Hepatomegaly is an enlargement of liver, which means it’s swollen beyond its usual size. It is a symptom of disease rather than a disease in itself. Sometimes, hepatomegaly may be accompanied by other symptoms of disease.
The liver is one of the most important organs in the body. Your liver has a lot of important jobs. It helps clean your blood by getting rid of harmful chemicals that your body makes. It makes a liquid called bile, which helps you break down fat from food. And it stores sugar, called glucose, which gives you a quick energy boost when you need it. All in all, the liver performs more than 500 vital functions.
An enlarged liver on its own may not have any symptoms. But if a medical condition is causing your enlarged liver, you may experience serious symptoms such as:
• jaundice, or yellowing of the skin and eyes
• muscle aches
• abdominal pain or mass
• poor appetite
• swelling of the feet and legs
• easy bruising
• weight loss
• increasing abdominal size
Any of these symptoms require evaluation by your doctor.
There are many potential causes of hepatomegaly. Some of the most common include:
Hepatitis is the medical term for inflammation of the liver. It typically occurs as a result of a viral infection or alcohol-induced liver damage. The condition can be short-term (acute) or long-term (chronic).
• Alcoholic liver disease (ALD):
Excessive alcohol consumption can lead to a buildup of fat cells in the liver. Doctors refer to this as steatosis. Steatosis can interfere with the liver’s ability to carry out its vital functions. In severe cases, ALD may lead to severe liver scarring, or cirrhosis.
• Nonalcoholic fatty liver disease (NAFLD):
This condition is also characterized by steatosis and associated liver dysfunction. Unlike ALD, it is not the result of excessive alcohol consumption. It is typically due to conditions such as diabetes or diets that are high in fats and cholesterol.
• Liver cancer:
Cancers that originate in the liver are known as primary liver cancers, while those that spread to the liver from other parts of the body are called secondary liver cancers.
• Heart failure:
The portal vein is the vein that provides blood to the liver. Heart failure can cause circulatory problems that increase pressure on the portal vein. Over time, this can lead to liver enlargement. Some doctors refer to heart-related liver problems as cardiac liver.
Risk Factors –
You’re more likely to develop an enlarged liver if you have a liver disease. Factors that can increase your risk of liver problems include:
• Excessive alcohol use.
Drinking large amounts of alcohol can be damaging to your liver.
• Large doses of medicines, vitamins or supplements.
Taking larger than recommended doses of vitamins, supplements, or over-the-counter (OTC) or prescription medicines can increase your risk of liver damage.
Acetaminophen overdose is the most common cause of acute liver failure in the United States. Besides being the ingredient in OTC pain relievers such as Tylenol, it’s in more than 600 medications, both OTC and prescription.
• Herbal supplements.
Certain supplements, including black cohosh, ma huang and valerian, can increase your risk of liver damage.
Infectious diseases, viral, bacterial or parasitic, can increase your risk of liver damage.
• Hepatitis viruses.
Hepatitis A, B and C can cause liver damage.
• Poor eating habits.
Being overweight increases your risk of liver disease, as does eating unhealthy foods, such as those with excess fat or sugar.
To diagnose hepatomegaly, a doctor may:
• take a thorough medical history
• touch or lightly tap the abdomen to sense the size and consistency of the liver and to see if it is sensitive to touch
• order blood tests to look for infections and check the levels of different liver enzymes
• order imaging tests, such as a CT scan, ultrasound, or MRI
• take a sample, or biopsy, of the liver tissue for further analysis
Treatment for hepatomegaly involves treating the underlying cause.
The treatment for hepatitis depends on the type of hepatitis a person has. The different types and their associated treatments include:
• Hepatitis A:
There is no specific treatment for hepatitis A. Most people will recover fully within several weeks or monthsTrusted Source.
• Hepatitis B:
There is no specific treatment for acute hepatitis B. Treatment for chronic hepatitis B involves antiviral medications to reduce liver damage and increase long-term survival.
• Hepatitis C:
Chronic hepatitis C infections require treatment with drugs called direct-acting antivirals. Treatment typically takes 12–24 weeks, depending on the extent of the liver damage.
• Hepatitis D:
People with hepatitis D require treatment with pegylated interferon-alpha. This drug helps slow the progression of the condition. Those with end stage liver disease may require a liver transplant.
The treatment for ALD will involve treating the alcohol use disorder itself. This may include one or more of the following:
• undergoing a supervised medical detox
• trying behavioral therapies, such as cognitive behavioral therapy or motivational enhancement therapy
• trying family therapy
• trying group therapy
• treating any co-occurring or comorbid mental health conditions
The treatment for NAFLD will depend partly on the underlying cause. Some potential treatment options include:
• making dietary changes, including reducing the intake of cholesterol and fats
• controlling blood sugar levels
• managing underlying health conditions, such as increased insulin levels and type 2 diabetes
The treatment for liver cancer will partly depend on whether the cancer is primary or secondary. Other factors to consider include the size and stage of the cancer. Some potential treatment options include:
• radiation therapy
• surgery to remove the tumor
• liver transplant
▪︎ Heart failure
Although there is currently no cure for heart failure, there are treatments available that can help manage the condition and prevent further complications. Some examples include:
• making lifestyle changes, such as:
• quitting smoking
• avoiding alcohol
• avoiding or limiting caffeine
• managing stress
• losing weight, if necessary
• being physically active
• eating a healthful diet
• taking medications, such as:
• angiotensin-converting enzyme inhibitors
• angiotensin 2 receptor blockers
• undergoing surgery to correct irregularities or blocked arteries
Ayurvedic Perspective –
In Ayurveda hepatomegaly is described as one of the type of Udara Roga named as Yakritdalyodar. In Ayurveda there are many herbs and natural remedies available for treatment of liver disorder. Main causative factor of this disease is Mandagni, altered food habits etc.
Triphala Churna and Mandoor Bhasma is advised to the patient.
Triphala contain Haritaki, Amalaki and Bibhitak. Haritaki is a good liver tonic, promote overall body health and for the support of digestive system and functioning and have Vatanuloman property. Bibhitak is laxative in nature, cure loss of appetite and enhance immunity. Amalaki also balance Agni. In Ayurveda all Udara Roga caused by mainly
due to Agni Mandhya and all the drugs contents have
property of increase the Agni.
Mandoor Bhasma is an iron formulation. It contains iron dust, Triphala decoction, cow’s urine and Aloe vera juice. In Ayurveda it is used for anemia, jaundice, hepatomegaly( Yakritdalyudar) and also in
spleenomegaly (Pleehodara). In this formulation Triphala and
cow’s urine works as a Virechana Dravya which helps in
detoxifcation of liver and whole body and Yakritdalyudara is
one type of Udara Roga and Virechana is first line of treatment
in Udara Roga so it is helpful in Yakritdalyudara.
▪︎ Ayurvedic Herbs
The following herbs are found to be very effective in protecting the liver and curing all kinds of liver disease:
▪︎ Home Remedies
You may try the following home remedies for healthy liver and improve its function-
• 4 gms of Indian gooseberry taken with water every day for 15-20 days, helps to regulate overall liver function.
• Juice of Guduchi taken daily on empty stomach, detoxifies the liver.
• Consumption of 5-6 ml of bhumy amalaki swarasa for 3-4 days is also beneficial.
• Pomegranate, raisins, coconut water, sugar cane juice, etc., can be consumed regularly.
To reduce your risk of liver disease, you can:
• Eat a healthy diet. Choose a diet full of fruits, vegetables and whole grains.
• Drink alcohol in moderation, if at all. Check with your doctor to find out what’s the right amount of alcohol for you, if any.
• Follow directions when taking medications, vitamins or supplements. Limit yourself to the recommended doses.
• Limit contact with chemicals. Use aerosol cleaners, insecticides and other toxic chemicals only in well-ventilated areas. Wear gloves, long sleeves and a mask.
• Maintain a healthy weight. Eat a balanced diet and limit foods that are high in sugar and fat. If you’re overweight, ask your doctor or a nutritionist about the best way for you to lose weight.
• Quit smoking. Ask your doctor about strategies to help you quit.
• Use supplements with caution. Talk with your doctor about the risks and benefits of herbal supplements before you take them. Some alternative medicine treatments can harm your liver.
Herbs and supplements to avoid include black cohosh, ma huang and other Chinese herbs, comfrey, germander, greater celandine, kava, pennyroyal, skullcap and valerian.
It may be frightening to learn that your liver is enlarged. However, most of the causes of liver enlargement are benign and treatable. Your medical history and symptoms will guide the appropriate workup. Open communication with your healthcare workers will ensure that you understand the diagnostic and treatment plan for hepatomegaly and will help mitigate any anxiety you might have.
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