Hepatology/Liver Disorders

Liver disorders arise from a broad range of causes.  If your liver is not working well, or is inflamed, a number of symptoms can occur.  These may include yellowing of the skin (jaundice), dark yellow or brown urine, nausea, bleeding in the intestines, fatigue, weakness, and swelling of your legs or belly.  Our providers are here to help with the diagnosis, evaluation and treatment of liver disorders.

Diagnosing Liver Conditions

Our care team consists of nurses, nurse practitioners and physicians. In addition to a physical exam and a review of your medical history, your care team will likely use a combination of tests to determine the cause of your liver condition.  These can include blood tests, imaging tests and sometimes a liver biopsy.

• Blood tests can be used to both assess the current health of your liver as well as to investigate for possible sources of liver damage and inflammation. 
• Imaging tests like an ultrasound (US), computed tomography (CT) or magnetic resonance imaging (MRI) are sometimes used to assess the liver, gallbladder, biliary tree and blood vessels
• Elastography is an additional option for noninvasive testing that, using ultrasound technology, allows for a non-invasive measure of liver fibrosis (scarring) 
• Liver biopsy is sometimes needed for more definitive evaluation of the cause of liver damages or to measure the degree of scar tissue present in the liver.  This is done by inserting a small needle through the skin and into the liver to obtain a small piece of liver tissue.

Liver Disorders Treated

Our physicians help in the diagnosis and care of a broad spectrum of liver diseases as well as cirrhosis.  When appropriate we will coordinate with other healthcare providers and surgeons to provide multidisciplinary care to provide an individualized treatment recommendation for each patient. Below is a list of common liver disorders we treat:

Alcohol related liver disease

• Alcoholic cirrhosis
• Alcohol associated fatty liver disease is a buildup of fat inside the liver due to excessive alcohol consumption.
• Alcoholic hepatitis is where the liver becomes inflamed from moderate to heavy consumption of alcohol.

Viral hepatitis

• Hepatitis A is a liver infection caused by the hepatitis A virus.
• Hepatitis B is a liver infection caused by the hepatitis B virus spread from bodily fluids such as blood or semen.
• Hepatitis C is an infection of the liver caused by contact with contaminated blood.

Autoimmune liver diseases

• Autoimmune hepatitis occurs when the immune system attacks liver cells, causing inflammation of the liver.
• Primary sclerosing cholangitis occurs when the immune system attacks the liver’s bile ducts (drainage system).
• Primary biliary cholangitis occurs when the immune system attacks the liver’s bile ducts (drainage system).
• Overlap autoimmune conditions are a combination of the above issues both occuring simultaneously.

Genetic (inherited) liver conditions

• Hemochromatosis is where the body builds up excessive amounts of iron which can in turn damage tissues and organs.
• Alpha-1 antitrypsin deficiency is a disorder where an abnormal protein can build up in the liver, causing inflammation.

Nonalcoholic fatty liver disease

• Nonalcoholic steatohepatitis is characterized by a buildup of fat in the liver which causes inflammation and liver damage in people who drink little or no alcohol.

Other liver diseases

• Drug-induced liver disease is an injury to the liver caused by prescription or over-the-counter medications, herb, or supplements.

Liver Cancer

• Hepatocellular Carcinoma
• Cholangiocarcinoma

Treatment

Certain liver conditions are treatable and even curable with medication. Our team will tailor treatment to each individual that may consist of a combination of monitoring, lifestyle changes and medications depending on the underlying liver disorder.

Medications

An example of a potential treatment is that we can treat hepatitis B with medication so that the virus is suppressed and no longer found in the blood stream.  Given recent advances in medicine, hepatitis C is generally curable with only a short course of oral medication therapy. We can treat other conditions like hemochromatosis, autoimmune hepatitis and primary biliary cholangitis to reduce the inflammation caused by these disorders and prevent progression of liver scarring and development of cirrhosis.

Lifestyle changes

We may recommend lifestyle changes to help you avoid further damage to your liver, such as:

• Limiting or completely avoiding alcohol: Alcohol is absorbed and metabolized by the liver and can both cause direct inflammation as well as worsen certain liver disorders or worsen symptoms.
• Losing weight or maintaining a healthy weight: Losing weight and controlling blood sugar levels if diabetes is present can help protect your liver from further damage.