Liver Disease: Types, Symptoms and Causes

The liver is one of the body’s most vital organs, responsible for filtering toxins, aiding digestion and supporting metabolism. When the liver becomes damaged, its ability to perform these functions declines, leading to a wide range of health problems. 

Many diseases and disorders can cause the liver to function improperly or stop functioning. Hepatologists (physicians who specialize in liver disease) at Froedtert & the MCW provide care for people with short-term (acute) and long-term (chronic) liver disease as well as end-stage liver disease. Most people with liver disease can be treated without surgery. 

Our team includes hepatologists, physician assistants, nurses and other specialists with advanced training in liver and digestive diseases, as well as transplant care. Outpatient visits take place in the GI/Hepatology Clinic at Froedtert & MCW, where we care for patients with a wide range of needs — from mild liver disease to long-term follow-up after transplant. Our hepatologists also provide expert consultation for patients hospitalized with liver disease.

What Is Liver Disease?

Liver disease is a serious condition that can progress silently until advanced stages. Early detection and treatment are critical to protecting liver function and preventing complications.

Who Is at Risk? 

• People with chronic hepatitis infections 
• Individuals with obesity, diabetes or heavy alcohol use 
• Those with a family history of liver disease or cancer 
• Patients with cirrhosis from any cause 

Types of Chronic Liver Disease 

Many liver diseases and disorders can cause the liver to function improperly or stop functioning. The types of liver problems include a wide range of conditions that damage the liver, each with distinct causes and effects.

• Alcohol-induced liver disease — Damage to the liver caused by long-term alcohol use.
• Fatty liver disease — A buildup of fat in the liver cells. It may be due to alcohol abuse, obesity, hepatitis C, diabetes or other causes.
• Cirrhosis — Permanent scarring of the liver caused by long-erm damage from many possible conditions.
• Non-cancerous liver tumors — Growths in the liver such as hemangioma, adenomas, cysts and other benign lesions.
• Liver Cancer — Cancer that can develops due to cirrhosis, viral hepatitis, iron overload or other chroice liver diseases.
• Metabolic diseases — Inherited conditions such as hemochromatosis too much iron in the body) and Wilson’s disease (too much copper in the body).
• Autoimmune liver disease — Conditions in which the immune system attacks the liver or bile ducts, which can lead to cirrhosis or liver failure.
• Hepatitis B and C — Viral infectsion spreas through blood that cause inflammation (swelling) of the liver.
• Drug-induced liver disease — Liver damage caused by certain prescription medications, over-the-counter drugs, supplements, herbal products or environmental toxins.
• Bile duct diseases — Conditions that affect the tubes (bile ducts) that carry bile from the liver.
• Liver abscesses — Infections that cause pockets of pus to form in the liver.
• End-stage liver disease —The most advanced stage of chronic liver disease, when the liver can no longer function properly.

Our specialists evaluate each patient carefully to determine the cause of liver disease and develop a personalized treatment plan.

Early Liver Disease 

In the beginning, liver disease may not cause noticeable problems. When symptoms do appear, they are often subtle and nonspecific, which can make early detection challenging. 

Common early indications include: 

• Fatigue and malaise: Feeling unusually tired or generally unwell. 
• Nausea or loss of appetite: Reduced interest in food or persistent stomach upset. 
• Upper abdominal pain: Discomfort or pain in the right upper abdomen. 
• Mild fever or flu-like symptoms: Sometimes seen in acute hepatitis infections. 
• Abnormal liver blood tests or abnormal imaging of the liver, such as an ultrasound.

These early indications may be overlooked or mistaken for other conditions, which is why routine checkups and liver function tests are important if risk factors are present. 

Signs and Symptoms of Advanced Liver Disease 

As liver damage progresses, the organ struggles to perform vital functions like filtering toxins, producing bile and regulating blood clotting. This leads to more pronounced and serious symptoms: 

• Jaundice: Yellowing of the skin and eyes due to bile buildup. 
• Dark urine and pale stools: Changes in waste color caused by impaired bile flow. 
• Itchy skin (pruritus): Often without a visible rash. 
• Digestive difficulties: Trouble processing fatty foods, weight loss, and muscle wasting. 
• Swelling (ascites and edema): Fluid accumulation in the abdomen, ankles, or feet. 
• Easy bruising and bleeding: Reduced clotting factor production. 
• Spider angiomas and red palms: 
• Visible changes in skin and nails. 
• Confusion or memory problems (hepatic encephalopathy): Toxin buildup affecting brain function. 
• Hormonal changes: Irregular periods in women, breast enlargement or testicular shrinkage in men. 

In advanced liver disease, complications such as portal hypertension, internal bleeding from varices (varicose veins) and liver cancer may occur, making the condition life-threatening without advanced medical intervention. 

Stages and Complications 

Chronic liver disease can progress through several stages: 

Hepatitis (Inflammation) 

• Early stage where the liver becomes inflamed due to infection, toxins, alcohol or metabolic issues. 
• There are often no symptoms, but may cause fatigue, nausea or abdominal pain. 
• If treated early, inflammation can be reversible. 

Fibrosis (Scarring) 

• Persistent inflammation leads to scar tissue formation. 
• Scar tissue disrupts blood flow and liver function. 
• Some fibrosis can be reversed if the underlying cause is addressed. 

Cirrhosis (Severe Scarring) 

• Extensive, permanent scarring replaces healthy tissue. 
• The liver struggles to function properly, leading to complications like jaundice, ascites (fluid buildup) and easy bruising. 
• Damage at this stage is not reversible, but progression can be slowed. 

Liver Failure (End-Stage Liver Disease) 

• The liver can no longer perform vital functions such as detoxifying blood or producing bile. 
• Symptoms include confusion (hepatic encephalopathy), severe swelling and internal bleeding. 
• This stage is life-threatening and often requires a liver transplant.

How is Liver Disease Detected? 

Liver disease is detected through a combination of medical history, physical examination, laboratory testing and advanced imaging. At Froedtert & MCW, hepatology specialists use these diagnostic tools together to provide an accurate assessment and guide personalized treatment plans. 

• Physicians begin by reviewing risk factors such as alcohol use, viral hepatitis or family history and may look for signs like jaundice or abdominal swelling. 
• Blood tests are commonly used to evaluate liver function and measure enzymes or proteins that signal damage. 
• Imaging studies such as ultrasound, CT, or MRI scans help visualize the liver’s structure, identify scarring or detect tumors. 
• In certain cases, a liver biopsy may be performed, where a small tissue sample is taken and examined under a microscope to confirm the diagnosis. 

What Happens if Liver Disease Isn’t Detected Early? 

Undiagnosed liver disease can silently progress to cirrhosis, liver cancer or complete liver failure. By the time symptoms appear, treatment options may be limited. Regular screening and early medical care are essential for those at risk. 

Treatment Options 

Hepatologists (physicians who specialize in liver disease) at Froedtert & MCW provide care for people with acute and chronic liver disease as well as end-stage liver disease. Most people with liver disease can be treated without surgery. 

• Lifestyle changes: Healthy diet, exercise, limiting alcohol and avoiding tobacco. 
• Medications: To treat hepatitis, autoimmune disease or metabolic disorders. 
• Procedures: Locoregional therapies for tumors or surgery in select cases. 
• Liver transplant: For patients with end-stage disease when other treatments are no longer effective. 

Liver Failure, Advanced Liver Disease & Liver Transplant 

Liver failure can occur suddenly (acute liver failure), or it can develop over time as the result of chronic liver disease.

When the liver can no longer function well enough to support the body, this is called end-stage liver disease. For some patients, a liver transplant may be the best treatment option.

The Froedtert & MCW Liver Transplant Program performs approximately 40 liver transplants each year. Our program brings together experienced transplant surgeons, hepatologists, social workers, psychologists, pharmacists, dietitians and specialized nurses to coordinate every aspect of care. The transplant team meets regularly to review and discuss each patient being considered for transplant.

Patients with advanced liver disease are evaluated in the GI/Hepatology Clinic to determine whether transplant is an appropriate option. Blood tests are used to measure liver function and estimate disease severity. 

These results help determine whether a transplant would improve survival compared with continuing medical management.

Patients who receive a liver transplant recover in a dedicated inpatient transplant unit staffed by nurses specially trained in transplant care. After surgery, patients are seen daily by hepatologists for medical management and by transplant surgeons for surgical care. Long-term follow-up continues in the Transplant Clinic, where hepatologists oversee ongoing care and transplant surgeons remain closely involved.

For patients with end-stage liver disease who are not candidates for transplant, we offer palliative care focused on symptom management, quality of life and supportive care for patients and families.

Preventing Liver Disease: Every Day Steps for a Healthier Liver 

While not all liver conditions can be prevented, many lifestyle choices play a big role in keeping your liver strong. Here are practical steps patients can take: 

Eat a Balanced Diet 

• Choose plenty of fruits, vegetables, whole grains and lean proteins.
•  Limit saturated fats, fried foods, and added sugars, which can contribute to fatty liver disease. 
• Stay hydrated — water helps the liver flush out toxins. 

Stay Up to Date on Vaccinations 

• Vaccines for hepatitis A and B can protect against viral infections that damage the liver. 
• Ask your healthcare provider if you’re at risk and whether vaccination is recommended for you. 

Maintain a Healthy Weight 

• Being overweight increases the risk of non-alcoholic fatty liver disease (NAFLD). 
• Aim for regular physical activity and portion control to support liver health. 

Use Medications Wisely 

• Some medicines and supplements can harm the liver if taken incorrectly. 
• Always follow dosing instructions and avoid mixing alcohol with medications. 
• Talk to your doctor before starting new supplements or herbal remedies.

Practice Safe Habits

• Wash hands regularly and avoid sharing needles or personal items (like razors or toothbrushes) to reduce risk of viral hepatitis.
  Practice safe sex to lower the chance of hepatitis B and C transmission.