Common diseases that affect the liver and gallbladder

Learn about the most common liver and gallbladder-related diseases and their causes. Click here to read more!
Last update26th Jan 2021

Let’s review some of the most common liver diseases and gallbladder-related diseases that can affect the liver:

  • Liver failure
  • Hepatitis
  • Cirrhosis
  • Hepatocellular carcinoma
  • Nonalcoholic steatohepatitis
  • Hepatic encephalopathy
  • Wilson’s disease
  • Gilbert’s syndrome
  • Cholestasis
  • Gallstones and cholecystitis
  • Cholangitis

Liver failure

Liver failure reflects a loss of liver function. Many pathological processes can lead to liver failure, but 80–90% of liver parenchyma must be destroyed before liver failure manifests clinically.

Ascites is the buildup of fluid in the abdomen secondary to liver failure. The most serious complication of ascites is spontaneous bacterial peritonitis, which is an infection of the ascitic fluid.

Figure 1. Liver failure can cause ascites, a buildup of fluid in the abdomen, which can progress into spontaneous bacterial peritonitis if the ascitic fluid becomes infected.

Hepatitis

Hepatitis is an injury to the liver parenchyma, which is composed mainly of hepatocytes. Hepatitis is associated with an influx of inflammatory cells into the liver.

Hepatitis can be caused by a viral infection, autoimmune disease, or can be secondary to drug (both legal and illegal) and alcohol use.

Figure 2. Common causes of hepatitis include viral infection, autoimmune disease, drug use, and alcohol use.

Cirrhosis

Cirrhosis refers to a progressive, fibrosing, nodular condition that disrupts the normal architecture of the liver. Any chronic insult to the liver such as alcoholism, drug use, or viral hepatitis can cause cirrhosis.

Cirrhosis can result in portal hypertension, which is high blood pressure in the portal vein. The most serious complication of portal hypertension is variceal bleeding within the digestive tract.

Figure 3. Cirrhosis can occur as the result of any chronic insult to the liver such as alcoholism, drug use, or viral hepatitis.

Hepatocellular carcinoma

Hepatocellular carcinoma is a primary liver cancer. It often occurs in patients who contracted hepatitis B or C and developed chronic cirrhosis which eventually became cancerous.

Figure 4. Patient with hepatitis B or C may develop chronic cirrhosis which can progress into hepatocellular carcinoma.

Nonalcoholic steatohepatitis

Nonalcoholic steatohepatitis is a term used to describe liver inflammation and damage that is caused by an accumulation of fat in the liver. It is commonly associated with obesity. This condition can also lead to cirrhosis and hepatocellular carcinoma.

Figure 5. Nonalcoholic steatohepatitis can lead to liver cirrhosis which can progress into hepatocellular carcinoma.

Hepatic encephalopathy

Hepatic encephalopathy is a decline in brain function that occurs as a result of severe liver disease. When the liver cannot adequately remove toxins, the buildup of toxins causes brain damage. This may present as an altered level of consciousness and neuromuscular disturbances such as a flapping tremor (known as asterixis).

Figure 6. Symptoms of hepatic encephalopathy may include altered levels of consciousness and asterixis (e.g., flapping tremor).

Wilson’s disease

Wilson’s disease is a genetic disorder associated with excess copper buildup in the brain and liver.

Figure 7. Wilson’s disease is associated with excess copper accumulation in the brain and liver.

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Gilbert’s syndrome

Gilbert’s syndrome is a genetic disorder where the liver does not properly process bilirubin which results in jaundice.

Figure 8. Jaundice is a symptom of Gilbert’s syndrome, a genetic disorder involving the incomplete processing of bilirubin.

Cholestasis

Cholestasis is a condition where bile builds up in the liver and impairs liver function. The buildup is due to impaired release from the liver cells (e.g., intrahepatic) or obstruction of the flow through the hepatic or common bile ducts (e.g., extrahepatic).

Figure 9. Cholestasis can be intrahepatic, where bile builds up in the liver due to impaired release from liver cells, or extrahepatic, where the flow of bile is obstructed through the hepatic or common bile ducts.

Gallstones and cholecystitis

Gallstones are hardened deposits of bile that form in the gallbladder. They can obstruct the bile ducts and the flow of bile. Cholecystitis is inflammation of the gallbladder and is often due to gallstones blocking the cystic duct.

Figure 10. Gallstones can cause an obstruction of the bile ducts. This can lead to inflammation of the gallbladder (e.g., cholecystitis), if the cystic duct becomes blocked.

Cholangitis

Cholangitis is inflammation of the bile duct system, usually caused by a bacterial infection. Cholangitis can occur because of an autoimmune disease (e.g., primary sclerosing cholangitis or primary biliary cholangitis) or a gallstone obstructing the bile ducts.

Figure 11. Inflammation of the bile duct system can be caused by primary sclerosing cholangitis, primary biliary cholangitis, or a gallstone obstructing the bile ducts.

This sums up some of the most common liver diseases you’ll encounter. Check out our other articles to learn how to take a good medical history when assessing liver function.

That’s it for now. If you want to improve your understanding of key concepts in medicine, and improve your clinical skills, make sure to register for a free trial account, which will give you access to free videos and downloads. We’ll help you make the right decisions for yourself and your patients.

Recommended reading

  • Chalasani, N, Younossi, Z, Lavine, JE, et al. 2012. The diagnosis and management of non-alcoholic fatty liver disease: practice guideline by the American Gastroenterological Association, American Association for the Study of Liver Diseases, and American College of Gastroenterology. Gastroenterology142: 1592–1609. PMID: 22656328
  • Fuchs, S, Bogomolski-Yahalom, V, Paltiel, O, et al. 1998. Ischemic hepatitis: clinical and laboratory observations of 34 patients. J Clin Gastroenterol26: 183–186. PMID: 9600366
  • Lok, ASF and McMahon, BJ. 2007. Chronic hepatitis B. Hepatology45: 507–539. PMID: 17256718
  • Moussavian, SN, Becker, RC, Piepmeyer, JL, et al. 1985. Serum gamma-glutamyl transpeptidase and chronic alcoholism. Influence of alcohol ingestion and liver disease. Dig Dis Sci30: 211–214. PMID: 2857631
  • Myers, RP, Cerini, R, Sayegh, R, et al. 2003. Cardiac hepatopathy: clinical, hemodynamic, and histologic characteristics and correlations. Hepatology37: 393–400. PMID: 12540790
  • Rej, R. 1978. Aspartate aminotransferase activity and isoenzyme proportions in human liver tissues. Clin Chem24: 1971–1979. PMID: 213206
  • van de Steeg, E, Stránecký, V, Hartmannová, H, et al. 2012. Complete OATP1B1 and OATP1B3 deficiency causes human Rotor syndrome by interrupting conjugated bilirubin reuptake into the liver. J Clin Invest122: 519–528. PMID: 22232210

About the author

Amer Wahed, MD FRCPath
Professor and Vice Chair (Clinical Pathology) and Associate Residency Program Director in the Department of Pathology and Laboratory Medicine at the University of Texas, Health Science Center at Houston, USA.
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