Liver Disease

“Liver disease” is a broad term covering conditions that affect how the liver works. The liver performs vital functions, including processing nutrients, producing bile for digestion, filtering toxins, and helping blood to clot.

Many liver conditions cause no symptoms in the early stages, so problems are sometimes first detected through blood tests or scans. When symptoms do appear, it may indicate inflammation or longer-term liver damage (such as scarring).

At the Royal Buckinghamshire Hospital, we provide consultant-led assessment to identify the likely cause of liver symptoms or abnormal tests and create a clear management plan.

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Types of Liver Disease

Liver disease includes a range of conditions, such as:

• Fatty liver disease (often linked to weight, insulin resistance, diabetes, and cholesterol)
• Alcohol-related liver disease
• Viral hepatitis (for example hepatitis B or C)
• Autoimmune liver disease (where the immune system attacks liver tissue)
• Cholestatic/bile duct conditions (affecting bile flow)
• Cirrhosis (scarring of the liver from long-term damage)
• Liver inflammation (hepatitis) from various causes
• Genetic/metabolic conditions (less common)

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Common Causes and Risk Factors

Risk factors vary depending on the condition, but may include:

• Excess body weight, insulin resistance, type 2 diabetes, high cholesterol
• Regular high alcohol intake
• Viral infections (hepatitis)
• Family history of liver disease
• Certain medications and supplements (some can affect the liver)
• Autoimmune conditions
• Past exposure risks (for example travel, medical procedures, or blood exposure in certain settings)

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Symptoms of Liver Disease

Symptoms can be non-specific at first. Possible symptoms include:

Early or general symptoms

• Feeling very tired or generally unwell
• Loss of appetite and unintentional weight loss
• Nausea or being sick
• Discomfort or pain in the upper right abdomen (under the ribs)
• Itchy skin
• Reduced libido or general low energy

Symptoms that may suggest more advanced disease

• Jaundice (yellowing of the skin or whites of the eyes)
• Dark urine and/or pale stools
• Swelling of the tummy (fluid build-up/ascites)
• Swelling in the legs/ankles (oedema)
• Easy bruising or bleeding (including frequent nosebleeds or bleeding gums)
• Confusion, drowsiness, memory changes, or altered sleep pattern
• Vomiting blood or passing black, tarry stools (can indicate internal bleeding)

Not all symptoms mean serious liver disease, but persistent or worsening symptoms should be assessed.

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Diagnosis at Royal Buckinghamshire Hospital

Your consultant will aim to confirm the cause and assess severity. Assessment may include:

• Detailed review of symptoms, alcohol intake, medications/supplements, and risk factors
• Physical examination (including abdomen and signs of jaundice or fluid retention)
• Blood tests, including liver function and inflammation markers
• Ultrasound scan of the liver and gallbladder/bile ducts where appropriate
• Additional tests depending on findings, which may include:
  • Viral hepatitis screening
  • Autoimmune markers
  • Iron studies and other metabolic tests
  • Further imaging (CT/MRI) if needed
  • Specialist referral for additional testing where appropriate

You’ll receive a clear explanation of results and next steps.

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Treatment & Management

Treatment depends on the underlying cause and how advanced any liver damage is. Your plan may include:

Treating the underlying cause

• Support with weight management, diet and physical activity for fatty liver disease
• Reducing or stopping alcohol if alcohol-related disease is suspected
• Antiviral treatment pathways for hepatitis (where indicated)
• Specific medications for autoimmune or bile duct-related conditions (if diagnosed)

Managing symptoms and complications

If liver disease is more advanced, management may focus on controlling complications such as fluid retention, itch, bleeding risk, or confusion, and coordinating specialist care when required.

Monitoring and prevention

• Repeat blood tests and follow-up imaging where appropriate
• Medication review to avoid treatments that may worsen liver function
• Vaccination advice and lifestyle guidance where relevant
• Managing cardiovascular risk factors (particularly in fatty liver disease)

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When to seek urgent help

Seek urgent same-day medical advice if you have any of the following:

• Jaundice (new yellowing of eyes/skin)
• Vomiting blood or black, tarry stools
• New confusion, severe drowsiness, or marked personality change
• Rapidly increasing abdominal swelling, severe abdominal pain, or fever
• Severe weakness, fainting, chest pain, or breathlessness

These symptoms can indicate complications that need immediate assessment.

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If you have symptoms of liver disease, abnormal liver blood tests, or ongoing abdominal discomfort and fatigue, contact Royal Buckinghamshire Hospital for assessment and guidance. There is no need to be registered with the hospital, or live locally.

If you have insurance which covers consultations, we can in most cases invoice the insurer directly. Where you are paying directly, any costs will always be discussed.