Gutbliss - Dr. Robynne Chutkan

Liver Disease


The liver, an organ the shape and size of a football located in the upper right quadrant of the abdomen, is essential to digestion and detoxing the body of harmful substances. Liver disease is caused by damage to the liver, which can come in the form of excessive alcohol consumption, infection from viruses like hepatitis B and C and others, or by other means. Chronic liver damage can lead to cirrhosis (or scarring) of the liver, and ultimately liver failure and death.

Over 100 types of liver disease exist, with some of the most common types being: nonalcoholic fatty liver disease, acute liver failure, cirrhosis, and liver cancer. Most forms of liver disease are benign, but the liver is also a common site to which cancer spreads, because when cancer cells from other organs infiltrate the bloodstream, they are eventually filtered through the liver.

Obese individuals, alcoholics, and those infected with hepatitis are most at risk for developing liver disease.


Signs and symptoms of liver disease include:

  • Abdominal pain
  • Abdominal swelling
  • Ascites (buildup of fluid in the abdomen or pelvis)
  • Dark urine
  • Edema (swelling) in the legs and ankles
  • Fatigue
  • Frequent bruising
  • Jaundice
  • Loss of appetite
  • Nausea
  • Pale, chalky stool
  • Vomiting
  • Mental confusion

Ascites is an abnormal buildup of fluid in the abdomen or pelvis, and it can cause weight gain and a rapidly expanding waistline. Ascites is usually caused by liver disease, but about 10% of the time cancer is the culprit, and the ascites is malignant. If your liver disease is cancerous (whether its cancer that has spread to the liver or primary liver cancer), you may experience bloating accompanied by ascites (you may look and feel several months pregnant) as well as jaundice.


Damage to your liver is the primary cause of liver disease and can come in many forms, including:

  • Autoimmune liver diseases
  • Parasitic or viral infections
  • Alcohol abuse
  • Obesity
  • Cancer spreading from other organs
  • Primary liver cancer

Genetics may also play a role in developing liver disease. Conditions such as Wilson’s disease, hyperoxaluria, oxalosis, and hemochromatosis, are genetic conditions that encourage the buildup of substances in the liver that cause damage and in turn, liver disease.


Check for Ascites

Paying close attention to what your body is telling you can be an important factor in early diagnosis for many diseases and conditions, including liver disease. If you are experiencing an expanding waistline accompanied by jaundice, administering a self-check for ascites, and seeking medical attention are critical. How can you tell if your bloat is from air or ascites? When you lie flat on your back, ascites fluid will fall to the sides and accumulate in your flanks, whereas air will rise to the top of your belly. If you think you may have ascites, you should seek immediate medical attention because although the causes of ascites are not all cancerous, they’re all serious. The combination of bloating and jaundice, which turns the eyes and skin yellow, should raise suspicions for cancer that has spread to the liver, although it can also occur with benign forms of liver disease.

Observe Your Stool & Urine

Observing your bowel and urination habits as well as the appearance of your bowel movements and urine, offer you important feedback about your health. Pale, chalky stool can be a sign of liver disease or clogged bile ducts, and it is often accompanied by dark urine as the bile gets excreted through the kidneys instead of the digestive tract. If you experience any of these signs, see your doctor and be sure to tell him or her about your health history and symptoms. Further investigation in diagnosing your liver disease may include:

  • Blood tests: blood samples are taken and tested for liver enzyme levels
  • Imaging tests: ultrasound of the liver may be administered to assess liver damage
  • Biopsy: a small sample of tissue from the liver is taken and tested for cancer and other diseases


How you treat your liver disease is based on the cause and progression of your specific disease. Many types of liver disease can be successfully treated with lifestyle modifications along with regular monitoring of liver function.

Lifestyle Modifications

Promoting healthy liver function is paramount, no matter the form or stage of your liver disease. Even in the case of cirrhosis, although scarring of the liver is irreversible, preventing additional scarring is important in maintaining your health and preserving liver function and can be accomplished using lifestyle modifications. Healthy eating, regular exercise and eliminating liver toxins like alcohol and acetaminophen from daily life are key.

The following lifestyle modifications are also useful tips in treating liver disease:

  • Eliminate use of NSAIDs, which are hard on the liver and increase your risk of internal bleeding.
  • Lose weight if you are currently overweight.
  • Eat a low protein diet, as protein can increase toxins in the body, and a damaged liver’s ability to rid the body of toxins is often compromised.
  • Completely eliminate alcohol.
  • Eat a low sodium diet to reduce ascites fluid buildup.
  • Avoid sleep aids and anti-anxiety medications.

Medication & Surgery

In some forms of liver disease, lifestyle modifications may not be enough, and medication or even liver transplant surgery may be necessary. Even if medication and/or surgery is needed, lifestyle modifications can help tremendously in promoting better liver function and in healing from surgery and are important components of liver disease treatment no matter the form or severity.

Promoting healthy liver function is paramount, no matter the form or stage of your liver disease. Even in the case of cirrhosis, although scarring of the liver is irreversible, preventing additional scarring is important in maintaining your health and preserving liver function.


Dr Robynne Chutkan
Dr. Chutkan's Newsletter
Read the latest news and research from Dr. Chutkan’s blog. From the most up to date science on the microbiome, to the best in gut-derived wellness – we are your complete guide to gut health! Sign-up now and receive free access to our 7-Day Microbiome Reboot Course.