Hepatomegaly is the medical term for an enlarged liver. It is not a disease in itself but occurs due to underlying conditions. Sometimes, hepatomegaly accompanies other symptoms.

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 symptoms, possible causes, and treatment options.

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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 becomes 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 possible 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 acute or chronic.
  • Alcohol-related liver disease (ALD): Excessive alcohol consumption can lead to a buildup of fat cells in the liver, which doctors refer to 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.
  • Non-alcohol-related fatty liver disease (NAFLD): This condition also causes steatosis. Unlike ALD, it is not the result of excessive alcohol consumption. It is typically due to other conditions, such as diabetes, or diets that are high in fat 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 known as secondary liver cancers. Each year, about 41,260 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. The liver does not usually store fat. However, the following factors can cause it to do so:

Steatosis can contribute to hepatomegaly, so a person can have both at the same time.

The diagnosis of hepatomegaly typically involves multiple steps. It may involve a doctor:

  • taking a thorough medical history
  • touching or lightly tapping the abdomen to gauge the size and consistency of the liver and check whether it is sensitive to touch
  • ordering blood tests to look for infections and check the levels of different liver enzymes
  • ordering imaging tests, such as a CT, ultrasound, or MRI scan
  • taking a sample, or biopsy, of the liver tissue for further analysis

The treatment for hepatomegaly depends on the underlying cause.

Hepatitis

The type of hepatitis a person has will determine their treatment options. The different treatments include:

  • Hepatitis A: There is no specific treatment for hepatitis A. Most people will recover fully within several weeks or months without needing antiviral treatment. Rarely, people develop acute liver failure and may need a transplant.
  • Hepatitis B: Most cases of acute hepatitis B do not require treatment unless a person has other conditions that put them at risk of complications. The treatment for chronic hepatitis B may involve antiviral medications to reduce liver damage and increase long-term survival.
  • Hepatitis C: Chronic hepatitis C infections require treatment with direct-acting antiviral drugs. The 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. Individuals with end stage liver disease may require a liver transplant.

ALD

The treatment for ALD focuses on treating alcohol use disorder. It may include one or more of the following:

  • supervised medical detox
  • behavioral therapies, such as cognitive behavioral therapy or motivational enhancement therapy
  • family therapy
  • group therapy
  • treating any co-occurring or comorbid mental health conditions

NAFLD

The treatment for NAFLD depends partly on the underlying cause. The possible treatment options include:

  • making dietary changes, including reducing the intake of cholesterol and fats
  • reaching or maintaining a moderate weight
  • controlling blood sugar levels
  • managing underlying health conditions, such as type 2 diabetes

Cancer

The treatment for liver cancer partly depends 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:

Heart failure

Although there is currently no cure for heart failure, treatments are available that can help manage the condition and prevent further complications. Some examples include:

Some people may experience hepatomegaly during pregnancy. Some of the causes can severely affect the health of the pregnant person and the fetus.

In infants, hepatitis B infections can be severe or even life threatening. In about 90% of acute hepatitis B cases, the infection passes from the pregnant person to the baby. The likelihood of transmission is lower for chronic hepatitis B, occurring in 10–20% of cases.

Pregnant people who have ALD or NAFLD have an increased risk of developing complications.

Children can develop hepatomegaly as a result of NAFLD or nonalcoholic steatohepatitis (NASH). The latter is a more advanced form of 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:

  • obesity
  • 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 indicate that a person should consider making some lifestyle changes.

However, 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
  • cancer

It is the underlying cause of hepatomegaly, rather than hepatomegaly itself, that can cause complications. For example, if someone has NAFLD, they have an increased risk of various complications, including:

  • cardiovascular disease
  • type 2 diabetes
  • metabolic syndrome
  • high blood pressure
  • abnormal levels of cholesterol and triglycerides in the blood

If someone has liver damage, this may cause an accumulation of fluid within the abdomen. The medical name for this is ascites. Albumin may also leak from blood vessels into the abdomen.

A small amount of abdominal fluid does not typically cause symptoms. However, moderate amounts cause weight gain and a distended stomach. Large amounts may cause the abdomen to become taught, swollen, and uncomfortable.

The swelling can also cause pressure on the stomach and lungs, which may affect appetite and breathing.

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.

Due to this, a person should speak with a doctor if they:

  • experience any symptoms of an enlarged liver
  • develop any other new or unusual symptoms
  • have conditions that increase their risk of developing liver disease, such as alcohol use disorder
  • could have come into contact with blood containing a hepatitis virus

The outlook for people with hepatomegaly depends on the cause of the hepatomegaly and the extent of the liver damage. People with hepatitis A usually recover without treatment, for example.

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 speak with a doctor about their individual outlook.

The best way to prevent hepatomegaly is to take good care of the liver, which people can do by:

  • using medications sparingly
  • avoiding combining 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
  • avoiding sharing personal grooming tools, such as razors or tweezers
  • avoiding sharing needles
  • using barrier methods of contraception during sex, such as condoms
  • following a balanced diet that is low in saturated fats
  • exercising regularly
  • reaching or maintaining a moderate weight
  • seeing a doctor for thorough, routine physical exams

Hepatomegaly is the medical term for an enlarged liver. It can be a sign of an underlying disease. Some conditions that can cause hepatomegaly include fatty liver disease, alcohol use disorder, hepatitis, and cancer.

A person may have hepatomegaly and not be aware of it. However, if the liver becomes 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 consult a doctor for a diagnosis.