What Is Hepatomegaly?

Your liver is your body's detoxification system, which is very important for your overall health and well-being. Unfortunately, several health conditions, including alcoholism, can damage your liver and even cause it to enlarge.

An enlarged liver is also known as hepatomegaly, a sign that something isn't right in your body. 

But how can you tell if your liver is enlarged, and what should you do if you suspect you have hepatomegaly? According to experts, here's what you should know about hepatomegaly—including symptoms, causes, and treatments.

What Is Hepatomegaly?

Your liver does a lot of essential jobs that keep your body functioning, like digesting your food and ensuring that nutrients break down and distribute to other body parts.

But several illnesses can impact the liver, and hepatomegaly is a symptom of some of those illnesses. Hepatomegaly is the swelling of the liver beyond its average size, Nikolaos Pyrsopoulos, MD, PhD, professor and chief in the division of gastroenterology and hepatology at Rutgers New Jersey Medical School, told Health.

"The liver detoxifies, metabolizes, and clears things from your body—including alcohol," explained Dr. Pyrsopoulos. "But when it is overwhelmed, it becomes inflamed."

When that happens, "fat deposits replace healthy liver cells, and you start to get a fatty liver," Kathryn Boling, MD, a primary care physician at Mercy Medical Center in Baltimore, told Health. "When you're totally healthy, your liver is a normal size."

What Causes Hepatomegaly?

There's a laundry list of potential underlying diseases that cause hepatomegaly. Although, alcohol abuse is to blame in many cases, said Dr. Pyrsopoulos. 

"When somebody is drinking in excess, the liver can't keep up," explained Dr. Pyrsopoulos. And as a result, the liver swells and enlarges.

In addition to alcohol abuse, some of the causes of hepatomegaly include:

• Cancer that spreads to the liver
• Congestive heart failure
• Glycogen storage disease
• Hepatitis A, B, and C
• Hereditary fructose intolerance
• Mononucleosis
• Niemann-Pick disease, which is a rare illness that affects the body's ability to metabolize fat in cells
• Primary biliary cholangitis, which is a chronic disease of the liver's bile ducts
• Sclerosing cholangitis, which is a disease of the liver's bile ducts
• Fat in the liver from metabolic problems like diabetes, obesity, and high triglycerides

What Are the Risk Factors of Hepatomegaly?

You may be at greater risk of hepatomegaly if you or your family have a history of the following:

• Autoimmune disease
• Inflammatory bowel disease (IBD)
• Malignancy
• Chronic liver disease
• Sickle cell disease

You can reduce your risk of hepatomegaly by reducing certain lifestyle risks, including:

• Traveling to a country where malaria is present
• Consuming alcohol
• Getting tattoos or blood transfusions and engaging in sexual behavior that puts you at risk for human immunodeficiency virus (HIV) and hepatitis B and C
  

What Are the Symptoms of Hepatomegaly?

According to Dr. Boling, most people aren't aware when their liver swells. But you may have various symptoms if your hepatomegaly is due to liver disease, including:

• Jaundice
• Abdominal distension
• Nausea
• Itchy skin
• Weight loss
• Fever
• Pale stool or dark urine
• Changes in bowel habits

How Is Hepatomegaly Diagnosed?

Healthcare providers may use a few different methods to diagnose hepatomegaly. 

First, a healthcare provider may be able to feel it during a physical exam, according to Dr. Boling. The lower part of your liver typically reaches down to the bottom of your ribs on the right side of your body. 

It usually can't be felt with your fingertips unless you take a deep breath. But when you have hepatomegaly, a healthcare provider may be able to sense it.

A healthcare provider will examine you and ask questions such as:

• Did you notice fullness or a lump in the abdomen?
• What other symptoms do you have?
• Is there any abdominal pain?
• Is there any yellowing of the skin (jaundice)?
• Is there any vomiting?
• Are there any unusual-colored or pale-colored stools?
• Has your urine appeared to be darker than usual (brownish)?
• Have you had a fever?
• What medicines are you taking, including over-the-counter (OTC) and herbal medicines?
• How much alcohol do you drink?

Other options a healthcare provider might pursue to make a diagnosis may include:

• Abdominal X-ray or ultrasound
• CT scan of your abdomen
• Liver function tests, including blood clotting tests
• MRI scan of your abdomen

How To Treat Hepatomegaly

Since hepatomegaly isn't technically a disease, it's essential to treat the underlying issue, said Dr. Pyrsopoulos. 

For example, if a healthcare provider suspects the issue is hepatitis C, they will likely prescribe medication. Or if a healthcare provider suspects that alcohol abuse is behind your hepatomegaly, they'll encourage you to stop drinking.

Treating the underlying causes of hepatomegaly may keep the symptom from worsening and help prevent further damage.

"This is a salvageable situation," said Dr. Pyrsopoulos. "If we can catch it at an early stage, the liver can bounce back. If not, it can lead to permanent damage."

A Quick Review

Hepatomegaly is the swelling of the liver beyond its average size. While hepatomegaly is not a disease, it's typically caused by an underlying illness.

Not all of the underlying conditions are considered medical emergencies. However, some are serious or can lead to severe conditions. So, consult a healthcare provider if you have signs or symptoms of an enlarged liver.