Before a doctor can decide on what treatment would be appropriate for a patient with liver disease, a correct diagnosis needs to be made.
The treatment also depends on whether the patient has acute or chronic liver disease, whether one is dealing with fibrosis or cirrhosis, and whether the liver disease is the result of a viral infection, an autoimmune hepatitis, a genetically inherited disease, so-called fatty liver disease, the result of excessive drinking/drug abuse, or whether there is a cancerous tumour in the liver.
In severe cases of liver failure, a liver transplant may be a patient’s only hope.
Treatment of various liver diseases
There is no effective treatment available for hepatitis A. Bed rest is mandatory. All fatty foods and alcohol need to be avoided. If the infection is the result of contact with infected sewage, great care must be taken to avoid further contact with the contaminating source. A week after initial infection, the patient will no longer be contagious. Hepatitis A does not cause chronic hepatitis, according to the Merck Manual.
Hepatitis B and C
Chronic hepatitis B and C are treated with antiviral drugs. There is variety of medicines that can be taken orally, which can be used to treat hepatitis B and C. Treatment can last 12 - 48 weeks. Early treatment of hepatitis C can stop it from becoming chronic, and prevent cirrhosis of the liver. Hepatitis B is more difficult to treat as it tends to recur once the treatment is stopped. Those with hepatitis B might have to take antiviral drugs for life.
Medicines which make the immune system less active (immune-suppressants e.g. cortisone) are the main treatment for auto-immune hepatitis, according to the Children’s Liver Disease Foundation.
Congenital liver diseases
Treatment obviously depends on which type of liver disease someone has. In some cases, a liver transplant is advised, and in others there is medication available.
With all forms of liver disease, the diet has to be watched carefully, so as not to put unnecessary stress on the liver.
In babies, this may include a special milk formula.
In the case of biliary atresia, a surgical procedure can be done to allow bile to drain from the liver however many patients will require liver transplant assessment.
In the case of Wilson’s disease (where copper accumulates in the liver), medication or a transplant are the two forms of treatment.
In the case of Gilbert Syndrome (defects in the liver’s uptake of bilirubin) treatment is not required – it is a harmless condition.
Non-alcoholic fatty liver disease
The treatment for this condition involves identifying and treating underlying metabolic conditions (such as diabetes), improving insulin resistance with lifestyle changes and medication, and using antioxidants to protect the liver from cirrhosis, according to the British Medical Journal.
Cirrhosis (excessive alcohol or drug use)
While there is no treatment that will reverse cirrhosis of the liver, treatment is aimed at stopping or delaying the disease process, according to the Canadian Liver Foundation. If the cirrhosis is a result of alcohol or drug abuse, the substance abuse must be stopped completely to prevent further damage. As in all cases of serious liver damage, doctors will treat fluid build-up with medication, and recommend a reduced salt and protein intake. Laxatives may be given to speed up the removal of toxins from the intestines.
Many different conditions can cause complete liver failure. The only treatment that can restore liver function is a transplant.
Reviewed by Dr. Mark W Sonderup, B Pharm, MB ChB, FCP (SA). Senior Specialist, Division of Hepatology, Department of Medicine, University of Cape Town and Groote Schuur Hospital, Cape Town (January 2015).
Preventing liver disease
Diagnosing liver disease
Causes of liver disease
Image: Male liver anatomy from Shutterstock