Hepatomegaly – Causes, Symptoms, Treatment, Prognosis

By Dr Raghuram Y.S. MD (Ay) & Dr Manasa, B.A.M.S

Hepatomegaly means an enlarged liver. It is actually not a disease. It is in fact a sign of an underlying problem like a liver disease, congestive heart failure or cancer.

Table of Contents

Home remedies

Below mentioned are some of the simple remedies for liver enlargement which may be tried after consulting with your doctor –

Aloe vera – pulp of the single leaf of the plant is taken and mixed with black salt and ginger. This should be taken every morning for 10 days.

Amla – 300 grams of powder of Indian gooseberry should be mixed with 100 grams of dried ginger powder. 1 teaspoonful of this should be taken with warm water twice in a day.
Read – Amla Benefits, Dose, How To Use, Side Effects, Home Remedies

Bitter gourd – juice of bitter gourd mixed with small amount of salt is helpful.

Chicory juice – obtained from its flowers, seeds and roots is highly beneficial.

Dandelion Root – tea prepared from this root is useful.

Haritaki – Terminalia chebula powder mixed with jaggery in equal proportions (roughly 1.5-2 grams each) should be taken at least twice daily with warm water for 1-1.5 months.

Herbal decoction – Make a decoction of 1 teaspoon each of fennel seeds, ginger and coriander, 5 numbers of black pepper, garlic cloves and leaves of holy basil in 1-1.5 cups of water for 5 minutes. Strain it, add 1 teaspoon of honey once the liquid gets warm and take it twice daily after meals.

Kantakari – Solanum xanthocarpum is highly beneficial in treating hepatosplenomegaly i.e. enlargement of both liver and spleen.

Lemon juice – is an effective remedy for hepatomegaly. It reduces liver inflammation owing to its richness of vitamin C and other antioxidants and diuretic properties. For better results, it should be taken early in the morning, on empty stomach.

Onion – is diuretic, has cleansing properties, detoxifies liver and reduces liver inflammation, hence beneficial in hepatomegaly.
Read – Onion Uses, Remedies, Research, Side Effects

Tamarind tea – should be taken 2-3 times a day. Tamarind is a naturally detoxifying agent and reduces liver inflammation.

Other remedies –

Papaya – eating fruit or drinking its juice
Spearmint juice with sugar
Orange juice on empty stomach
Daily intake of long brinjals
Green Tea

Ayurveda concept

Read – Yakrutodara

Treatment

The treatment for enlarged liver involves treating the condition or disease that is causing it. Below mentioned are some of the recommended treatments –

Medications and treatments for liver failure / infections
Chemotherapy, surgery or radiation for liver cancer
Liver transplant when there is liver damage

Lifestyle changes

Quitting alcohol or any other drugs
Eating healthy diet
Doing regular exercise
Losing weight if you are obese or overweight
Read – Effective Obesity Treatment, Remedies And Ayurveda Tips

Prevention

Following healthy lifestyle
Maintaining a healthy weight
Managing blood sugar levels
Restriction or avoiding alcohol intake
Quit smoking
Taking supplements in consultation with doctor
Following recommendations for safe handling if you are working with chemicals, insecticides or aerosolized cleaners

If the hepatomegaly is discovered earlier, there is a better outcome in the treatment. Recovery and reduction of symptoms also depends on the scale of underlying causes of hepatomegaly.

Causes of Hepatomegaly

1. Liver diseases

Liver cirrhosis
Hepatitis A, B and C
Hepatitis caused by infectious mononucleosis
Alcoholic fatty liver disease
Nonalcoholic fatty liver disease
Amyloidosis – abnormal protein accumulation in liver
Wilson’s disease – genetic disorder, marked by copper accumulation in the liver
Hemochromatosis – caused due to iron accumulation in the liver
Gaucher’s disease – caused by fatty substances accumulating in the liver
Liver cysts – fluid filled pockets in the liver
Hemangioma and adenoma – presence of non-cancerous liver tumors in the liver
Toxic hepatitis
Obstruction of gallbladder or bile ducts
Read – Liver Diseases: Causes, Symptoms, Treatment, Home Remedies

2. Cancers

Secondary / metastatic liver carcinomas
Leukemia
Lymphoma
Liver cancer
Multiple myeloma
Read – 10 Diet and Lifestyle Tips To Prevent Cancer

3. Problems of heart and blood vessels

Budd-Chiari syndrome – caused by blockage of veins of liver
Heart failure
Pericarditis – inflammation of tissue surrounding the heart
Congestive hepatomegaly – Congestive heart failure can cause blood to back up into the hepatic veins. These are the veins that help drain blood from the liver. When they back up, liver will become congested and grow larger. This is called as congestive hepatomegaly.
Read – Ayurvedic Treatment For Heart Diseases – Hridroga Chikitsa

4. Congenital conditions

Hemolytic anemia
Polycystic liver disease
Sickle cell disease
Hereditary fructose intolerance

5. Infection

Glandular fever (infectious mononucleosis)
Hepatitis
Liver abscess / Pyogenic abscess
Malaria
Amoeba infections
Hydatid cyst
Leptospirosis
Actinomycosis
Read – Ayurvedic Home Remedy For Liver Diseases

6. Biliary conditions

Primary biliary cirrhosis
Primary sclerosing cholangitis

7. Metabolic disorders

Cholesteryl ester storage disease
Porphyria
Niemann Pick disease
Glycogen storage disease

(Haemochromatosis, Wilson’s disease, Non-alcoholic fatty liver disease – mentioned in liver diseases are also included here)
Read – Jaundice With Alcoholic Liver Disease – A Clinical Case Presentation

8. Drugs

Alcohol abuse
Drug induced hepatitis

9. Other conditions

Granulomatous conditions – Sarcoidosis
Zellweger’s syndrome
Hunter’s syndrome
Carnitine palmitoyltransferace I deficiency
Read – Fatty Liver: Symptoms, Ayurvedic Treatment, Remedies, Tips

Symptoms

Most times an enlarged liver may not cause any symptoms.

When a liver disease causes enlargement of liver, it may present the below mentioned symptoms –

Pain in the abdomen, and abdominal mass
Increasing abdominal size
Feeling of fullness or discomfort in your belly
Fatigue and weakness
Nausea and vomiting
Jaundice
Weight loss
Poor appetite
Muscle aches
Itching
Swelling of feet and legs
Easy bruising
Read – Kamala Roga Chikitsa: Liver Disorder Causes, Symptoms, Treatment

If the symptoms are too troublesome you need to see a doctor as soon as possible. Below mentioned symptoms require immediate medical attention –

Severe abdominal pain
Jaundice and fever
Shortness of breath
Black, tarry stools
Bright red blood in stools
Bloody or coffee ground vomit

These symptoms might indicate medical emergency.
Read – Dyspnoea – Difficulty in breathing: Causes, Pathophysiology, Diagnosis

Risk Factors

Having a liver disease is the greatest risk factor for hepatomegaly. You are likely to develop enlargement of liver if you have a liver disease. Below mentioned are the factors and conditions which tend to increase your risk of getting liver problems.

Autoimmune disorders afflicting the liver
Taking large amounts / doses of medicines, vitamins or supplements predisposes to hepatomegaly. Overdose of acetaminophem is the commonest cause for acute liver failure in US. Reading the labels and knowledge of what medicines or supplements causes liver enlargement will help.
Infectious diseases – including viral, bacterial or parasitic diseases increases risk of liver damage
Inflammatory bowel disease
Hepatitis viruses
Poor eating choices and habits – unhealthy foods and those rich in excess fat or sugar are risk factors for liver damage
Being overweight
Sickle cell disease
Read – Autoimmune Hepatitis: Causes, Symptoms, Diagnosis, Treatment

Lifestyle factors

Excessive use of alcohol
Blood transfusions
Tattooing
Blood transfusions
Unprotected sex
Traveling to foreign countries associated with risks for malaria
Taking herbs like ma huang, comfrey and mistletoe in excess

Diagnosis

Physical examination – Liver enlargement is usually diagnosed by your physician while feeling / examining your abdomen. Enlarged liver is felt during palpation and percussion of abdomen.

Other tests and procedures –

Blood tests – to determine liver enzyme levels and to identify the viruses causing enlargement of liver

Imaging tests – CT scan, USG or MRI

Magnetic resonance elastography – uses sound waves to create a visual map of the liver tissue stiffness. This map is called elastogram. This is now days considered as an alternative to liver biopsy and is noninvasive.

Liver biopsy – may be advised to find out the cause for liver enlargement.
Read – Autoimmune Hepatitis Ayurvedic Concept, Explanation, Treatment