Enlarged Liver: What You Need to Know
Common causes of enlarged liver include:
- drinking alcohol in excess and frequently
- cirrhosis (scarring of the liver)
- infections, including hepatitis
- liver cancer or other cancers that have moved to the liver
- other medical conditions, such as congestive heart failure
Most people cannot feel an enlarged liver, but you may notice some other symptoms. These symptoms can include gastrointestinal problems or yellowing of the skin and whites of the eyes, depending on the underlying condition causing the enlarged liver.
Seek prompt medical care for:
Seek immediate medical care (call 911) for the following symptoms:
Continue reading this article to learn more about enlarged liver symptoms, causes, and treatments.
Hepatomegaly, also called enlarged liver, is swelling of the liver. In some cases, both the liver and spleen become enlarged together, a condition called hepatosplenomegaly. Enlarged liver may interfere with the liver’s ability to function properly.
The liver is an organ in the digestive system that carries out many essential functions. These functions include:
- producing bile to help break down food into energy
- clearing the blood of bilirubin and toxins, including those from medication, alcohol, and drugs
- controlling fat storage
- controlling cholesterol production and release
- fighting infections
- producing blood plasma proteins
The liver and the immune system work together to produce inflammation to eliminate harmful substances in the liver.
Inflammation is part of an immune response. It is also important for the liver to repair damaged liver cells. When the inflammation continues, however, it can initiate early liver disease, inflame the liver, and cause it to enlarge.
Many symptoms may occur along with enlarged liver, depending on what is causing the condition. Some symptoms include:
- yellowing of the skin and whites of the eyes (jaundice)
- abdominal pain, swelling, or bloating
- diarrhea, pale-colored stool, or bloody stool (stool may be red or black)
- nausea with or without vomiting
- difficulty breathing
- discolored urine
- fever or chills
- itchy skin
- lack of appetite and unintentional weight loss
- swelling of the legs or feet
An enlarged liver can be a symptom of a life threatening condition. Seek immediate medical care (call 911) if you, or someone you are with, have any of these symptoms:
- severe or unusual abdominal pain
- change in mental status or sudden behavior change
- difficulty walking
- rapid heart rate (tachycardia)
- severe fatigue
- vomiting blood or black material resembling coffee grounds
Also seek prompt medical care if you are being treated for liver disease and your symptoms worsen, persist, or recur.
Enlarged liver is usually caused by liver disorders related to other conditions or disorders affecting other body systems.
Causes of enlarged liver
Causes of enlarged liver can include:
- excessive alcohol use
- congestive heart failure
- liver cancer or other cancers that have spread to the liver
- glycogen storage disease, an inherited disorder that causes liver enlargement
- hemochromatosis, a buildup of excess iron in body tissues, particularly the liver
- infectious mononucleosis, also called mono
- sclerosing cholangitis, inflammation, and destruction of the bile ducts
- steatosis (fatty liver disease)
- viral hepatitis (hepatitis A, B, and C)
- autoimmune diseases
Serious or life threatening causes of enlarged liver
In some cases, an enlarged liver may be caused by a serious or life threatening condition. These causes include:
- adverse drug reactions, such as acetaminophen toxicity
- blood infections
- injury to the liver or bile-draining tubes
- Reye’s syndrome
Some people have a higher risk of liver damage, which can lead to an enlarged liver. Some of these risk factors include medical conditions, family medical history, and other factors related to lifestyle choices.
Risk factors for enlarged liver related to your medical background and family history include:
- autoimmune disorders
- inflammatory bowel disease
- liver disease or liver cancer
- having an infection, including hepatitis
Risk factors for an enlarged liver related to lifestyle include:
- excessive alcohol use
- eating a diet high in sugar and fat
- taking too much of some vitamins or medications
- taking certain herbal supplements, such as black cohosh, chaparral, comfrey, germander, valerian, ma huang, skullcap, kava, mistletoe, and pennyroyal
Because it is unlikely you will feel that your liver is enlarged, your doctor may diagnose hepatomegaly when evaluating you for other symptoms. Other symptoms will vary depending on the underlying disease, disorder, or condition. Your doctor may suspect enlarged liver during a physical exam conducted for another reason.
Usually, the edge of the liver emerges just to the lower edge of your right rib cage. If it is enlarged, your doctor may be able to feel it when you take a deep breath.
To diagnose your condition, your doctor will ask questions, including:
- Have you noticed a feeling of fullness or a lump in your abdomen?
- Have you experienced any abdominal pain?
- Have you had any vomiting or vomiting of blood?
- Have you had any unusually colored stools?
- Have you had a fever or chills?
- How much alcohol do you drink? Have you noticed any increased pain after drinking alcohol?
- Have you noticed changes in your skin? A change in color? New blood vessels? Any itching?
- What medications do you take?
- Have you had any other symptoms?
Based on the physical exam and your answers to these questions, your doctor may want to conduct some tests. These could include:
- Abdominal ultrasound: This imaging test uses ultrasound to view the liver and abdominal organs.
- Imaging tests: An abdominal X-ray will look at the liver and surrounding organs. A CT scan or MRI will provide more details, including the composition of the liver and any potential changes.
- Liver function tests: These blood tests may include liver enzyme levels and a complete blood count, among other tests.
- Liver biopsy: A healthcare professional removes a small tissue sample of the liver to examine it under a microscope to look for changes.
To treat an enlarged liver, your doctor will focus on treating the condition that is causing the liver to swell. Since there are many problems that can cause liver damage, treatments vary.
Some things you can do to protect your liver and help prevent liver disease that causes hepatomegaly include:
- cutting back on drinking alcohol or stopping altogether
- maintaining a moderate weight
- eating a healthy diet and getting enough exercise
- getting vaccinated against hepatitis A and hepatitis B
- managing other health conditions, such as getting iron levels under control
- taking vitamins and supplements only under a doctor’s guidance and in the correct dosages
- getting appropriate treatment if cancer is causing an enlarged liver
Because an enlarged liver can be caused by serious diseases, failure to seek treatment can result in serious complications or permanent liver damage.
It is important to follow the treatment plan you and your doctor design specifically for you to reduce the risk of potential complications, which can include:
- cirrhosis (scarring of the liver that causes severe dysfunction)
- hepatic encephalopathy (a brain disorder caused by liver disease)
- hepatocellular carcinoma (liver cancer)
- liver failure
- portal hypertension (increased blood pressure in the veins around the liver, stomach, and esophagus)
- spread of cancer
- spread of infection
Enlarged liver is a sign of liver disease. A liver may become inflamed and enlarged while fighting off infection, cancer, or other conditions affecting the liver.
The liver is resilient and can at times heal itself. However, prolonged inflammation can cause permanent damage and lead to complications.
It is important to listen to your body and talk with your doctor if you notice any health symptoms. Imaging and liver function tests can help identify the cause of an enlarged liver. Treatment usually involves treating the underlying cause.