The liver is located in the upper right part of the abdomen, just above the ribcage. It weighs about 1500 grams. The gallbladder, a pear-shaped pouch located against the liver, temporarily stores bile fluid. Its main functions include storing glycogen (a crucial fuel for the body), filtering and breaking down various substances (such as alcohol), and producing various proteins. Substances absorbed from food are transported to the liver via the portal vein. The liver filters the blood and can break down toxins, possessing significant regenerative abilities. Additionally, bile fluid is produced in the liver and transported to the gallbladder. Bile primarily consists of broken-down red blood cells. When the gallbladder contracts, bile fluid is sent through the bile ducts to the small intestine, where it is needed for fat digestion.

By determining the proteins present in the liver and gallbladder, it can be determined whether these organs are functioning properly or possibly damaged. Based on various values and potential symptoms, the cause can be identified. It can have various causes such as alcohol consumption, medication use, severe obesity, fatty liver, hepatitis or gallstones.

Gallstones

When bile thickens, it can solidify and form gallstones. These usually develop in the gallbladder but can also occur in the bile ducts. Gallstones come in different types and sizes, with cholesterol stones being the most common. Many people have gallstones but never experience symptoms. When a gallstone becomes lodged, symptoms can occur, including severe abdominal pain, pale-colored stool, and/or jaundice. Your general practitioner can usually diagnose based on your symptoms.

Cholestasis

Cholestasis, or bile stasis, can occur when the drainage of bile from the gallbladder is blocked. This can be caused by various conditions, such as liver issues (hepatitis, primary biliary cholangitis, or cirrhosis), gallbladder or bile duct problems (bile duct atresia, gallstones, bile duct inflammation, or gallbladder or bile duct tumors). Symptoms may include jaundice, itching, pale-colored stool, and/or dark urine. Treatment depends on the underlying cause.

Bile duct inflammation

Inflammation of the bile ducts, or cholangitis, occurs when the bile ducts inside or outside the liver become inflamed. This can result from narrowing or blockage of the bile ducts. This can hinder bile flow and allow bacteria from the small intestine to settle in the bile ducts, causing an infection. The narrowing or blockage is often due to a gallstone, but it can also be caused by a congenital abnormality, tumor or parasite. Symptoms can vary and typically start with pain in the upper right abdomen, fever with chills, jaundice and sometimes itching. Liver cirrhosis can develop if the small bile ducts inside the liver also become inflamed, leading to the formation of scar tissue. Diagnosis involves blood tests and further imaging like an ultrasound or MRI scan of the bile ducts. Treatment involves antibiotics along with a procedure called endoscopic retrograde cholangiopancreatography (ERCP). In some cases, the gallbladder might need to be surgically removed (e.g., in the case of gallstones).

Hepatitis

The term hepatitis (inflammation of the liver) is derived from Greek; “hepar” means liver, and “itis” means inflammation. It is often caused by a virus (hepatitis A, B, C, D, or E), but it can also result from autoimmune diseases, alcohol use, non-alcoholic fatty liver disease, or medications. Due to the liver’s substantial reserve capacity, symptoms usually appear only in the advanced stages. It can cause various symptoms, starting with general malaise, fatigue, reduced appetite, fever, right upper abdominal pain (possibly with nausea and vomiting). Later symptoms can include jaundice, pale-colored stool, dark urine, and often itching. The general practitioner can perform further tests to make a diagnosis.

Cirrhosis

Cirrhosis occurs when the liver is so affected by scar tissue that it cannot function properly. This can result from liver inflammation where liver cells die and are replaced by scar tissue. The longer the problem persists, the more the scarring will expand. It is crucial to halt this process in time. If treated promptly, it can reverse and complications can be prevented. Left untreated, it can eventually lead to liver failure. It can arise from chronic infections, poisoning, or chronic diseases (such as hepatitis B, C or D, autoimmune hepatitis, primary biliary cholangitis, chronic inflammation due to fatty liver, chronic liver damage from prolonged alcohol use, hemochromatosis or Wilson’s disease). In the early stages, this disease often causes minimal symptoms. Common symptoms include nausea, reduced appetite, weight loss, fatigue, abdominal pain, jaundice and itching. A combination of tests can lead to diagnosis. Treatment depends on the underlying cause.

Would you like to learn more about your liver and gallbladder? These aspects are extensively examined in the Vital Organs, Total Health and PME comprehansive packages.

Sources

• Maag lever darm stichting: Leverfunctieonderzoek. Available at https://www.mlds.nl/ziekten/onderzoeken/leverfunctieonderzoek/
• Maag lever darm stichting: Galstuwing. Available at https://www.mlds.nl/ziekten/galstuwing/
• Maag lever darm stichting: Galwegontsteking. Available at https://www.mlds.nl/ziekten/galwegontsteking/
• Maag lever darm stichting: Hepatitis. Available at https://www.mlds.nl/ziekten/hepatitis/
• Maag lever darm stichting: Levercirrose. Available at https://www.mlds.nl/chronische-ziekten/levercirrose/
• Nederlandse Leverpatiënten Vereniging: De lever. Available at https://www.leverpatientenvereniging.nl/de-lever