The largest organ in the body, the liver plays a crucial role in many bodily functions. It sits in the upper right quadrant of the abdomen, beneath the diaphragm and on top of the stomach. We would not be able to survive without the liver, but several conditions can affect it, such as hepatitis and cirrhosis. Hepatomegaly causes the liver to swell beyond its normal size. Rather than being a disease, however, this condition often signals an underlying issue such as cancer or congestive heart failure.
Hepatomegaly is an abnormal swelling of the liver, which leads to enlargement of the organ. A non-specific sign, it often results from pathological processes such as infections or tumors; sometimes jaundice -- a yellow discoloration of the skin -- accompanies this symptom. Because it is often asymptomatic in mild cases, hepatomegaly tends to go unnoticed for long periods. Depending on the underlying cause, there is a possibility of long-term liver damage. Fortunately, though, the condition is often treatable.
People with mild cases of hepatomegaly will often experience no symptoms. If serious swelling is present due to an underlying disease, however, an individual may experience abdominal pain, bile reflux, muscle aches, weight loss, easy bruising, nausea, weakness, fatigue, and a feeling of fullness. Liver function tests will also show evidence of enlargement.
An enlarged liver is often a sign of an underlying health issue. Some of the most common causes of hepatomegaly are liver diseases such as cirrhosis and hepatitis; excess alcohol consumption, congestive heart failure, and fatty liver are common causes of the former. Some of the less common causes include cancers such as leukemia, lymphoma and myeloma, hepatic cysts, gallbladder obstruction, and Gaucher’s disease—a disorder in which fatty substances build up in the liver.
Individuals have a greater chance of developing hepatomegaly if they have preexisting liver disease. Some of the factors that may increase the risk of liver problems include excessive alcohol use, infections, poor eating habits, and large doses of supplements or medications. A person is also more likely to develop an enlarged liver if they have a family history of inflammatory bowel disease, liver cancers, autoimmune disorders, chronic liver disease, or obesity.
While many are mild, some cases of hepatomegaly warrant immediate medical attention. For instance, an individual should visit the emergency department if they are experiencing severe abdominal pain, shortness of breath, fever and jaundice, bloody stools, or bloody vomit. At the hospital, the physician can treat the symptoms after determining the underlying cause.
Diagnosis often begins with a physical exam, during which the physician will palpate the liver; this will allow them to determine whether or not the organ is enlarged. To determine the underlying cause, the doctor may order a variety of tests such as x-rays, CT scans, MRI scans, ultrasounds, blood tests, or liver function tests. If the physician suspects a serious condition, he or she may opt to perform a liver biopsy—a procedure that requires extracting a small sample of the liver to examine under a microscope.
Treatment for hepatomegaly depends on the underlying cause. For instance, medications can effectively treat infections such as hepatitis, while people with cancer may need surgery or radiation. If too much alcohol is the source of the problem, quitting may help prevent further damage. In some severe cases, therapy may involve a liver transplant.
Finally, if left untreated, the underlying condition will likely worsen over time. And in some cases, the situation may even be life-threatening. For instance, enough damage to the liver can interrupt the organ's ability to perform vital functions such as filtering blood and removing toxins.
Individuals can minimize their risk of developing hepatomegaly by managing a few lifestyle factors. For instance, it may help to follow a healthy diet, maintain a healthy weight, and limit alcohol consumption. It is also a good idea to consult with a physician prior to taking vitamins or herbal supplements, as they may affect the liver.
The outlook for hepatomegaly depends on the underlying cause. If a serious illness such as cancer is not the precursor, then the condition is often treatable. Medications are effective at reducing symptoms of liver disease and congestive heart failure, which in turn correct hepatomegaly. Rarely, severe damage to the liver will lead to long-term complications.
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