Liver Disease Management


Liver disease management, and the broader practice of hepatology, refers to the prevention, diagnosis and treatment of conditions related to the liver, gallbladder, binary tree and pancreas.

Some of these conditions include:

  • Hepatitis
  • Fatty liver disease
  • Cirrhosis of the liver
  • Liver cancer
  • Pancreatitis

Our qualified hepatologists are specialists in the prevention, diagnosis and management of these diseases, ensuring the best possible treatment for your liver.

Functions of the Liver and Prevalence of Liver Diseases

The liver is one of the most important internal organs, playing a vital role in over 500 bodily functions.

The most well-known liver function is its role in processing and breaking down any toxins that may be harmful to our bodies.

The liver is also responsible for the production of bile, cholesterol, and other special proteins. In addition, it plays a vital role in storing excess iron and glucose.

An estimated 6 million people are affected by some form of liver disease in Australia. Liver disease may either be genetically inherited or caused by risky lifestyle choices.

Below are some of the most common liver diseases.

Hepatitis B

Hepatitis B is a contagious disease that is transmitted via infected blood or other body fluids. The disease targets and attacks the liver, resulting in acute (less than 6 months) or chronic (more than 6 months) illness.

Chronic infection progressively damages the liver, resulting in inflammation and scarring. The scar tissue on the liver is irreversible and may develop into cirrhosis. Although 95% of adults clear the disease within 6 months, infants with hepatitis B have a 9 in 10 chance of developing a chronic illness.

Over 226,566 Australians are living with chronic hepatitis B, and many are unaware that they are infected.

Risk factors include:

  • Injecting drugs
  • Family origins from areas with high rates of the hepatitis B virus (East/South-East Asia, Sub-Saharan Africa and southern regions of Eastern/Central Europe).
  • Sexual contact (both heterosexual or homosexual).
  • Needle related injuries (for example, health care workers).
  • Use of unsterilised equipment when tattooing.
  • Symptoms include jaundice (yellowing of the skin/eyes), fatigue, nausea, dark urine, vomiting, muscle or joint pain, loss of appetite and pain on the right-hand side of the abdomen.

  • While there is no cure for hepatitis B, most adults will naturally recover from the infection within 6 months. However, people with severe hepatitis B may require antiviral medication and a hospital stay in extreme circumstances.

    Treatment for chronic hepatitis B focuses on minimising damage to the liver and preventing you from transmitting the infection. Our hepatologists may suggest antiviral medications, interferon injections or, in severe cases, a liver transplant.

    Hepatitis C

    Hepatitis C is a blood-borne virus that is spread via the contact of infected blood with another. The primary source of hepatitis C comes from perinatal transmission and unsafe use of intravenous drugs.

    Over 130,000 Australians live with chronic hepatitis C, as only 25% of patients experience acute (less then 6 months) illness. Lack of diagnosis and low rates of treatment contribute to the prevalence of the liver disease.

    Untreated chronic hepatitis C leads to progressive liver inflammation and is one of the leading causes of cirrhosis, liver cancer and liver failure.

    Risk factors include:

  • Injecting drugs
  • Blood transfusions before 1991
  • Tattoos and piercings conducted with unsterilised equipment
  • Needle related injuries (for example, health care workers)
  • Family origins from areas with high rates of hepatitis C (Eastern Mediterranean region and European region).

  • Approximately 80% of patients do not exhibit symptoms, making a diagnosis of the hepatitis C virus difficult.

    However, those severely affected by the disease may show symptoms of jaundice (yellowing of the skin/eyes), fatigue, nausea, dark urine, vomiting, joint pain, loss of appetite and abdominal pain.

    Treatment for hepatitis C is quick and simple once diagnosed. Antiviral medicines are 95% effective in eradicating the disease within 8-12 weeks and have minimal side effects.

    Fatty Liver Disease

    Also known as non-alcoholic fatty liver disease (NAFLD), fatty liver disease is a term that incorporates a range of conditions caused by the build-up of fat in the liver.

    The disease affects 1 in 3 Australians, and it is the most common cause of chronic liver disease in developed countries.

    Poor lifestyle choices such as your diet or lack of exercise are common causes of the disease.

    Two common types of fatty liver disease are:

  • Simple steatosis: the gradual build-up of fat without inflammation or liver damage
  • Non-alcoholic steatohepatitis: the accumulation of fat causes liver inflammation, resulting in damaged cells and scarring of liver tissue.

  • Risk factors include:
  • High cholesterol levels
  • High triglyceride levels (a type of fat found in the blood)
  • Obesity
  • Type 2 diabetes
  • High blood pressure
  • Fatty liver disease is hard to diagnose as it rarely presents symptoms.

  • Undiagnosed and untreated fatty liver disease can lead to significant health problems, such as cirrhosis.

    However, a doctor can detect fatty liver disease when reading routine blood test results of patients and may refer you to a hepatologist.

    A consultation with our specialists can help provide medical advice that will help change your lifestyle and diet to help minimise the build-up of fat in your liver.

    Alcohol-Related Liver Disease

    Alcohol-related liver disease is a condition where the liver becomes inflamed and swollen due to excessive drinking. If untreated, the damage can lead to irreversible scarring of the liver tissue, which is known as cirrhosis.

    The liver produces a toxic substance called acetaldehyde to help break down alcohol in our blood. Excessive consumption of alcohol can lead to an overproduction of acetaldehyde which damages healthy liver cells.

    In 2017 close to two-thirds of alcohol-induced deaths of Australians were due to liver disease.

    Risk factors include:

  • Binge drinking
  • Drinking excessively over an extended period
  • Obesity
  • Pre-existing liver conditions
  • Genetics (problems processing alcohol or substance dependence)
  • Government health officials recommend that healthy men and women should consume no more than 4 standard drinks a day and 10 standard drinks a week.

  • Symptoms may include jaundice (yellowing of skin/eyes), nausea, and swelling of the abdomen and legs.

    Treatment depends on the severity of liver damage and may require avoiding alcohol consumption or medication.

    Cirrhosis Of The Liver

    Cirrhosis is an irreversible state of advanced liver disease where the organ replaces healthy cells with scar tissue due to chronic damage. Common causes of liver cirrhosis are hepatitis B/C, fatty liver disease and excessive alcohol consumption.

    The accumulation of scar tissue creates liver disorders, slowing its capacity to perform functions such as the processing of harmful toxins.

    Risk factors include:

  • Excessive drinking
  • Obesity
  • Viral hepatitis

  • Symptoms gradually worsen as the liver accumulates scar tissue. Such symptoms include fatigue, easily bruising, jaundice (yellowing of skin/eyes), weight loss, spider veins on the skin, red palms, hair loss, itchy skin, dark urine, dark coloured faeces, vomiting blood and confusion.

    Treatments for cirrhosis will focus on managing the underlying disease causing the scarring, such as hepatitis or fatty liver disease. In severe cases where the liver has extensive scar tissue, a transplant may be necessary.

    Liver Cancer

    Hepatocellular carcinoma (HCC) is the most common form of liver cancer. Liver cancer results in the growth of abnormal cells on the tissue, forming liver tumours. In Australia, HCC is the 7th most common cause of cancer-related deaths, with a survival rate of 20% for males and 17% for females.

    Risk factors include:

  • Fatty liver disease
  • Type 2 diabetes
  • Viral hepatitis
  • Obesity
  • Smoking tobacco
  • Excessive drinking
  • Family history of HCC

  • Symptoms are likely to appear as the cancer develops. These include fatigue, abdominal pain and swelling, pain in the right shoulder, loss of appetite, nausea, jaundice (yellowing of skin/eyes), fever and pale coloured faeces.

    It is possible to treat HCC, depending on how early the cancer is detected. If you have any chronic liver disease you should make appointments with a hepatologist every 6 months to increase chances of early cancer detection.

    Treatment requires a multidisciplinary approach and may require either surgery or liver transplantation.


    Pancreatitis is the irritation of cells and inflammation of the pancreas. It can be acute (less than 6 months) or chronic (longer than 6 months). Scar tissue can develop in the pancreas, leading to a loss of function and impacting the digestive system.

    Pancreatic diseases can leave the body without treatment. However, more severe cases can cause life-threatening complications such as kidney failure, diabetes or pancreatic cancer.

    Risk factors include:

  • Smoking tobacco
  • Obesity
  • Family history of pancreatitis
  • Excessive drinking

  • Symptoms may include fever, nausea, tender abdomen, abdominal pain that radiates to your back and worsens after eating.

    If you are experiencing severe discomfort, you may require hospital attention. Our hepatologists can provide specialist care when treating pancreatitis by offering recommendations on changing your diet and lifestyle.

    Looking After Your Liver

    While some diseases are chronic and may last a lifetime, there is a range of treatments to help minimise the damage to your liver.

    A change to your diet is a fundamental treatment for your liver. This can include avoiding alcohol, cigarettes, cutting down on salt or eating less red meat, cheese and eggs.

    Healthy lifestyle choices that help encourage you to lose weight and manage high blood pressure can also help.

    If you have a negative test result, which means no blood has been detected in the samples you provided, this does not mean you do not or will not develop bowel cancer. It is recommended you remain vigilant and monitor for any symptoms of bowel cancer, and repeat the screening test in two years time.

    While colonoscopy is effective in reducing deaths from bowel cancer there have been limitations to its effectiveness. There has been increasing awareness of the potential for "missed lesions" but there have also been significant developments to help reduce this risk.

    These developments include improved preparation of the colon, use of high definition wide-angle colonoscopes and video equipment carbon dioxide insufflation of the colon, retroflexion of the endoscope to look behind folds as well as the assessment of withdrawal time and adenoma detection rates by the endoscopist.

    These advancements in technology will assist in reducing the amount of bowel cancer-related deaths, however, the message here should be that early intervention provides higher chances of survival.


    How can a hepatologist help manage a liver condition?

    A hepatologist treats all conditions related to the liver, this includes hepatitis, fatty liver disease, cirrhosis of the liver, liver cancer and pancreatitis.

    When should you see a hepatologist?

    Typically, your doctor will refer you to see a hepatologist if you display symptoms of liver disease or present abnormal results in blood tests. If you have a pre-existing liver condition, regular follow up appointments may be necessary for cancer screening.

    What is the difference between a hepatologist and gastroenterologist?

    Gastroenterologists in Australia are also registered as hepatologists, qualifying them to deal with liver conditions.
    However, a specialised hepatologist has a more in-depth understanding of the liver, whereas a gastroenterologist focuses on the digestive system or the gastrointestinal tract.

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