Liver Disease

Your liver is a large and powerful organ that performs hundreds of essential functions in your body. One of its most important functions is filtering toxins from your blood. While your liver is well-equipped for this job, its role as a filter makes it vulnerable to the toxins it processes. Too many toxins can overwhelm your liver’s resources and ability to function. This can happen temporarily or over a long period of time.

When healthcare providers refer to liver disease, they’re usually referring to chronic conditions that do progressive damage to your liver over time. Viral infections, toxic poisoning and certain metabolic conditions are among the common causes of chronic liver disease. Your liver has great regenerative powers, but constantly working overtime to restore itself takes its toll. Eventually, it can’t keep up.

What are the stages of chronic liver disease?

Chronic liver disease progresses in roughly four stages:

1. Hepatitis.
2. Fibrosis.
3. Cirrhosis.
4. Liver failure.

Stage 1: Hepatitis

Hepatitis means inflammation in your liver tissues. Inflammation is your liver’s response to injury or toxicity. It’s an attempt to purge infections and start the healing process. Acute hepatitis (an immediate and temporary response) often accomplishes this. But when the injury or toxicity continues, so does the inflammation. Chronic hepatitis causes hyperactive healing that eventually results in scarring (fibrosis).

Stage 2: Fibrosis

Fibrosis is a gradual stiffening of your liver as thin bands of scar tissue gradually add up. Scar tissue reduces blood flow through your liver, which reduces its access to oxygen and nutrients. This is how your liver’s vitality begins to gradually decline. Remarkably, some amount of fibrosis is reversible. Your liver cells can regenerate, and scarring can diminish if the damage slows down enough for it to recover.

Stage 3: Cirrhosis

Cirrhosis is severe, permanent scarring in your liver. This is the stage where fibrosis is no longer reversible. When your liver no longer has enough healthy cells left to work with, its tissues can no longer regenerate. But you can still slow or stop the damage at this stage. Cirrhosis will begin to affect your liver function, but your body will attempt to compensate for the loss, so you might not notice at first.

Stage 4: Liver failure

Liver failure begins when your liver can no longer function adequately for your body’s needs. This is also called “decompensated cirrhosis” — your body can no longer compensate for the losses. As liver functions begin to break down, you’ll begin to feel the effects throughout your body. Chronic liver failure is a gradual process, but it is eventually fatal without a liver transplant. You need a liver to live.

How common is liver disease?

Approximately 1.8% of U.S. adults (4.5 million adults) have liver disease. It causes about 57,000 U.S. deaths a year. Globally, it causes about 2 million deaths per year, or 4% of all deaths. Deaths are mostly from complications of cirrhosis, with acute liver failure accounting for a small portion. Liver disease affects men and people assigned male at birth (AMAB) twice as often as women and people assigned female at birth (AFAB).