Liver disease

The liver is the second largest organ in the body. It is located under the rib cage in the right upper part of the abdomen. The liver can be affected by a variety of illnesses, including:

• Viral hepatitis, including hepatitis A, B and C
• Cirrhosis of the liver
• Alcohol-related liver disorders, including fatty liver disease
• Liver cancer, including hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma
• Metastatic liver tumors
• Liver cysts and polycystic disease
• Benign (noncancerous) liver tumors, including hemangiomas, focal nodular hyperplasia (FNH) and hepatic adenoma

There are five known types of viral hepatitis, an inflammation of the liver caused by infection. A different virus causes each, and the different forms of hepatitis can be spread in different ways. According to the American Liver Foundation, hepatitis can spread through contact with contaminated food or water and stool, blood and other body fluids. Hepatitis can also spread from a woman to her baby during childbirth.

Many people with hepatitis don't have symptoms, but people who do may have a tender or enlarged liver, fever, weakness, nausea, vomiting or jaundice. Some people recover from hepatitis without treatment, but others develop chronic illness. Vaccines can help prevent hepatitis A and B.

Hepatitis C is the number one cause of liver cancer and liver transplantation. Our team is very aggressive in treating hepatitis C before transplant and follows strict protocols in the care of post-transplant patients with hepatitis C. We have improved cure rates from about 50 percent to almost 99 percent with minimal side effects and medication interactions.

Cirrhosis develops when liver cells are damaged and replaced by scar tissue. Cirrhosis is caused most often by alcohol abuse. Other causes include hepatitis and other viruses, some chemicals and poisons, too much iron or copper in the body and severe reactions to drugs.

Doctors can treat some types of cirrhosis, but often there is no cure. Treatments are frequently aimed at managing major complications of cirrhosis, such as bleeding, changes in mental function and fluid build-up in the abdomen.

In addition to causing cirrhosis of the liver, alcohol can cause other liver diseases. Fatty liver disease—extra fat in the liver that makes it harder for the liver to function—is the most common alcohol-related liver disorder. Often this condition will completely reverse itself if the person gives up alcohol.

Alcoholic hepatitis is a short-term illness that may cause abdominal pain, fever, enlarged liver and elevated white blood cell counts. If you have alcoholic hepatitis and don't stop drinking, cirrhosis can develop.

Frequently, liver cancer is cancer that has metastasized—spread from some other part of the body. Cancer that starts in the liver appears to be associated with viral hepatitis, other infections, drugs and environmental toxins.

Methodist Healthcare's Liver and Biliary Cancer Center provides personalized services for liver, pancreas and biliary cancers, which while they are relatively rare, are aggressive and generally associated with poor outcomes. Most patients require multidisciplinary specialty cancer care for successful treatment with emphasis on aggressive surgical care. Highly-specialized surgical options can offer the possibility of a cure for these types of malignancies

Liver failure means that a large part of your liver has become damaged and is no longer able to function. It is a life-threatening condition that demands urgent medical care.

The first symptoms of liver failure are often nausea, loss of appetite, fatigue and diarrhea. Because these symptoms can have any number of causes, liver failure may be difficult to diagnose initially. However, as liver failure progresses, the symptoms become more serious. The patient may develop jaundice, become confused, disoriented and extremely sleepy or bruise and bleed easily. There is a risk of coma and death. Immediate treatment is needed, and the only treatment option may be a liver transplant.

Liver failure may develop rapidly (acute) or gradually (chronic). Chronic liver failure develops slowly over the years and is usually due to long-term alcohol use or hepatitis. Acute liver failure occurs suddenly and is usually a reaction to poisoning or a medication overdose.

Patients with life-threatening liver disease should be considered for liver transplantation. Our medical experts, social workers and financial specialists are always available to answer questions and provide assistance regarding liver transplantation.

Methodist Healthcare offers a number of treatment options for patients with liver disease and liver cancer. Treatment options may vary depending on each patient and the disease he or she is receiving treatment for. Our treatment options include advanced, cutting-edge therapies and procedures.

Our program is the only liver program in South Texas to offer an innovative therapy called endoscopic variceal obturation for patients. The procedure involves using tissue adhesives, such a cyanoacrylate, in patients who bleed from gastric fundal varices. This procedure is referred to as "glue injection of gastric varices."

Many times, for patients with end-stage liver disease or liver failure, the only treatment option is a liver transplant. At Methodist Healthcare, we host one of the top programs in the country for transplantation, offering comprehensive treatment programs as well as ongoing educational sessions for patients and their families.

We work to ensure our patients have access to the latest in clinical research and treatment options.

Our surgeons are trained in advanced techniques involving liver, pancreas and biliary surgery focusing on the surgical removal of tumors of the liver, pancreas, bile ducts and other parts of the gastrointestinal tract.

We offer expert care for patients with bile duct injuries and biliary strictures, cystic lesions of the liver and patients with cholangiocarcinomas (bile duct cancer).

Our surgeons and interventional radiologists offer surgical interventions in:

• Liver resection
• Intraoperative ultrasound
• Radiofrequency ablation
• Liver transplantation
• Surgery for portal hypertension
• Radiofrequency and microwave ablation (laparoscopic and open)