruses

  • CMV cytomegalovirus

  • Epstein-Barr virus (EBV)

Autoimmune Hepatitis (AIH)

This disease belongs to the so-called autoimmune diseases caused by a defect in the immune system. AIH is a chronic condition in which there is inflammation and gradual destruction of liver cells. The consequences of such a condition can be cirrhosis of the liver or complete liver failure. Factors that increase the risk of developing autoimmune hepatitis include the presence of other autoimmune diseases, elevated levels of IgG antibodies, and joint pain. In addition, women are more likely to develop it than men.


Liver cirrhosis

Cirrhosis is the final stage of chronic liver disease. It is associated with a decrease in parenchyma (cells responsible for all liver functions) and progressive fibrosis, presence of inflammatory and necrotic foci.


The symptoms of cirrhosis are:

  • Fatigue, very fast exhaustion

  • Loss of appetite and weight loss

  • Flatulence, pain in the region of the right hypochondrium

  • Itchy skin caused by jaundice

  • Swelling and fluid accumulation in the lower extremities

  • Significant increase in abdominal girth

  • Spontaneous bleeding from the nose and mouth

  • Decreased libido, impotence

  • Nausea, vomiting

The main cause of liver cirrhosis is alcoholism. Through metabolism, 90% of the alcohol taken is removed from the body. The threshold dose of pure alcohol (ethanol) per day is 60-80 g for men and 20-40 g for women. Alcohol abuse causes structural changes in liver cells and then progresses to various stages, including fatty liver, inflammation and finally cirrhosis. Cirrhosis of the liver is most likely to develop in people who consume more than 120 g of alcohol per day.

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