Steatotic liver disease
Steatotic liver disease (formerly known as fatty liver disease) is a group of conditions associated with excessive fat buildup in the liver. If more than 5% of the liver’s weight is fat, it is considered steatotic.
Subcategories of steatotic liver disease include:
• Metabolic dysfunction-associated steatotic liver disease (MASLD). Formerly known as non-alcohol related fatty liver disease (NAFLD), but clinicians use the newer terms to more accurately reflect factors that contribute to the fat buildup in an affected liver.
o Metabolic dysfunction-associated steatohepatitis (MASH). Formerly known as non-alcoholic steatohepatitis (NASH). A serious form of MASLD in which the accumulation of fat leads to inflammation, tissue damage, and scarring.
Metabolic risk factors for MASLD/MASH
o High triglycerides
o Obesity
o Low HDL cholesterol
o Hypertension
o Prediabetes
o Type 2 diabetes
o Cardiovascular disease
o Sleep apnea
o Insulin resistance
• Alcohol-related liver disease (ALD). As its name suggests, ALD is caused by the excessive consumption of alcohol. Some cells die each time your liver filters alcohol, but in light to moderate drinkers it typically is able to make new cells to replace the old ones. For those who drink too much alcohol, the liver is unable to keep pace with the loss of cells, which can cause steatosis.
• Metabolic dysfunction-associated and alcohol-associated liver disease (MetALD). This occurs when a combination of metabolic risk factors and alcohol consumption contribute to the buildup of fat in the liver.
Cirrhosis
Cirrhosis is when someone’s liver is severely scarred and permanently damaged but they don’t look or feel sick because their body is still able to compensate for the damage. When the liver loses its ability to function properly and symptoms develop, the condition becomes decompensated cirrhosis. Our team treats cirrhosis from all causes.
Viral hepatitis
Viral hepatitis is an infection that causes inflammation in the liver. It is usually spread by contact with infected blood or bodily fluids and can cause short-term symptoms that may last a few weeks to a few months. Without treatment, viral hepatitis can lead to potentially life-threatening liver disease. We offer diagnosis, treatment and management of:
• Hepatitis B. The most common type of liver infection. It often causes short-term illness, but can become a chronic condition that requires management.
• Hepatitis C. Often spread by people sharing contaminated needles for drug use. This type of viral hepatitis is more likely to become a chronic condition.
Autoimmune liver disease is a group of conditions that occur when the immune system attacks liver cells. Common symptoms include fatigue, itchy skin, abdominal pain, jaundice, and an enlarged liver.
Autoimmune liver disease
Autoimmune liver disease includes the following conditions:
• Autoimmune hepatitis. The immune system attacks liver cells and causes inflammation. Genetic and environmental factors may trigger the disease, but the exact cause is unclear. Untreated autoimmune hepatitis can cause permanent scarring of the liver, called cirrhosis.
• Primary biliary cholangitis (PBC). Small bile ducts in the liver are attacked, causing blockages that trap bile and damage liver tissue. PBC is a chronic condition that can lead to cirrhosis and possible liver failure.
• Primary sclerosing cholangitis (PSC). This is a rare, long-term liver disease caused by inflammation of the bile ducts, often linked to inflammatory bowel disease (especially ulcerative colitis). Scarring of the bile ducts leads to liver damage that could eventually result in the liver losing its ability to support digestion and filter blood.
Drug-induced liver injury (DILI)
Drug-induced liver injury (DILI) is a rare condition that is caused by taking a harmful amount of certain medicines, herbal remedies, vitamins, or food supplements. Toxicity usually occurs after an overdose of medication or taking the damaging agent for several months.
Medicines that can cause DILI include:
• Pain and fever medicines that contain acetaminophen.
• Nonsteroidal anti-inflammatory medicines for pain and fevers (such as aspirin)
• Antibiotics used to treat bacterial infections
• Birth control pills
• Statins (for lowering cholesterol)
• Anabolic steroids
• Anti-epilepsy medications
• Herbal medicines and supplements (often unregulated for safety)
Symptoms vary and may include abdominal pain, fatigue, nausea and vomiting, dark urine, pale stools, and jaundice. These symptoms may suggest other problems, so consult with your doctor to be sure.
Hereditary hemochromatosis
Hereditary hemochromatosis is a rare condition caused by an altered gene that is passed on through families and causes the body to absorb and retain too much iron from food. The excess iron is stored in the organs and damages them over time, particularly affecting the liver, heart, and pancreas. Symptoms typically appear after age 40 in men and after age 60 in women and can include:
• Weakness
• Fatigue
• Memory fog
• Joint pain
• Abdominal pain
• Bronze or gray skin color
• Impotence/Loss of sex drive
• Liver failure
• Heart failure
• Diabetes
These symptoms can overlap other common conditions, so consult with your doctor if you experience any of them. If someone in your immediate family has been diagnosed with hemochromatosis, ask your doctor about genetic testing.
Liver cancer
Liver cancer is a malignant growth on the liver that can be life-threatening. Even if a tumor is removed, it may grow back or spread and damage nearby tissue. Signs and symptoms of liver cancer include:
• Pain on the right side of the upper belly
• A lump or feeling of heaviness in the upper abdomen
• Swollen belly
• Loss of appetite and feelings of fullness after having eaten very little food
• Weight loss
• Weakness or feeling very tired
• Nausea and vomiting
• Jaundice — a condition that causes yellow skin and eyes, pale stools and dark urine
• Fever
These symptoms can occur in many other health problems — not just liver cancer. If you notice any of these issues, your best bet is to make an appointment with your doctor right away. For patients who are diagnosed with liver cancer, we work closely with a multidisciplinary team of specialists at our Liver Center of Excellence, part of Capital Health Cancer Center, to provide personalized, comprehensive care plans. The center also offers histotripsy, a groundbreaking, non-invasive treatment option that uses focused ultrasound waves instead of heat, radiation, or scalpels to targets tumors with millimeter precision, offering new hope for patients who may not be candidates for surgery or conventional treatments.