Liver Trouble Without Warning? When to Screen Even If You Feel Healthy

Liver disease symptoms are very unique in its presentation. Normally, with any other organs, symptoms appear as soon as there is a problem. On the contrary, in liver disease, symptoms often appear very late. This late presentation is mainly due to the large size of the liver and staged damage to the liver confounded by its capacity for regeneration.

Interestingly, in a healthy individual weighing 70 kg, the liver weight is approximately 800 to 1200 grams, which is about 1 to 1.5% of body weight. It is a staged process where fatty liver develops first, which then progresses to fibrosis and eventually cirrhosis.

Initially when the liver starts getting damaged, there are hardly any obvious symptoms. What patients may experience is just generalized weakness. Sometimes, they might feel a sense of heaviness or notice swelling in the legs, but these are generalized symptoms and often go unnoticed. This stage is known as compensated liver disease, which means there are minimal to no symptoms, but internally liver damage is going on, often due to alcohol overuse, underlying hepatitis or any other liver conditions.

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When Do Liver Disease Symptoms Become Obvious?

In more advanced stages, symptoms become more visible — yellowish discoloration of the skin and eyes (jaundice), gynecomastia (development of breast tissue in men), abdominal swelling due to fluid accumulation (Ascites), muscle wasting, and the appearance of prominent veins or spider veins on the skin. Additional symptoms may include pitting edema (swelling of the legs).

Apart from these symptoms, there can be major symptoms like bleeding from the variceal veins near the food pipe, manifesting as blood in the vomit or passage of black stools. They can also get confused and in severe cases comatose (Hepatic Encephalopathy)

So, the question arises — how do we detect liver disease before the liver gets too damaged?

The first and most important step is maintaining a healthy lifestyle — keeping your weight under control and avoiding alcohol. Screening for hepatitis through routine blood tests and undergoing an abdominal ultrasound which can identify lot of liver diseases. Ultrasound is an excellent tool that can detect abnormalities of the liver at an early stage. Therefore, you should never ignore minor symptoms such as fatigue, loss of appetite, or low-grade fever, swelling in the legs and, itching and easy bruisability especially if there’s a history of liver disease in the family.

Bottom line is that prevention is the best cure for liver disease. Timely intervention can prevent a lot of complications, which could become far more dangerous if left unaddressed.

(This article is authored by Dr. Sanjeev Rohatgi, Consultant - Surgical Gastroenterology & Liver-Pancreas Transplantation, Manipal Hospital Whitefield.)