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When the Liver Is Injured
The normal liver is smooth and firm to the touch.
As liver disease progresses, changes occur and damage to the liver increases. For example:
- Fibrosis. After becoming inflamed, the liver tries to repair itself by forming tiny scars. This scarring, called "fibrosis," makes it difficult for the liver to do its job. As damage continues, many scars form and begin to join together, leading to the next stage, cirrhosis.
- Cirrhosis. With repeated damage, large areas of the liver can become permanently scarred and nodules may form. Blood cannot flow freely through scarred liver tissue. The liver begins to shrink and becomes hard. Chronic viral hepatitis is a common cause of cirrhosis of the liver, as is excessive drinking.
- Liver failure. As cirrhosis worsens, most liver function is lost. This means the liver is unable to filter wastes, toxins, and drugs from the blood. It can no longer produce the clotting factors necessary to stop bleeding. Fluid builds up in the abdomen and legs, bleeding in the intestines is common, and eventually mental functioning is slowed. At this point, a liver transplant is the only option.
- Liver cancer. Sometimes damage to liver cells includes altering the genes inside cells in a way that causes them to become cancerous. Patients with chronic hepatitis B or C are at higher risk for hepatocellular carcinoma, a type of liver tumor.
A recent study published in the New England Journal of Medicine attributed an increase in the number of cases of hepatocellular carcinoma in the United States over the past 20 years to the spread of HBV and HCV.
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