نظرة عامة
Liver fibrosis is a condition in which the liver is damaged again and again over time, leading to the gradual buildup of scar tissue. This damage is most often caused by conditions such as steatotic liver disease, heavy alcohol use or chronic viral hepatitis. As scar tissue replaces healthy liver tissue, the liver becomes less flexible and its ability to function may begin to decline. Fibrosis develops throughout the whole liver over time rather than forming a lump or growth such as a tumor or cancer.
If the cause of liver injury is not treated or controlled, fibrosis can progress and eventually lead to cirrhosis, a more advanced stage of liver disease in which extensive scarring causes lasting changes to the liver's structure and function. Cirrhosis can result in serious complications, including liver failure and a higher risk of liver cancer.
Hearing the term "liver fibrosis" can cause worry. Although fibrosis reflects liver damage over time, it does not always mean the damage is permanent. Evidence shows that early stages of fibrosis may stabilize or improve when the underlying cause of liver injury is found and treated.
الأعراض
Liver fibrosis itself usually does not cause symptoms, especially in the early stages. Many people with fibrosis feel well and do not know they have liver scarring until it is found during blood tests or imaging done for another reason.
When symptoms are present, they are often related to the condition causing liver injury, such as steatotic liver disease, alcohol-related liver disease or chronic viral hepatitis, rather than the scarring itself.
Symptoms that reflect worsening liver function or complications of advanced liver disease may include:
- Yellowing of the skin or eyes, called jaundice.
- Fluid buildup in the abdomen, called ascites.
- Swelling in the legs, feet or ankles, called edema.
- Confusion, trouble concentrating or changes in alertness, known as hepatic encephalopathy.
The presence of these symptoms may indicate a lot of liver damage and should be checked by a healthcare professional right away.
When to see a doctor
Make an appointment with a healthcare professional if you have any of the symptoms of liver fibrosis.
الأسباب
Liver fibrosis happens as a result of ongoing inflammation and injury in the liver. This damage activates the body's wound-healing response. When liver injury continues over time, scar tissue forms and slowly replaces healthy liver tissue. This process is driven by chronic liver disease rather than a single episode of liver damage.
In developed countries, the most common causes of liver fibrosis are conditions related to metabolic health, including metabolic dysfunction-associated steatotic liver disease linked to obesity, type 2 diabetes and insulin resistance. Heavy or long-term alcohol use is another leading cause of ongoing liver injury and fibrosis.
Chronic viral hepatitis also can lead to liver fibrosis. Hepatitis B remains a common cause of fibrosis worldwide, particularly in regions where the condition happens early in life. Hepatitis C, once a major cause of liver fibrosis, is now almost universally curable with antiviral treatment when found and treated early.
Other, less common causes of liver fibrosis include autoimmune liver diseases, inherited liver conditions, and diseases that damage or block the bile ducts. If the cause of liver injury is not treated or controlled, scar tissue can continue to build up and fibrosis may worsen over time.
عوامل الخطورة
Risk factors are conditions or behaviors that increase the chance of developing liver fibrosis or make liver damage more likely to get worse.
Factors associated with a higher risk of liver fibrosis include:
Having more than one risk factor can increase the likelihood that liver fibrosis will happen or get worse.
المضاعفات
Liver fibrosis increases the risk of long-term liver issues if scarring continues to worsen over time. Complications are not common in early fibrosis and are more likely to occur when fibrosis becomes advanced or changes to cirrhosis.
As healthy liver tissue is slowly replaced by scar tissue, the liver may become less able to carry out its regular functions. In the earlier stages, this decline in function may be hard to notice and is often found with blood tests rather than through symptoms. Over time, impaired liver function can affect how the body processes medicines, regulates blood components and clears toxins from the bloodstream.
When fibrosis changes to cirrhosis, more-serious complications can occur, including:
- Reduced blood flow through the liver, which can raise pressure in a blood vessel called the portal vein. This condition is called portal hypertension.
- Fluid buildup in the abdomen, called ascites.
- Bleeding, which may occur when portal hypertension causes enlarged veins, called varices, to burst.
- Confusion or trouble thinking clearly, known as hepatic encephalopathy. It is caused by the buildup of toxins the liver can no longer clear effectively.
- Liver failure, which occurs when the liver can no longer carry out its vital functions.
- Increased risk of liver cancer.
Finding conditions that cause liver injury early and treating them can help reduce the risk of worse complications.
الوقاية
Liver fibrosis may be prevented or slowed by reducing ongoing liver damage and treating liver disease early. Addressing risk factors before a lot of scarring develops can help protect liver health and reduce the likelihood of advanced liver disease.
These steps may help prevent liver fibrosis:
- Treat liver disease early. Early evaluation and management can reduce long-term inflammation and scarring.
- Avoid alcohol. Alcohol can worsen liver damage, especially in people with existing liver disease.
- Maintain a healthy body weight. Managing body weight may lower the risk of steatotic liver disease and ongoing liver inflammation. A healthcare professional can help develop a safe and effective weight management plan.
- Eat a healthy diet. Choose a diet rich in fruits, vegetables and whole grains, with lean sources of protein. Limit fatty and fried foods.
- Manage long-term health conditions. Conditions such as type 2 diabetes and high cholesterol can contribute to liver inflammation if not well managed.
- Prevent viral hepatitis. Getting vaccinated for hepatitis B and reducing exposure to all hepatitis viruses can help protect the liver.
- Keep regular follow-up appointments. Ongoing monitoring allows healthcare professionals to track liver health and adjust care as needed.