Liver disease | Mate ate hauā

Key points about liver disease

  • Liver disease (mate ate hauā) can be inherited or caused by damage to the liver such as from infection, alcohol use and obesity.
  • Over time, damage to the liver causes scarring (cirrhosis), which can lead to life-threatening liver failure.
Graphic illustration of liver location in the body
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The liver is the largest organ in our body and sits just under your rib cage on the right side of your abdomen. It performs many important functions involved in digesting foods and ridding your body of toxic substances such as:

  • producing bile to help break down food in the gut
  • breaking down harmful substances such as alcohol from the body
  • storing nutrients and vitamins
  • regulating the levels of many hormones and substances in the body such as cholesterol
  • fighting infections and disease.

There are many different types of liver diseases or disorders, caused by a variety of factors. The following are examples of the common causes of liver disease:

Causes Type of liver disease
Infection
  • Viruses and parasites can infect the liver, causing inflammation and reduced liver function.
  • Viruses can be spread through blood or semen, contaminated food or water, or close contact with a person who is infected.
Alcohol
  • Most people who consume alcohol do not suffer damage to the liver, but years of alcohol misuse can increase the chance of getting alcohol-related liver disease.
  • The amount of alcohol that causes liver damage differs from person to person.
  • Research has shown that on average, consuming more than 2 drinks per day in women and 3 drinks per day in men is more likely to have harmful effects on the liver.   
Obesity or overweight (BMI > 30)
  • People who are obese or overweight are more likely to have a build-up of fat in the liver which can lead to serious liver disease.
Drugs
  • Liver injury can be caused by prescribed medications, recreational or illicit drugs, hormones, herbal and dietary supplements.
  • Drug-induced liver injury
Genetics
  • An abnormal gene inherited from one or both of your parents can cause various substances to build up in your liver, resulting in liver damage.


Immune system abnormality  
  • Diseases in which your immune system attacks certain parts of your body (autoimmune) can affect your liver. 
  • Autoimmune hepatitis
  • Primary biliary cirrhosis
  • Primary sclerosing cholangitis

The common symptoms of liver disease include:

  • skin and eyes appear yellow (jaundice)
  • abdominal pain and swelling of the abdomen (tummy area)
  • itchy skin
  • dark coloured urine and pale coloured poo (stools)
  • weakness, feeling tired, weight loss
  • tendency to bruise easily.

When to see a doctor

Make an appointment with your doctor if you have any persistent signs or symptoms that worry you. Seek immediate medical attention if you have abdominal pain that is so severe that you can't stay still.

Not all types of liver disease can be prevented, such as those due to genetic causes or immune system abnormalities. But some types of liver disease, especially those related to lifestyle choices, can be prevented. 

Alcohol moderation

Avoiding excessive consumption of alcohol is an important first step in looking after your liver. Both men and women can get liver damage from excessive alcohol. Current recommendations are for no more than 2 standard drinks/day for women and 3 for men, with at least 2 alcohol-free days each week.

Watch this video about liver disease & alcohol

(external link)
(NHS, UK, 2018)

Weight reduction

Approximately 75% of obese people have a fatty liver. If you are overweight or obese, gradual weight loss and increasing exercise can reduce your risk of developing a fatty liver. Avoid rapid weight loss of more than 1 kilogram per week, as this can make liver disease worse. 

Quit smoking

Cigarette smoking may worsen some liver diseases and may increase your risk of developing liver cancer. Smoking impairs the liver’s ability to process medications, alcohol and other toxins and remove them from the body.

Get vaccinated

If you're at increased risk of contracting hepatitis or if you've already been infected with any form of the hepatitis virus, talk to your doctor about getting the hepatitis A and hepatitis B vaccines.

Practice safe sex

It’s not just HIV and other sexually transmitted infections you need to worry about with unsafe sex. Hepatitis B and C can both be contracted through unprotected vaginal or anal sex. The risk is increased during menstruation and with multiple sex partners.

Avoid risky behaviour

Intravenous drug use is a common way of contracting Hepatitis B and C, especially if needle sharing in involved. Sharing personal items like a toothbrush or razor blade with others can also transmit Hepatitis B and C.

Use medications wisely

Talk to your GP before mixing prescription medicines and herbal or dietary supplements. Only take prescribed or recommended doses and avoid alcohol while taking medications.

Hepatitis(external link) Best Practice Journal, NZ, 2009
Abnormal liver chemistry – evaluation and interpretation(external link) British Columbia Guidelines and Protocols Advisory Committee August 2011

Continuing professional development

Abnormal LFTs by Dr Kumudith Ekanayaka (external link)The Goodfellow Unit, NZ, 2018

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Credits: Healthify editorial team. Healthify is brought to you by Health Navigator Charitable Trust.

Reviewed by: Dr Derek JY Luo, MBChB (Otago) FRACP, Consultant Gastroenterologist

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