The liver filters the blood, processes nutrients and medicines, and makes proteins the body needs. Liver disease is any condition that keeps it from doing that work, including fatty liver disease, viral hepatitis, alcohol-related liver disease, and inherited or autoimmune conditions.
The most common form today is fatty liver disease, in which extra fat collects in the liver cells. It is closely linked to body weight, diabetes, and cholesterol, and it usually causes no symptoms until it is advanced. When ongoing injury scars the liver, the scarring is called fibrosis; severe, widespread scarring is called cirrhosis.
Common symptoms
Early liver disease is usually silent, which is why it is often discovered through routine blood work. When signs do appear, they can include fatigue, discomfort in the upper right abdomen, nausea, itching, easy bruising, swelling in the legs or abdomen, and yellowing of the skin or eyes (jaundice). Dark urine and pale stools can also signal a liver or bile duct problem.
How liver disease is evaluated
Evaluation usually begins with blood tests that measure liver enzymes and liver function, along with tests for viral hepatitis and other specific causes. An ultrasound is commonly used to look at the liver itself. A painless scan called liver elastography measures the stiffness of the liver to estimate scarring, often avoiding the need for a biopsy; a liver biopsy is reserved for cases where the diagnosis remains unclear.
Treatment approaches
Treatment depends on the cause. For fatty liver disease, the foundation is gradual weight loss through diet and regular physical activity, along with good control of diabetes, blood pressure, and cholesterol; even modest weight loss can reduce the fat in the liver.
Viral hepatitis can be treated with antiviral medicines. Whatever the cause, limiting alcohol, reviewing all medicines and supplements with your doctor, and staying current on recommended vaccinations help protect the liver. Regular follow-up shows whether the liver is improving or scarring is progressing.
When to contact a gastroenterologist
See a gastroenterologist if your blood tests show elevated liver enzymes, if imaging shows fat in the liver, or if you have risk factors such as diabetes and have never had your liver checked. Seek care promptly for jaundice, vomiting blood, black stools, new confusion, or rapid swelling of the abdomen — these can signal advanced disease and need urgent attention.
Take-home information sheet
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Questions about your care?
This page is general education, not personal medical advice. Your care team is happy to talk through what it means for you.