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Liver health

Your liver is important for keeping your body healthy. It makes chemicals in the body and breaks them down, helps us digest food and gives us energy.

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Liver health

Your liver is important for keeping your body healthy. It makes chemicals in the body and breaks them down, helps us digest food and gives us energy.

What does your liver do?

Let’s begin by finding your liver. Place your hand on the right-hand side of your stomach and over your ribs. There it is. It's the largest organ inside your body. It’s about the size of a rugby ball, wedge-shaped and weighs around 1.5 kilograms.

Your liver is important for keeping your body healthy. It makes chemicals in the body and breaks them down, helps us digest food and gives us energy. 

Every day your liver:

  • clears the blood of waste products, drugs and other toxins
  • makes and breaks down hormones
  • breaks down old or damaged red blood cells
  • stores extra glucose (sugar) so that the body can use it later
  • makes cholesterol which we need to make some hormones
  • makes most of the body’s proteins, including enzymes (proteins which speed up chemical reactions in the body)
  • helps the body digest some fats and vitamins
  • stores and releases iron 

Your liver is one of the few organs able to regenerate itself. This means it creates new tissue. So, it can still cope with doing all of these things even when it is a bit damaged, just not as well.

Liver, Better Health Channel, Department of Health, State Government of Victoria, Australia

What is hepatitis?

What hepatitis does to your liver

  • Hepatitis can last a few months, or the rest of your life.
  • Hepatitis can cause harm to your liver, resulting in liver scarring (fibrosis) or serious liver scarring (cirrhosis).
  • Liver check-ups could save your life.


Acute hepatitis

When you only have hepatitis for a short time, we call it "acute". The virus might make you sick for a few months but then you will likely get better. Some people may feel unwell. But most people do not get seriously ill if they have acute hepatitis.

Chronic hepatitis

It's possible to have hepatitis for more than 6 months. If you have hepatitis B or C, it can become “chronic”, meaning the virus stays in your body for a long time. You may not feel sick, but over time the virus can harm your liver and stop it working properly.

Over a long time, this damage can lead to scarring. We call this "fibrosis". If the liver is severely scarred, this is called "cirrhosis", and it affects the blood supply to the liver.  If you have a lot of scarring, the liver stops working. This is liver failure. If you have cirrhosis, you are more likely to get liver cancer. It can also lead to problems in the rest of your body.

 


Liver check-ups

Liver check-ups could save your life.

Hepatitis B and C can cause cirrhosis, liver failure or liver cancer. Even if you feel well, you should have check-ups to see if you need treatment.

When you get a liver check-up, you'll first have a blood test. This measures how well your liver is working. You might also need:

  • an ultrasound elastography (such as Fibroscan®) to check for liver stiffness
  • a liver ultrasound to check that the liver tissue looks healthy, and to look for liver cancer
  • a liver biopsy. This is where the doctor takes a sample of your liver tissue to look at it more closely.

These test results help your doctor to decide whether you need treatment for your liver. Treatment can slow down the damage and sometimes helps your liver heal. Your doctor may also ask you to have liver check-ups every 3, 6 or 12 months. This is to keep track of your liver’s health.

What should I do now?

If your doctor has just told you that you have hepatitis, here are some questions you might want to ask:

  • How did I get hepatitis?
  • What is hepatitis?
  • What symptoms might I get?
  • Do I need to tell anyone?
  • Should my partner/household contacts get vaccinated?
  • What tests do I need? Will I need to have tests forever?
  • Will I need treatment? What does that look like?
  • Can I be cured?
  • Do I need to see a specialist doctor?
  • What can I do to look after my liver?
  • What happens if I fall pregnant?

You might also like to bring someone for support when you see the doctor.

Acute vs. Chronic Hepatitis B, Hepatitis B Foundation

Acute Hepatitis, Timothy J. Schaefer; Savio John.

FibroScan, Gastroenterological Society of Australia

Ultrasound, healthdirect

Liver Biopsy, healthdirect

 

What is cirrhosis?

  • Having cirrhosis means that you have severe scarring on your liver.
  • In most cases it is a chronic condition, which means you have it for the rest of your life.
  • Proper treatment can lower the impact of cirrhosis on your health

Download 'Living with Cirrhosis' Resource

Cirrhosis is a condition where liver cells are damaged and replaced by scar tissue. Both hepatitis B, hepatitis C and hepatitis D can cause cirrhosis.

It usually takes 10-20 years for cirrhosis to happen. First, your doctor might tell you that you have something called fibrosis. If your fibrosis gets worse, it can cause severe liver scarring (cirrhosis). Cirrhosis usually lasts your whole life. But treating it early can mean that your liver isn’t harmed too badly.

The scar tissue on your liver affects the flow of blood and other fluids. Without proper blood flow, the liver becomes hard and lumpy. It finds it hard to do its normal functions.

You might also hear your doctor talk about compensated or decompensated cirrhosis.

Liver with and without cirrhosis


Compensated cirrhosis

Compensated cirrhosis means your liver is able to make up for the damage. It can do everything it needs to do, even though it is harder.

People with compensated cirrhosis often feel fine. They might not have any signs of illness for many years. If you carefully treat cirrhosis during this stage, you have a much better chance of slowing or stopping further illness.


Decompensated cirrhosis

Decompensated cirrhosis is much more serious. It means the damage to your liver stops it from working properly. You will start feeling unwell and your health will get worse. You need to talk about treating it with your doctor.

Symptoms of cirrhosis 

Many people are able to live a normal life and feel well for a long time with compensated cirrhosis.

There are lots of reasons why it might progress more quickly. For example, your age and if you have any other health issues.

Not everyone will have the same signs of cirrhosis, but some of the things that can happen are:

  • Feeling less hungry, weight loss and weakness.
  • Muscle and joint pain
  • “Ascites” (pronounced uh-sai-teez): more fluid in your belly. Your belly might grow larger and you might feel less hungry. You can also find it harder to breathe. It can also make your ankles swollen.
  • Easy bruising and bleeding. This happens because your blood does not clot as it should.
  • “Encephalopathy” (pronounced en·seh·fuh·lo·puh·thee): brain inflammation. Early signs are having trouble sleeping, or sleeping more. You might feel a change in your behaviour or mood (like feeling super happy or depressed). Or you might feel confused. You could even go into a coma because the liver can’t get rid of waste from the body.
  • Higher sensitivity to medicines and other drugs: this means you feel the effects of medicines more. This happens because the liver can’t clear them from your blood very well.
  • Jaundice: yellow eyes and skin because your body can’t clear “bilirubin”. This is the yellow substance made when red blood cells are broken down.
  • Skin conditions: some people get dark spots, rashes, or dry and itchy skin. Some also get ‘spider naevi’. These are tiny red spots with red blood vessels coming out from the centre.
  • Liver failure or liver cancer: some people with cirrhosis may get liver failure or liver cancer.
  • “Portal hypertension”: Early on, this may not make you feel unwell. It happens when you have high blood pressure in the veins coming from the intestines to the liver. Smaller veins can burst from the pressure. This can cause bleeding from the stomach, gullet or rectum. This bleeding is very dangerous and can kill you.

Some of these issues can be very serious. It is important to speak to your doctor or specialist if you have any of these signs of cirrhosis.

If you have any of the signs below, you must go to the emergency department (ED) or call 000 for an ambulance

  • Internal bleeding: poo is black and looks like tar. Or your vomit has blood, or something that looks like coffee grounds.
  • Confusion: you feel confused, cloudy, or more sleepy than you normally do. Do not drive yourself to the emergency room if you feel like this.
  • Fever: Infections are more common in people with cirrhosis because the immune system is weaker. Sometimes fluid in your belly can become infected. Or an infection can move to the kidneys, bladder, or lungs. This can be lifethreatening, it can kill you.
  • Jaundice: if your eyes turn yellow, it could be a sign something is going wrong.

You should tell the emergency staff that you have cirrhosis. This will make sure you get the right care.

How can I look after myself if I have cirrhosis?  

There are lots of things you can do to lower the impact of cirrhosis and help your liver function well.

If you have cirrhosis, you must get your liver tested every 6 months to check if there are changes. This is the only way to know if the damage is getting worse. It helps your doctor work out if there should be any changes made to your treatment.

Liver checks often involve blood tests. They may also involve an ultrasound or transient elastography using a Fibroscan®. This test checks how stiff your liver is. Your doctor or specialist may also tell you to get a liver biopsy. A biopsy is when they remove a small piece of liver tissue using a needle.

Alcohol can damage your liver. So if you have cirrhosis, drinking alcohol is likely to make the damage worse. It is best to stop drinking alcohol completely. This can be hard, even if you don’t drink a lot. You can talk to your doctor if you need help to drink less alcohol. Or you can visit the Alcohol and Drug Foundation website to find support services near you. These days there are lots of alcohol-free beers and wines, and other low-alcohol options that can help you drink less.

A doctor or dietician can look at how active you are, how hungry you get, and your body. They can give you advice on:

  • How often to eat and how much to eat every day. Normally, people with cirrhosis eat a little bit of food often.
  • What to eat. They can tell you how much of your food should be protein, carbohydrates, fat and salt

Drinking enough water and getting enough exercise are also important for your liver.
Some research suggests that drinking a bit of coffee is good for your liver health. It says that drinking some coffee can even lower your chances of liver cancer. But remember, it does not replace a healthy lifestyle.

Smoking can also damage your liver and can make you more likely to get liver cancer. You can talk to your doctor if you need help to quit smoking or contact Quitline on 13 78 48.

Other medicines can affect your liver, even if a doctor told you to take them. It is important you check with a specialist liver doctor before taking any medicine. This includes medicine you can get from a shop.

There are some supplements you can take which can help with nutrition or bone health if you have cirrhosis. But before you take anything, ask your doctor about it. This is for any type of herbal remedy, traditional Chinese medicine or supplement. Some of these may seem good for you, but they can be hard for your liver to process. This can be dangerous when you have cirrhosis.

llegal drugs can also harm your liver. And they can make you more likely to get another blood borne virus or get hepatitis C again. If you need help to stop using drugs, you can ask your doctor for help or visit the Alcohol and Drug Foundation website to find support services near you.

It is important to take care of your mental health as well as your physical health. Having cirrhosis can impact your mental health in many ways. It can make you:

  • feel confused or change your mood. This is due to “encephalopathy”, caused by your liver not clearing waste products well
  • feel tired
  • feel annoyed
  • feel anxious or depressed
  • change how you interact with others. For example you might not have much energy to spend time with friends. Or you might worry about telling people that you have liver disease.

You can talk to your doctor if you need more help to look after your mental health. Or contact a mental health service such as Beyond Blue for support on 1300 224 636.

ON THIS PAGE

1800 437 222 (1800 HEP ABC)

For free and localised viral hepatitis information and support services.

Visit website

 

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