Treating liver disease
Treating liver disease depends entirely on the condition you’re suffering from, and may involve taking medication, undergoing surgery, or getting a liver transplant.
The treatment also depends on whether you have acute or chronic liver disease, whether you’re dealing with fibrosis or cirrhosis, and whether the liver disease is the result of a viral infection, an autoimmune hepatitis, a genetically inherited disease, fatty liver disease, excessive drinking and/or drug abuse, or whether there’s a cancerous tumour in the liver.
Before your doctor can decide on the most appropriate treatment, a correct diagnosis must be made.
Treatment of various liver diseases
Congenital liver diseases
With all forms of liver disease, you’ll have to watch your diet carefully, so as not to put any unnecessary stress on the liver. In babies, this may include a special milk formula.
In the case of biliary atresia (a condition in which the common bile duct between the liver and the small intestine is blocked or absent), a surgical procedure can be done to allow bile to drain from the liver. However, many patients require liver transplant assessment.
In the case of Wilson’s disease (where copper accumulates in the liver), a chelating agent is used to remove the excess copper. Chelating agents are also used to treat haemochromatosis (where iron accumulates in the body) and to remove the iron deposits. In both these conditions, if the damage is too severe, a transplant may be needed.
In the case of Gilbert’s syndrome (which involves a defect in the liver’s uptake of bilirubin), treatment isn’t required. It’s a harmless condition seen mostly in young men, which presents with mild jaundice after strenuous exercise or a viral infection (e.g. cold, flu).
There’s no effective treatment available for hepatitis A.
Bed rest is mandatory, and all fatty foods and alcohol must be avoided. If the infection is the result of contact with infected sewage, great care must be taken to avoid further contact with the contaminating source.
A week after initial infection, you’ll no longer be contagious, and you may return to school or work. Hepatitis A is an acute infection, and doesn’t cause chronic hepatitis.
Hepatitis B and C
Chronic hepatitis B and C are treated with antiviral drugs. There are various medicines that can be taken orally.
Treatment can last 12 weeks for hepatitis C. Early treatment can stop it from becoming chronic, thus preventing cirrhosis of the liver. If treated early, hepatitis C may even be cured.
Hepatitis B is more difficult to treat as it tends to recur once the treatment has stopped. If you have hepatitis B, you might have to take antiviral drugs lifelong.
Medicines that make the immune system less active (immune suppressants, often in the form of steroids such as cortisone) are the main treatment for auto-immune hepatitis.
Non-alcoholic fatty liver disease (NAFLD)
The treatment for this condition involves identifying and treating underlying metabolic conditions such as diabetes, improving insulin resistance with lifestyle changes and medication, and using antioxidants to protect the liver from cirrhosis. Weight loss and exercise is mandatory.
While there’s no treatment that will reverse cirrhosis of the liver, treatment is aimed at stopping or delaying the disease process.
If the cirrhosis is a result of alcohol or drug abuse, the substance abuse must be stopped completely to prevent further damage.As in all cases of serious liver damage, your doctor will treat fluid build-up with medication, and recommend a reduced salt and protein intake. Laxatives may be given to speed up the removal of toxins from the intestines.
This is a stage where the liver no longer is able to perform all its viral functions. Many different conditions can lead to or result in liver failure. The only treatment that can restore liver function is a transplant.
Treatment of liver cancer depends on the stage that the cancer has reached. Surgery usually offers the best chance of a cure. If the tumour is small and in one part of the liver, while the rest of the liver is healthy, you might have to undergo surgery to remove it.
However, sometimes even a small tumour might not be easy for surgeons to reach, and therefore surgery to remove the tumour isn’t always an option. In some cases, a liver transplant might be the best option.
If you have liver cancer, your oncologist will discuss the best treatment options for you. This may include chemotherapy delivered straight into the liver with a catheter, an oral medication and/or radiation.
Make an appointment with your doctor if:
- You think you may have been infected with viral hepatitis.
- You experience liver-disease-related symptoms such as fatigue, loss of appetite, bruising, weight changes, itchy skin, water retention, pain in the upper right-hand side of the abdomen, nausea, vomiting, a change in urine or stool colour, blood in the stool, forgetfulness, confusion and/or jaundice.
Get urgent help if you experience abdominal pain that’s so severe that you can’t function or stay still.
Preventing liver disease
Reviewed by Dr Mark Sonderup, B Pharm, MB ChB, FCP (SA). Senior Specialist, Division of Hepatology, Department of Medicine, University of Cape Town and Groote Schuur Hospital. March 2018.