A Complete Guide to Your Liver
The liver is the largest organ inside your body, located just under your ribs on the upper-right side of your abdomen. It performs as many as 500 vital functions and plays a role in nearly every organ system in your body.
Perhaps the most important job your liver performs is filtering your blood all day. Not only does the liver rid your body of toxins and bacteria that could be harmful, but it also regulates clotting and stores important vitamins and minerals.
Over time, though, exposure to alcohol, fatty foods, different toxins, and certain medications can potentially cause your liver to function less efficiently. Your liver can even become damaged, leading to chronic liver disease, cirrhosis, and liver cancer.
Here's what you need to know about the anatomy and function of your liver, associated conditions, and how to keep the organ healthy.
Illustration by Dennis Madamba for Health
Anatomy of the Liver
The liver is a vital organ shaped like a cone or a wedge that sits below your lungs on the upper-right side of your abdomen. The small end of your liver is just above the spleen and stomach, and the large end is above the small intestine.
About the size of a football, the liver takes up most of the space in your rib cage. The organ accounts for 2% of most adults' body weight, meaning the liver usually weights three to five pounds.
The liver is reddish-brown, and the outside is smooth.
The liver has four primary sections, or lobes. These lobes can be further broken down into a total of eight segments. The segments are made up of 1,000 small lobules. These lobules are connected to small bile ducts. Bile ducts are tubes within the liver that carry bile, a waste product. The small ducts connect to larger bile ducts, ultimately forming the common hepatic duct. The common hepatic duct is what transports bile made by the liver cells to the gallbladder and the duodenum (or first part of the small intestine).
Anatomical Variations
Some people's liver might not fully develop correctly when they are in the womb. For others, the lobes might be underdeveloped or not have completely developed. The lobes might also atrophied, or wasted away. Sometimes, the liver have overdeveloped and have an extra lobe that usually grows below the liver.
Other conditions people may be born with that affect the liver aren't due to a difference in the development of the liver itself but the bile ducts within the liver. Biliary atresia is a condition where the bile ducts are scarred or blocked. Alagille syndrome is a genetic disorder that causes newborns to have fewer bile ducts in the liver than normal. Both conditions make it difficult for bile to move out of the liver. Since bile can't move out of the liver, the liver can become damaged.
What Does the Liver Do?
As the largest solid organ in the body, the liver is essential for digesting food, ridding your body of toxins, maintaining blood sugar levels, regulating blood clotting, and performing hundreds of other vital functions. In fact, it plays a role in nearly every organ system in the body.
But your liver's biggest role is to filter your blood 24 hours a day. In fact, your liver filters more than a liter of blood every minute. This amounts to about 22 gallons of blood per hour and more than 250 gallons of blood in a 24-hour time period. Plus, at any given moment, your liver houses about 13% of your body's blood supply, or about a pint of blood.
Overall, your liver is a busy and hard-working organ that performs more than 500 vital functions. Here are some of the more important functions your liver does:
Filters all of the blood in your body, breaking down poisonous substances like alcohol and drugs
Removes bacteria from the bloodstream to help prevent infections
Produces bile that is used in digestion and waste removal
Stores large amounts of vitamins A, D, E, K, and B12, as well as iron and copper
Removes excess glucose (sugar) from the bloodstream, stores it as glycogen (stored glucose), and converts the glycogen to energy when needed
Regulates blood clotting as needed
Associated Conditions
There are numerous liver conditions and diseases that can impact the health of your liver. Some are caused by viruses while others are caused by drinking too much or using drugs. The conditions can make scar or damage the liver and cause issues. Here is a closer look at some of the more common conditions affecting the liver:
Hepatitis
Hepatitis is inflammation to the liver. There are several forms of hepatitis, the most common being viral hepatitis, which is when a viral infection causes the inflammation. The most common forms of viral hepatitis in the U.S. are hepatitis A, B, and C. Depending on the form of hepatitis, the virus can be spread through contaminated food, bodily fluids, or blood.
More than half of people with viral hepatitis do not know that they have it. This puts them at risk for complications like liver disease and cancer and also makes it so that they may unknowingly pass the infection to others.
If viral hepatitis symptoms do appear, they may include:
Loss of appetite
Vomiting
Light-colored stools
Yellowing of the skin or eyes (jaundice)
Autoimmune hepatitis is another type of hepatitis. With this chronic condition, your immune system attacks your liver and causes inflammation and liver damage. Without treatment, autoimmune hepatitis can worsen and lead to complications, even cirrhosis, which is an irreversible scarring of your liver. Experts still aren't sure what causes autoimmune hepatitis.
Fatty Liver Disease
There are two main types of fatty liver disease: nonalcoholic fatty liver disease (NAFLD) and alcohol-associated fatty liver disease. In both, there is a buildup of fat in your liver. The fat buildup can lead to complications like liver disease and other health problems like cardiovascular disease.
NAFLD is the most common cause of liver disease in the world. Globally, the prevalence of NAFLD is estimated as high as 1 billion. It's estimated that 24% of adults in the U.S. have NAFLD. People who are overweight or have obesity are more likely to develop it. It usually doesn't cause any symptoms. If it does, you might feel tired or experience discomfort in your upper-right abdomen.
Alcohol-associated fatty liver disease is caused by an overconsumption of alcohol. As damage continues to occur, the fatty liver can progress to alcoholic hepatitis and eventually alcoholic cirrhosis.
Cirrhosis
Cirrhosis is a condition in which your liver is scarred and permanently damaged. The scar tissue replaces your healthy liver tissue and prevents your liver from functioning properly. Eventually, your liver will begin to fail.
The most common causes of cirrhosis are alcohol-associated liver disease, NAFLD, chronic hepatitis C, and chronic hepatitis B.
Some of the early symptoms of cirrhosis you might experience include tiredness, weakness, itchy skin, weight loss, and upper-right abdominal pain. But more commonly, you'd start having symptoms only once the cirrhosis has worsened. You may notice that you bruise or bleed more easily, that your skin or eyes are turning yellow, or that you have swelling in your lower extremities or abdomen.
Liver Cancer
It's possible for cancer to begin in your liver. This happens when cancer cells grow in the tissue of the liver. When cancer begins in the liver, it is called primary liver cancer. Both children and adults can get primary liver cancer.
The most common type of primary liver cancer in adults is hepatocellular carcinoma (HCC). Symptoms of HCC include a hard lump below your right-side rib cage, discomfort in your upper-right abdomen, and a swollen abdomen.
Certain factors, such as having obesity, NAFLD, or diabetes, can increase your risk of developing liver cancer.
Diagnostic Testing
If a healthcare provider suspects you have a problem with your liver, there are a variety of imaging options and blood tests that can be used to check for liver damage and help diagnose liver disease. Here are some of the more common tests used:
Liver function tests: These blood tests are used to check your liver’s health and detect liver damage. Typically, these tests are used to measure the levels of certain proteins and enzymes in your blood. Knowing these levels can help healthcare providers make a diagnosis.
Liver biopsy: During this procedure, a small piece of liver tissue is removed and sent to a lab so that liver’s condition can be examined and tested.
Transient elastography: Using a special ultrasound machine, your healthcare provider will measure the stiffness of your liver.
Magnetic resonance elastography: This non-invasive test contains features of both an ultrasound and magnetic resonance imaging (MRI). It is used to create a visual map showing gradients of stiffness throughout your liver.
Magnetic resonance cholangiopancreatography (MRCP): The MRCP is a specialized version of an MRI that produces detailed images of your liver as well as your gallbladder, bile ducts, pancreas, and pancreatic duct.
Tips for Keeping Your Liver Healthy
Because your liver plays such a vital role in your body, it is important to keep it as healthy as possible. This begins with being aware of what you are exposing your body to and trying to avoid substances, foods, and chemicals that cause your liver to work harder to protect you.
Here are some things you can do to keep your liver healthy:
Avoid toxins: Try to avoid or limit the amount of contact you have with cleaning products, chemicals, additives, smoke, and insecticides. These types of toxins can injure liver cells. If you do have to use aerosols, wear a mask and make sure the room is ventilated.
Limit alcohol use: Drinking an excess amount of alcohol can damage liver cells and scar your liver. Talk to a healthcare provider about how much alcohol is acceptable for you. For some people, quitting alcohol may be the best option.
Refrain from using drugs: Using illicit drug use can destroy your liver because of the number of toxins they contain. This can include marijuana and even prescription drugs like pain killers and sedatives that are abused.
Take all medications correctly: If you take too much of certain medications or mix medicines, your liver can be harmed. You also should never mix alcohol with other drugs and medications—even if they are not taken at the same time. Talk to a healthcare provider about the potential effects of any over-the-counter drugs and supplements you use.
Manage your weight: Being overweight or having obesity can increase the risk of developing a fatty liver condition. You can reduce the amount of fat in your liver by managing your weight, eating a well-balanced diet, and staying hydrated.
Get vaccinated: There are vaccines to protect against hepatitis A and B. You can check with a healthcare provider to see if you are up-to-date on your shots.
A Quick Review
Your liver is a vital organ in your body. It plays a role in many systems in your body and performs more than 500 functions. One of the most important functions is filtering out waste from your blood. The liver also produces bile to help with digestion and stores nutrients.
The liver is located in the upper-right side of your abdomen, just under the rib cage. If you develop any liver-related problems, you might experience pain or discomfort in that area. Hepatitis, fatty liver disease, cirrhosis, and liver cancer are example of some conditions that can affect your liver. If a healthcare provider suspects you have a liver problem, there are a number of diagnostic tests that could be used to determine the cause.
What you eat, drink, and expose yourself to can affect the health of your liver. You can take steps to keep your liver healthy, such as by avoiding toxins and getting vaccinated against hepatitis. Keeping your liver healthy can help ensure it continues to efficiently perform its hundreds of roles.
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