Hepatology/Liver
In addition to treating the digestive tract, Gastroenterology also entails treating liver diseases, which can be life threatening. As the largest internal organ in your body, the liver plays a major role in a number of vitally important metabolic, functional, and detoxification processes, including the production of bile. Bile is then stored in your gallbladder and travels to the small intestine after you eat to help break down food for digestion.
The liver also metabolizes any toxins, alcohol, nutrients, and medications it receives from your digestive tract and kills germs that enter your body through your intestines. With such important responsibilities, a healthy liver is necessary for survival.
The liver is unique in that it can regenerate itself. If part of the liver is removed, it can regrow tissue. However, if the liver is severely damaged, it cannot regenerate its own cells and needs to be replaced.
Many types of liver disease can take years to develop, typically without any symptoms. Oftentimes patients don’t know they have liver disease until it’s in the advanced stages. Others may be diagnosed with liver disease while being evaluated for another condition.
When present, symptoms of liver disease may include:
- Weakness / fatigue
- Loss of appetite / weight loss
- Nausea / vomiting
- Abdominal pain and bloating when fluid accumulates in the abdomen
- Itching
- Spider-like blood vessels on the skin
- Jaundice
- Portal hypertension, or high blood pressure in the portal vein, which carries blood from the stomach, intestines, spleen, gallbladder, and pancreas to the liver
- Fluid buildup in the feet, ankles, or legs (edema) or in the abdomen (ascites)
- Bruising and bleeding
At Carlisle Digestive Disease Associates, our Board-Certified, fellowship-trained Gastroenterologists are experts at diagnosing and treating all types of liver conditions, such as:
- Autoimmune Hepatitis
- Cirrhosis
- Fatty Liver Disease
- Hemochromatosis
- Hepatitis B
- Hepatitis C
- Primary Biliary Cirrhosis
- Primary Sclerosing Cholangitis (PSC)
Severe liver damage can cause liver failure. If you are at risk for a liver condition or experience any unusual symptoms, call Carlisle Digestive Disease Associates to schedule an appointment with one of our providers. We can be reached at (717) 245-2228 or you can use our online appointment request form.
Autoimmune Hepatitis
Autoimmune hepatitis, in which the body’s immune system attacks the liver, can cause serious liver damage and chronic inflammation. Autoimmune hepatitis is more common in women than in men, and risk factors include a family history of the disease, having another autoimmune disease such as celiac disease, hyperthyroidism, or rheumatoid arthritis, or having been infected with the Epstein-Barr, herpes simples, or measles virus. Symptoms include abdominal discomfort or an enlarged liver, fatigue, jaundice (yellowing of the skin and the whites of the eyes), joint pain, skin rashes and spider angiomas (spider-like blood vessels). Left untreated, the disease can cause cirrhosis and further complications. Your gastroenterologist will work with you to develop a plan which may include medications and lifestyle changes to manage your immune system’s response to slow the progression of the disease.
Cirrhosis
Cirrhosis occurs when the liver has been repeatedly damaged and forms scar tissue (fibrosis) in the process of repairing itself. Cirrhosis may be caused by hepatitis, nonalcoholic fatty liver disease (NAFLD), nonalcoholic steatohepatitis (NASH), heavy alcohol use, toxins, infections, drug reactions, and diseases of the liver or the bile duct. In the early stages cirrhosis may produce no symptoms, but as the disease progresses symptoms include weakness, fatigue, loss of appetite, nausea, abdominal pain and bloating. Late stage complications include jaundice (yellowing of the skin and the whites of the eyes), gallstones, insulin resistance, type2 diabetes, and liver cancer. While liver damage is generally irreversible, lifestyle changes such as losing weight or avoiding alcohol, and may prescribe medications to control any underlying conditions. Your doctor will work with you to develop a treatment plan to slow the progression of the disease and treat possible complications.
Fatty Liver Disease
Nonalcoholic fatty liver disease (NAFLD) is a condition in which fat builds up in the liver. NAFLD may go undetected for a time as it produces no symptoms, and it is often diagnosed when elevated liver enzymes are found through routine bloodwork. While simple fatty liver disease does not typically cause liver damage, a more serious form of the disease known as nonalcoholic steatohepatitis (NASH) is known to cause liver damage which may progress to cirrhosis, liver cancer, or liver failure. Risk factors for fatty liver disease include insulin resistance, being overweight or obese, and metabolic syndrome, in which patients report three or more of the following: high blood sugar, high cholesterol, high triglycerides, high blood pressure, or large waist size. Patients with type 2 diabetes are at a higher risk of developing both fatty liver and nonalcoholic steatohepatitis. Lifestyle changes are recommended for patients with fatty liver, including maintaining a healthy weight through exercise, eating a balanced diet, avoiding alcohol, and taking only recommended medications and supplements.
Hemochromatosis
Hemochromatosis causes the body to absorb too much iron from the diet, and store the excess in the liver, heart and pancreas. While some people report no symptoms, or attribute their symptoms to other causes, patients frequently report fatigue, weakness, joint pain and abdominal pain. As the disease progresses patients may experience impotence, loss of sex drive, diabetes, liver failure, or heart failure. Hemochromatosis may be hereditary, it may result from genetic mutations, or from receiving multiple blood transfusions. If not treated, hemochromatosis can make the skin appear gray or bronze, and it can also lead to heart problems, diabetes (resulting from pancreas damage), or cirrhosis. Hemochromatosis can be treated by regularly having blood drawn (phlebotomy) at a doctor’s office or hospital, which can prevent complications and may slow the disease’s progression.
Primary Biliary Cirrhosis
Primary Biliary Cirrhosis is an autoimmune disorder in which the body attacks itself and slowly destroys the bile ducts in the liver, causing liver damage which can lead to cirrhosis. GI symptoms include upper right abdominal pain, abdominal fluid buildup (ascites), greasy diarrhea (steatorrhea), edema (swollen feet/ankles), and jaundice (yellowing of the skin and eyes). Other notable symptoms include hyperpigmentation (darkening of the skin), fatigue, dry eyes and mouth, joint pain, muscle pain, elevated cholesterol, and underactive thyroid. Smoking increases the risk of developing Primary Biliary Cirrhosis, and the disease is most common in women between 30 and 60 years of age. The cause is not known, but some researchers suggest toxins and infections may play a role in the development of the disease, which can lead to serious complications including cirrhosis, gallstones, liver cancer, osteoporosis, portal hypertension, and an enlarged spleen.
Primary Sclerosing Cholangitis (PSC)
Primary sclerosing cholangitis is generally a slow-progressing disease characterized by inflammation within the bile ducts, which can cause scarring and narrowing of the bile ducts, eventually damaging the liver. First symptoms may be fatigue and severe itching all over the body; other symptoms include jaundice (yellowing of the skin and the whites of the eyes), upper abdominal pain, weight loss, enlarged spleen, fever, chills, or night sweats. The cause of primary sclerosing cholangitis is unknown, however many patients diagnosed with PSC also have Crohn’s disease or ulcerative colitis so it is important for patients with inflammatory bowel disease to inform their doctor of symptoms. Medications may be prescribed to treat infections, and medicines and supplements may help to reduce itching and other symptoms. Endoscopic procedures may be used to treat bile duct blockages. A liver transplant is the only known cure for PSC.
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