Alcohol related liver disease

Excess alcohol consumption can lead to a gradual scarring of the liver and eventually may lead to abnormalities of liver function. It is a very common cause of liver disease in the UK and it usually progresses gradually over many years.

Most patients will be unaware that their liver is at risk. Symptoms are only apparent at the advanced stages of liver damage. We can provide patients with a tailored set of investigations to assess for liver damage and can support patients in their efforts to reduce their alcohol consumption.

Fatty liver disease

Fatty liver disease is common liver disorder and is increasing in prevalence year by year. It can be associated with being overweight and is more common in patients who also have diabetes or high cholesterol. 

Only a proportion of patients with NAFLD will progress to advanced stages of liver disease, and simple tests are available to help determine who those patients are. There are no specific treatments yet for NAFLD, though lifestyle changes can have a beneficial impact on the condition and there are many new drugs in advanced stages of clinic trials.

Hepatitis B (HBV)

Chronic Hepatitis B is affects several hundred million people worldwide and one of the most common causes of cirrhosis and primary liver cancer. 

Infection is often acquired in early childhood and usually manifests no symptoms. Screening for this condition is important if there is a family history of HBV or if the patient is from a part of the world with high rates of infection. Though there is no cure, very effective treatments exist to control the infection and prevent liver disease. Many other patients will only require monitoring of

Hepatitis C (HCV)

Chronic Hepatitis C is the most common transmissible cause of liver disease in the UK and is a very important cause of end stage liver disease and primary liver cancer. 

Infection can remain undetected for many years and is usually asymptomatic. Routes of transmission include through transfusion of infected blood products before discovery of the virus in 1991. There are now several new highly effective and well tolerated medicines available to cure hepatitis C infection.

Hepatocellular carcinoma (HCC)

HCC is a primary liver cancer and is one of the major complications of chronic liver disease. A patient is usually only at risk of HCC once they have developed cirrhosis, but in some conditions such as chronic hepatitis B it can occur before. 

Simple screening tests exist, such as regular liver ultrasound scanning, to detect HCC in its early stages when curative treatment such as surgery or liver transplantation may be possible.


Cirrhosis refers to extensive scarring of the liver and can occur after many years of liver disease. Any form of chronic injury can lead to cirrhosis but the most common causes are alcohol, hepatitis C and fatty liver (NAFLD). 

Once a patient has developed cirrhosis, they may go on to develop the symptoms and signs of poor liver function and their condition may progress to liver failure. Treatment of the underlying cause and regular monitoring are vital to caring for a patient with cirrhosis, and screening is recommended for complications such as portal hypertension and hepatocellular cancer.

Portal hypertension

In patients with cirrhosis, the normal flow of blood through the liver can be impeded causing high back pressure in the veins draining into the liver. This is called portal hypertension and may lead to the development of fluid in the abdomen (ascites), an enlarged spleen or the formation of varices. 

Varices are dilated blood vessels in the lining of the gut, most often near the bottom of the oesophagus or beginning of the stomach, which can rupture suddenly and cause brisk internal bleeding. This can be treated by endoscopy and screening tests are recommended to detect varices before they bleed to allow preventative therapy.


These are a group of diseases that primarily affect the bile ducts draining the liver. 

By impeding the free flow of bile, these diseases may cause progressive damage to the liver over time and can directly cause complications in the bile ducts themselves such as obstructive jaundice, bile infection, stones and bile duct cancer.

Abnormal Liver Function Tests (LFTs)

Liver function tests (LFTs) are frequently performed to detect early signs of liver injury or inflammation and to directly measure liver function. 

They may be performed in patients at risk of liver disease or sometimes as a part of a general screen in patients who are non-specifically unwell.  Transient derangements of LFTs can sometimes occur with general viral infections or as part of a reaction to a new medication. A patient with an LFT abnormality should be further investigated to exclude significant liver disease.

Liver transplantation

In patients with end stage liver disease or primary liver cancer, liver transplantation may be the only option to improve long term survival and quality of life. When performed in expert hand and carefully selected patients, it can offer excellent long term outcomes. 

Liver transplantation in the UK is governed through a national transplantation programme and is usually performing using organs donated to national organ donor pool. It is also sometimes possible for a relative to successfully donate a part of their own liver for transplantation. 

Patients who have had a liver transplant require treatment with medication to prevent rejection and regular specialist follow up to ensure the good health and function of their new liver.