What is hepatomegaly?
Hepatomegaly is swelling of the liver beyond its normal size. An abnormal enlargement of a liver may be a sign of a variety of serious diseases.
How common is hepatomegaly?
Hepatomegaly can affect patients at any age. It commonly appears at the older age. However, it can be seen in children who are severely burned or infected with parasites, etc. It can be managed by reducing your risk factors. Please discuss with your doctor for further information.
What are the symptoms of hepatomegaly?
In itself, an enlarged liver typically has no symptoms. Signs and symptoms of this condition include:
- Pain in the upper right belly;
- Muscle aches (myalgia);
- Poor appetite and weight loss;
- Yellowing of the skin and the whites of the eyes (jaundice);
- Abdominal pain or mass;
- Swelling of the feet and legs;
- Easy bruising;
- Increasing abdominal size.
There may be some symptoms not listed above. If you have any concerns about a symptom, please consult your doctor.
When should I see my doctor?
You should contact your doctor if you have any of the following:
- Severe abdominal pain;
- Fever and jaundice;
- Bloody or coffee ground vomit;
- Shortness of breath;
- Black, tarry stools or bright red blood in stools.
If you have any signs or symptoms listed above or have any questions, please consult with your doctor. Everyone’s body acts differently. It is always best to discuss with your doctor what is best for your situation.
What causes hepatomegaly?
Among the most common causes of liver enlargement are:
- Alcoholic liver disease, which includes alcoholic fatty liver disease, alcoholic hepatitis and cirrhosis.
- Nonalcoholic fatty liver disease, a lifestyle-related metabolic disease.
- Viral hepatitis (hepatitis A, B, C, D or E).
- Liver cancer, or cancer that has spread to the liver from a different organ.
There are other less common liver diseases may cause liver enlargement:
- Some types of leukemia;
- Some types of lymphoma;
- Multiple myeloma;
- Wilson’s disease;
- Gaucher’s disease;
Heart and blood vessel problems
- Blockage of the veins that drain the liver (Budd – Chiari syndrome);
- Congestive heart failure;
- Narrowing (stenosis) of the heart’s tricuspid or mitral valves;
- Liver abscess, caused by parasites (amebiasis) or bacteria;
- Other parasitic infections (malaria, schistosomiasis, fascioliasis, and toxocariasis);
- Relapsing fever, which humans catch from body lice or ticks.
Damage from toxins
- Drug – induced liver injury from such medications as acetaminophen (Tylenol, others) and amoxicillin – clavulanate (Augmentin, Amoclan);
- Toxic hepatitis from exposure to poisons, such as the industrial chemicals carbon tetrachloride and chloroform.
Complex liver and systemic diseases
- Autoimmune hepatitis;
- Primary biliary cirrhosis;
- Primary sclerosing cholangitis;
- Altered glycogen metabolism/ Glycogen storage disease;
- Deficiency of lisosomal acid lipase.
What increases my risk for hepatomegaly?
There are many risk factors for hepatomegaly, such as:
- Alcohol abuse: drinking large amounts of alcohol can damage your liver.
- Large doses of medicines, vitamins or supplements: taking larger than recommended doses of vitamins, supplements, or over –the – counter (OTC) and prescription medicines may increase your risk of liver damage.
- Medicinal herbs: certain herbs, including comfrey, ma huang and mistletoe, can increase your risk of liver damage.
- High levels of AST, ALT (enzymes that can indicate liver damage).
Diagnosis & treatment
The information provided is not a substitute for any medical advice. ALWAYS consult with your doctor for more information.
How is hepatomegaly diagnosed?
As part of the physical examination for possible liver disease, doctors use their fingertips to press on the right side of your belly just below your rib cage and feel (palpate) the lower edge of your liver, noting its size, texture, and tenderness. Depending on the underlying cause, an enlarged liver may feel soft, firm or irregular. Well-defined lumps may be present as well.
This exam provides only a very rough estimate of liver size, though. For a precise measurement, you’ll need imaging, typically starting with an abdominal ultrasound. If there’s a need for more detailed images, you may also have a computerized tomography (CT) scan or magnetic resonance imaging (MRI).
Once your doctor determines that you have an enlarged liver, further tests help determine the cause. These tests include:
- Blood tests. A blood sample is tested to determine liver enzyme levels. This can give clues about the health of your liver. Blood tests can also identify viruses that can cause enlarged liver, such as the hepatitis viruses.
- Magnetic resonance elastography uses shear waves to create a visual map (elastogram) of the stiffness of liver tissue. This test is noninvasive and can be an alternative to a liver biopsy.
- Removing a sample of liver tissue for testing (liver biopsy). Your doctor may recommend a biopsy to collect a sample of liver tissue for laboratory testing. A liver biopsy is often done using a long, thin needle that’s inserted through your skin and into your liver. The needle draws out a core of tissue that is then sent to a laboratory for testing. Your doctor may use ultrasound to help guide the biopsy.
Tests to determine the cause of hepatomegaly vary, depending on the suspected cause, but may include:
- Abdominal X-ray;
- Abdominal ultrasound (may be done to confirm the condition if the doctor thinks your liver feels enlarged during a physical exam);
- CT scan of the abdomen;
- Liver function tests, including blood clotting tests;
- MRI scan of the abdomen.
How is hepatomegaly treated?
Your treatment options depend upon the underlying disorders that cause your liver enlargement. Some of the treatments your doctor will recommend are:
- Medications and treatments for liver failure or infections like hepatitis C.
- Chemotherapy, surgery, or radiation for liver cancer.
- A liver transplant for liver damage.
- Treating the source for metastatic cancer.
- Treatment for lymphoma or leukemia, depending upon the type, degree of spread, and your general health.
- Quitting alcohol or any others drugs.
Some of the most common causes, including alcoholic hepatitis and nonalcoholic fatty liver disease, improve dramatically with alcohol abstinence, a healthy diet, regular exercise, and weight loss.
Lifestyle changes & home remedies
What are some lifestyle changes or home remedies that can help me manage hepatomegaly?
The following lifestyles and home remedies might help you cope with hepatomegaly:
- Choose a healthy diet. Choose a diet full of fruits, vegetables, and whole grains.
- Drink alcohol in moderation, if at all. Check with your doctor to find out what’s the right amount of alcohol for you.
- Follow directions when taking medications, vitamins or supplements. Limit yourself to the recommended doses when taking vitamins, supplements, and over-the-counter or prescription medications.
- Limit contact with chemicals. Use aerosol cleaners, insecticides, and other toxic chemicals only in well-ventilated areas. In addition, wear gloves, long sleeves and a mask.
- Maintain a healthy weight. If your weight is healthy, work to maintain it. If you need to lose weight, cut back on the number of calories you eat each day and increase the amount of daily exercise. Ask your doctor about healthy ways to lose weight.
- Use supplements with caution. Talk with your doctor about the risks and benefits of dietary supplements and herbal remedies before you take them. Many of these products can be harmful to your liver, particularly those containing combinations of ingredients and marketed for bodybuilding or weight loss. Specific herbs to avoid include germander, chaparral, senna, mistletoe, comfrey, ma huang, valerian root, kava, celandine, and green tea extracts.
If you have any questions, please consult with your doctor to better understand the best solution for you.
Hello Health Group does not provide medical advice, diagnosis or treatment.
Review Date: November 24, 2016 | Last Modified: September 12, 2019
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Enlarged liver. http://www.mayoclinic.org/diseases-conditions/enlarged-liver/basics/definition/con-20024769. Accessed October 10, 2016.