About Enlarged Liver (Hepatomegaly)
An enlarged liver (hepatomegaly) occurs when the liver has swollen beyond its normal size.
Why it is Problematic
An enlarged, swollen liver is, in itself, not a disease; rather, it is indicative of an underlying condition. Many of the underlying conditions that cause an enlarged liver are serious and require immediate medical assistance. Some of the underlying conditions that cause an enlarged liver are cirrhosis, hepatitis, alcoholic liver disease, fatty liver, and cancer.
Causes and Risk Factors
There are many potential causes of an enlarged liver, including liver disease; the ingestion or inhalation of toxins such as alcohol, medications, herbs or chemicals; certain autoimmune, genetic, or metabolic conditions; infection; viruses; and poor nutrition.
Individuals with liver disease are at an increased risk for developing an enlarged liver. Some of the liver diseases commonly associated with an enlarged liver are:
- Alcoholic liver disease
- Budd-Chiari syndrome
- Nonalcoholic fatty liver disease (NASH/NAFLD)
- Wilson's disease
Other factors that can contribute to the development of an enlarged liver are:
- Alcohol. Drinking alcohol beyond your body's individual threshold can lead to an enlarged liver.
- Herbal Supplements. Certain herbal supplements, including black cohosh, comfrey, pennyroyal, and mistletoehave been shown to cause liver damage.
- Infection. Certain infections can contribute to liver problems and an enlarged liver.
- Malnutrition. Poor dietary choices or not eating can cause liver damage.
- Medications and Supplements. Over-the-counter and prescription medications should be taken only as directed. Some vitamins and minerals are not appropriate for everyone. Always speak with your doctor before taking any new supplement.
An enlarged liver may be asymptomatic or cause only vague, unnoticed symptoms. When an enlarged liver occurs in tandem with a liver disease the most common symptoms include:
- Jaundice (yellowing of the skin and the whites of the eyes)
- Pain in the right upper quadrant of the abdomen
- Nausea and/or vomiting
An enlarged liver may be detected during a physical exam. A doctor investigates the size and texture of the liver and, based on these initial findings, may recommend any of the following:
- Blood tests. Your doctor may recommend liver function tests to assess liver enzyme levels in your blood. Blood tests can also help determine if a viral, genetic, autoimmune, or metabolic disorder is causing your enlarged liver.
- Diagnostic imaging tests. Imaging tests are a collection of non-invasive diagnostic tools to view the liver. These tests include CT scan, MRI, and ultrasound. Imaging tests are often used in conjunction with blood tests to aid in diagnosis.
- Magnetic Resonance Elastography. This new, non-invasive imaging technology is effective in recording the texture of the liver via sound waves. This option is not widely available at present, but is considered an efficient alternative to a liver biopsy procedure.
- Liver Biopsy. A liver biopsy is an invasive procedure in which tissue samples are collected from the surface of the liver for diagnostic testing.
Treatment and Prevention
Because an enlarged liver is not a disease but is the product of an underlying condition, treatment varies in accordance with the underlying cause. All of the underlying causes of an enlarged liver require medical attention. If you or someone you know is exhibiting any of the symptoms of an enlarged liver, contact your doctor immediately.
Basic measures to prevent liver problems include:
- Avoiding alcohol, drugs, and smoking
- Maintaininga well-balanced diet and maintaining a healthy weight
- Exercising regularly
- Taking over-the-counter and prescription medicines only as directed and never with alcohol
- Consulting a doctor before taking any new herbal or dietary supplement