What Is Hepatomegaly? Here's What Experts Say About This Liver Condition

Hepatomegaly isn't a disease but a sign that something's wrong.

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

That's a complication known as hepatomegaly, and it's a sign that something isn't right in your body. But how can you know if your liver is enlarged, and what should you do if you suspect you have hepatomegaly? Doctors break it down.

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What is hepatomegaly?

Your liver does a lot of important jobs in your system, like digesting your food and making sure that nutrients are processed and distributed to other body regions, according to the National Institutes of Diabetes and Digestive and Kidney Diseases (NIDDK).

Hepatomegaly is the swelling of the liver beyond its normal size. Hepatomegaly isn't a disease on its own—instead, it's a sign of an underlying problem like liver disease, Nikolaos Pyrsopoulos, MD, PhD, professor and chief in the division of gastroenterology and hepatology at Rutgers New Jersey Medical School, tells Health.

"The liver detoxifies, metabolizes, and clears things from your body, including alcohol," Dr. Pyrsopoulos says. "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 Baltimore's Mercy Medical Center, tells Health. But, she adds, "when you're totally healthy, your liver is a normal size."

What causes hepatomegaly?

There's a laundry list of potential reasons, although alcohol abuse is to blame in many cases, Dr. Pyrsopoulos says. "When somebody is drinking in excess, the liver can't keep up," he explains. As a result, it swells, he explains.

Here are the most common causes of hepatomegaly, according to the US National Library of Medicine:

  • Alcohol use, particularly alcohol abuse
  • Cancer spreading to the liver
  • Congestive heart failure
  • Glycogen storage disease
  • Hepatitis A
  • Hepatitis B
  • Hepatitis C
  • Hepatocellular carcinoma
  • Hereditary fructose intolerance
  • Mononucleosis
  • Leukemia
  • Niemann-Pick disease (a rare illness that affects the body's ability to metabolize fat in cells)
  • Primary biliary cholangitis (a chronic disease of the liver's bile ducts)
  • Reye syndrome
  • Sarcoidosis
  • Sclerosing cholangitis (a disease of the liver's bile ducts)
  • Portal vein thrombosis
  • Fat in the liver from metabolic problems like diabetes, obesity, and high triglycerides

What are the symptoms of hepatomegaly?

Most people aren't aware when their liver swells, Dr. Boling says. But, if your hepatomegaly is due to liver disease, the Mayo Clinic says you may have these symptoms:

  • Abdominal pain
  • Fatigue
  • Nausea and vomiting
  • Yellowing of the skin and the whites of the eyes

How is hepatomegaly diagnosed?

Hepatomegaly can be diagnosed a few different ways. First, your doctor may be able to feel it during a physical exam, Dr. Boling says. The lower part of your liver normally reaches down 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, your doctor may be able to sense it.

Other options your doctor might pursue for a diagnosis, per the Mayo Clinic:

  • A blood test to look at your liver enzyme levels
  • A CT scan, MRI, or ultrasound of your abdomen
  • Magnetic resonance elastography, which uses sound waves to measure how stiff your liver tissue is
  • A biopsy of your liver

How is hepatomegaly treated?

Since hepatomegaly isn't technically a disease, Dr. Pyrsopoulos says it's important to treat the underlying issue. If your doctor suspects that alcohol abuse is behind your hepatomegaly, they'll encourage you to stop drinking.

Dr. Pyrsopoulos stresses the importance of listening to your doctor. "This is a salvageable situation," he says. "If we can catch it at an early stage, the liver can bounce back. If not, it can lead to permanent damage."

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