Hepatomegaly is the medical term for an enlarged liver. It is a symptom of disease rather than a disease in itself. Sometimes, hepatomegaly may be accompanied by other symptoms of disease.
The liver is one of the most important organs in the body. It removes toxins from the blood, supports digestion, and helps regulate hormones and cholesterol. In all, the liver performs more than 500 vital functions.
In this article, learn about hepatomegaly, including the accompanying symptoms, possible causes, and treatment options.
Hepatomegaly is the medical term for an enlarged liver. It is a symptom of an underlying disease, not a disease in itself.
When the liver is significantly enlarged, a person may feel as though they are full on the right side of their body, or they may report some discomfort in that area.
People may also experience some accompanying symptoms of an underlying liver problem. These may include:
There are many potential causes of hepatomegaly. Some of the most common include:
- Hepatitis: Hepatitis is the medical term for inflammation of the liver. It typically occurs as a result of a viral infection or alcohol-induced liver damage. The condition can be short-term (acute) or long-term (chronic).
- Alcoholic liver disease (ALD): Excessive alcohol consumption can lead to a buildup of fat cells in the liver. Doctors refer to this as steatosis. Steatosis can interfere with the liver’s ability to carry out its vital functions. In severe cases, ALD may lead to severe liver scarring, or cirrhosis.
- Nonalcoholic fatty liver disease (NAFLD): This condition is also characterized by steatosis and associated liver dysfunction. Unlike ALD, it is not the result of excessive alcohol consumption. It is typically due to conditions such as diabetes or diets that are high in fats and cholesterol.
- Liver cancer: Cancers that originate in the liver are known as primary liver cancers, while those that spread to the liver from other parts of the body are called secondary liver cancers. Each year, around 30,000 people in the United States receive a diagnosis of primary liver cancer.
- Heart failure: The portal vein is the vein that provides blood to the liver. Heart failure can cause circulatory problems that increase pressure on the portal vein. Over time, this can lead to liver enlargement. Some doctors refer to heart-related liver problems as cardiac liver.
Liver steatosis is the medical term for a buildup of fats in the liver. It is a common condition, affecting around 1 in 3 adults in the U.S.
The liver does not usually store fat. However, the following factors can cause it to do so:
- increased levels of fat in the blood, or hyperlipidemia
- insulin resistance
- type 2 diabetes
- alcohol use disorder
- hepatitis C
There are four different grades of liver steatosis. These grades depend on the percentage of fat cells that make up the liver’s overall weight.
- Grade 0 (healthy): Fat cells comprise 0–5% of the liver’s overall weight.
- Grade 1 (mild): Fat cells comprise 5–33% of the liver’s overall weight.
- Gade 2 (moderate): Fat cells comprise 34–66% of the liver’s overall weight.
- Grade 3 (severe): Fat cells comprise more than 66% of the liver’s overall weight.
To diagnose hepatomegaly, a doctor may:
- take a thorough medical history
- touch or lightly tap the abdomen to sense the size and consistency of the liver and to see if it is sensitive to touch
- order blood tests to look for infections and check the levels of different liver enzymes
- order imaging tests, such as a CT scan, ultrasound, or MRI
- take a sample, or biopsy, of the liver tissue for further analysis
Treatment for hepatomegaly involves treating the underlying cause. The sections below will outline some potential causes and their associated treatment options in more detail.
The treatment for hepatitis depends on the type of hepatitis a person has. The different types and their associated treatments include:
- Hepatitis A: There is no specific treatment for hepatitis A. Most people will recover fully within several weeks or months.
- Hepatitis B: There is no specific treatment for acute hepatitis B. Treatment for chronic hepatitis B involves antiviral medications to reduce liver damage and increase long-term survival.
- Hepatitis C: Chronic hepatitis C infections require treatment with drugs called direct-acting antivirals. Treatment typically takes 12–24 weeks, depending on the extent of the liver damage.
- Hepatitis D: People with hepatitis D require treatment with pegylated interferon-alpha. This drug helps slow the progression of the condition. Those with end stage liver disease may require a liver transplant.
The treatment for ALD will involve treating the alcohol use disorder itself. This may include one or more of the following:
- undergoing a supervised medical detox
- trying behavioral therapies, such as cognitive behavioral therapy or motivational enhancement therapy
- trying family therapy
- trying group therapy
- treating any co-occurring or comorbid mental health conditions
The treatment for NAFLD will depend partly on the underlying cause. Some potential treatment options include:
- making dietary changes, including reducing the intake of cholesterol and fats
- controlling blood sugar levels
- managing underlying health conditions, such as increased insulin levels and type 2 diabetes
The treatment for liver cancer will partly depend on whether the cancer is primary or secondary. Other factors to consider include the size and stage of the cancer. Some potential treatment options include:
Although there is currently no cure for heart failure, there are treatments available that can help manage the condition and prevent further complications. Some examples include:
- making lifestyle changes, such as:
- taking medications, such as:
- undergoing surgery to correct irregularities or blocked arteries
Some women experience hepatomegaly during pregnancy. Some causes of hepatomegaly during pregnancy can severely affect the health of the woman and the fetus.
In infants, hepatitis B infections can be severe or even life threatening. Around 90% of women with acute hepatitis B pass the infection onto the baby. The likelihood of transmission is lower for chronic hepatitis B, with 10–20% of women passing the infection onto the baby.
Pregnant women who have ALD or NAFLD are at increased risk of developing hepatomegaly and other complications.
Children can develop hepatomegaly as a result of NAFLD or nonalcoholic steatohepatitis (NASH). The latter is a more advanced form of NAFLD.
The National Institute of Diabetes and Digestive and Kidney Diseases note that almost 10% of U.S. children may have NAFLD.
Children who have the condition do not usually experience any outward symptoms. When symptoms do occur, they tend to include fatigue and discomfort in the upper right abdomen.
Researchers do not yet know what causes NAFLD in children. However, it appears to be more common among children with the following conditions:
- high lipid disorders
- insulin resistance
- type 2 diabetes or prediabetes
- hepatitis C
The extent to which a slightly enlarged liver is dangerous depends on the reason for the enlargement.
For people with NAFLD, a slightly enlarged liver is unlikely to pose a major threat to health. However, it could be an indication that a person should consider making some lifestyle changes.
That said, certain conditions can cause a slightly enlarged liver to become a significantly enlarged and damaged liver without treatment. Such conditions include:
- alcohol use disorder
- hepatitis B, C, and D
In general, mild hepatomegaly indicates that it is time to visit a doctor for a full physical evaluation.
Hepatomegaly usually does not cause any symptoms. In fact, the liver conditions that lead to hepatomegaly can progress significantly without causing any symptoms at all.
Because of this, a person should see a doctor if they:
- experience any symptoms of an enlarged liver
- develop any other symptoms of liver disease
- have any conditions that increase their risk of developing liver disease
The outlook for people with hepatomegaly depends on the cause of the hepatomegaly and the extent of the liver damage.
People with hepatitis A and acute hepatitis B usually recover without treatment.
People with the early stages of NAFLD may also have a positive outlook. A mildly damaged liver can often repair itself if a person makes the necessary lifestyle changes early on.
People who have other forms of liver damage will need to ask their doctor about their individual outlook.
The best way to prevent hepatomegaly is to take good care of the liver. The following tips may help:
- using medications sparingly and not mixing medications without a doctor’s approval
- consuming alcohol in moderation, if at all
- limiting exposure to toxic substances, such as chemicals in cleaning products and paints
- not sharing personal grooming tools, such as razors or tweezers
- not sharing needles
- using barrier methods, such as condoms, during sex
- following a healthful diet that is low in saturated and trans fats
- exercising regularly
- maintaining a moderate weight
- seeing a doctor for thorough, routine physical exams
Hepatomegaly is the medical term for an enlarged liver. It is a symptom of disease, not a disease in itself.
Some conditions that can cause hepatomegaly include fatty liver diseases, alcohol use disorder, hepatitis, and cancer.
A person may have hepatomegaly and not be aware that they have it. However, if the liver is significantly enlarged, a person may experience discomfort or fullness in the upper right side of their abdomen.
Some liver conditions are treatable if a person detects them and seeks treatment in the early stages.
Anyone concerned about the health of their liver should see a doctor for a diagnosis and appropriate treatment.