What is the liver?

The liver is one of the largest organs in your body. It sits under your ribcage on the right side of your body and weighs just over 1kg.

The liver is divided into 2 main sections called lobes.

The liver receives blood from 2 sources:

• The hepatic artery carries blood to the liver from the heart.
• The portal vein carries blood to the liver from the digestive organs (gut).

After the liver processes the blood, it travels from the liver back to the heart via the hepatic vein.

The liver makes bile, a yellow-green substance that helps your body digest food by breaking down fat. The bile gets stored in the gallbladder and passes to the small intestine (gut) via the bile duct.

Liver tissue can repair itself and regrow (regenerate) after being damaged. This means that you only need a small amount of healthy liver tissue to function normally. But if damage is ongoing or severe, the liver may become scarred, and you may start to experience symptoms of liver disease.

What is the function of the liver?

The liver has many important functions. It:

• makes and stores sugars and fats to be used for energy
• makes bile to help digest your food
• makes important proteins for use in the body, including albumin and blood clotting factors
• clears waste products from your blood, including medications (like paracetamol) and toxins (like alcohol)
• stores vitamins and minerals, including iron
• helps your immune system to fight infection

What medical conditions are related to the liver?

The liver has many roles in the body, so a wide range of conditions can affect it, including:

• hepatitis viruses — A, B, C
• other viruses, such as cytomegalovirus (CMV) and Epstein-Barr Virus (EBV)
• fatty liver disease
• haemochromatosis
• Wilson disease
• autoimmune liver diseases
• cancer — including primary liver cancer, as well as metastasis (spread) of other cancers to the liver

Conditions that affect the liver can cause scarring, also known as cirrhosis. Cirrhosis can lead to liver failure.

Which symptoms are related to these conditions?

You might not notice symptoms in the early stages of liver disease since symptoms can be vague and depend on your condition. Symptoms that may indicate something is wrong with your liver include:

• jaundice
• dark urine
• nausea
• vomiting
• diarrhoea
• appetite loss
• weight loss
• feeling generally unwell
• fever
• bloated abdomen, swollen ankles
• abdominal pain in the upper right side
• anaemia, vomiting blood or passing black stools (denoting altered blood)
• changes in mental state — confusion, drowsiness
• changes in sleep pattern (awake at night)

When should I see my doctor?

If you have any of the symptoms listed above and they won’t go away, see your doctor.

If you have any of these symptoms, seek medical help immediately:

• jaundice
• drowsy and confused or very sleepy
• vomit blood or black poos
• fever and shivery
• short of breath
• very swollen belly
• develop sudden stomach pain or fever

Liver health check

If you’re at a higher risk of liver disease due to older age, alcohol use or a medical condition, ask your doctor about having a liver health check. This will usually involve a blood test and an imaging scan, such as an ultrasound or FibroScan (a specialised ultrasound scan that assesses specific markers of liver damage), or a tissue sample from a liver biopsy.

How can I take care of my liver?

Not all conditions that affect the liver can be prevented, but there are ways you can help to keep your liver healthy and reduce the chance of liver disease.

Limit alcohol

Alcohol is a toxin that your liver is responsible for processing. Minimise the strain on your liver by limiting the amount of alcohol you drink. The Australian Alcohol Guidelines recommend that you drink no more than 10 standard drinks a week, and no more than 4 standard drinks in any one day.

Get vaccinated

Hepatitis A is transmitted via contaminated food and water. If you are travelling to an area where hepatitis A is common, get vaccinated against it. Ask your doctor or travel health clinic for more information.

Vaccination against hepatitis B is given routinely to infants in Australia as part of the National Immunisation Program Schedule. If you aren’t sure whether you or your child are fully vaccinated against hepatitis B, ask your doctor.

Food and water safety

Wash your hands before eating or preparing food. When travelling to some countries, use bottled water for drinking and brushing teeth.

Practise safe sex

You can get hepatitis B by having unprotected sex. Reduce your chance of catching hepatitis B by always having safe sex and getting regular STI checks.

Inject safely

You can get hepatitis B and C if your blood comes in contact with the blood of a person carrying one of these viruses. If you inject drugs, always use clean equipment. Don’t share needles or any other drug equipment, including syringes, spoons or water.

Maintain a healthy lifestyle

Eat a balanced diet and keep physically active to reduce your chance of liver disease. Maintaining a healthy lifestyle will also help keep your weight in a healthy weight range and reduce your chance of other health conditions, such as heart disease, type 2 diabetes, stroke and cancer.

Quit smoking

Smoking creates extra work for your liver, as cigarettes contain toxic chemicals that your liver must clear from your body. Smoking also increases your chance of developing many liver conditions, including fatty liver disease and liver cancer. If you develop these conditions and continue to smoke, you’re also more likely to develop complications.

Liver detoxes and cleanses

There is little evidence to support claims that liver detoxes, cleanses and supplements work. Any benefits you experience following these diets or using these supplements is probably due to cutting down the amount of alcohol, fatty foods or sugar you consume. Your liver and kidneys are very effective at removing toxins and wastes from your body. You can maximise their effectiveness by having a healthy lifestyle.

If you are considering a liver detox supplement, you should talk to your doctor or pharmacist first. Make sure you know what it contains and whether it is likely to interact with any medicines you take.

Resources and support

• Aboriginal and/or Torres Strait Islander people have a higher risk of liver disease than non-Indigenous Australians. Australian Indigenous HealthInfoNet has a list and map of appropriate health services.
• LiverWELL collaborates with Aboriginal and Torres Strait Islander Communities to improve access to support services for testing and treatment. Call the LiverLine on 1800 703 003.
• Hepatitis Australia has a fact sheet about cirrhosis. Call the National Hepatitis Infoline: 1800 437 222 (1800 HEP ABC) for confidential, free access to hepatitis information and support.
• The Liver Foundation has information about liver diseases and treatments. They also have recipes and information about diets to help maintain a healthy liver.

Other languages

• Health Translations Victoria has information on the health of your liver and hepatitis B and liver cancer in English and other languages.