Hepatomegaly is when you have an enlarged liver. It’s often a sign of a serious health concern.
Your liver is the largest internal organ. It helps your body:
- digest fats
- store sugar in the form of glycogen
- fight off infections
- produce proteins and hormones
- control blood clotting
- break down medications and toxins
The liver is also the only internal organ that can grow back after surgery, which makes live liver donation possible. If you donate a portion of your liver, it will regenerate to its original size. The transplanted portion will also grow.
If you have an enlarged liver, it could mean that you have:
- a liver disease
- cancer, such as leukemia
- a genetic disease
- heart and blood vessel abnormalities
- an infection
- toxin poisoning
Many of the symptoms that cause hepatomegaly can impair your liver’s ability to function and help your body.
While hepatomegaly is always a cause for medical evaluation, not all of the underlying conditions are considered medical emergencies. Make an appointment with your doctor if you have signs or symptoms of an enlarged liver.
An enlarged liver on its own may not have any symptoms. But if a medical condition is causing your enlarged liver, you may experience serious symptoms such as:
- jaundice, or yellowing of the skin and eyes
- muscle aches
- abdominal pain or mass
- poor appetite
- swelling of the feet and legs
- easy bruising
- weight loss
- increasing abdominal size
Any of these symptoms require evaluation by your doctor.
Call 911 or seek emergency medical attention immediately if you have:
- severe abdominal pain
- fever and jaundice
- bloody or coffee ground vomit
- shortness of breath
- black, tarry stools or bright red blood in stools
These symptoms are considered medical emergencies.
Hepatomegaly is often a sign that the tissue within the liver isn’t functioning properly. Taking certain medications, such as amiodarone and statins, may also cause liver injury.
Common causes include:
- metastatic cancer, or cancer that starts in other organs and spreads to the liver
- nonalcoholic fatty liver disease (NAFLD), or buildup of fat in your liver not due to alcohol
- heart and blood vessel abnormalities, or conditions that block the veins that drain the liver or bring it blood
- liver cancer, or cancer that grows from within the liver
- cirrhosis, or advance damage and scarring of the liver due to toxins like alcohol
- viral hepatitis (most commonly A, B, or C), or different liver infections each caused by a virus
- alcoholic liver disease, or a range of liver damage that includes fatty deposits, inflammation, and scaring due to alcohol consumption
Congestive heart failure can also cause blood to back up into the hepatic veins. These are the veins that help drain blood from the liver. When they back up, the liver will become congested and grow larger. This is called congestive hepatomegaly.
Less common causes of hepatomegaly include:
- lymphoma, or blood cancer in the lymphatic system
- leukemia, or a type of blood cancer of the bone marrow
- multiple myeloma, or a type of blood cancer of the bone marrow specific to plasma cells
- hemochromatosis, or iron buildup in the liver
- Wilson’s disease, or copper buildup in the liver
- Gaucher’s disease, or a disorder that causes fatty substances to build up in the liver
- toxic hepatitis, or liver inflammation due to chemical poisoning
- bile duct or gallbladder obstruction, or backup of bile and inflammation within the liver, often from gallstones
- hepatic cysts, or fluid-filled sacs within the liver from a variety of causes
Some infections and certain medical conditions can cause growths to form within your liver. Growths in the liver can be benign (not cancer) or malignant (cancer). Typically, any growth will cause your liver to increase in size.
Some people are genetically at greater risk for hepatomegaly. You may be at a greater risk if you or your family has a history of:
- autoimmune disorders, especially ones that affect the liver
- inflammatory bowel disease
- chronic liver disease
- liver cancers
- sickle cell disease
Lifestyle factors can also increase a person’s risk for hepatomegaly. These lifestyle factors include:
- excessive alcohol consumption
- tattoos, blood transfusions, and unprotected sex, which put you at risk for HIV and hepatitis B and C
- traveling to foreign countries associated with risks for malaria
- taking herbs like ma huang, comfrey, and mistletoe
Talk to your doctor if you have concerns about your risks for hepatomegaly. Always tell your doctor about any over-the-counter or herbal supplements you’re taking.
Your liver is a triangular organ. It’s located below your diaphragm, under the lower edge of your right ribcage. You may have an enlarged liver if your doctor can feel it during a physical exam. A typical liver can’t be felt with your fingers.
The size and weight of your liver increases naturally with age. For children, the liver is typically measured by its span, through its thickest part from top to bottom. Adult livers are measured by length.
The average liver size varies by age and can be:
- 6.4 cm for 1 to 3 months
- 7.6 cm for 4 to 9 months
- 8.5 cm for 1 to 5 years
- 10.5 cm for 5 to 11 years
- 11.5 to 12.1 cm for 12 to 16 years
- 13.5 cm +/- 1.7 cm for adult women
- 14.5 cm +/- 1.6 cm for adult men
Body shape, weight, and sex can also affect the size of your liver. Your doctor will take these into account when examining your liver for possible signs of hepatomegaly.
To find out why you have hepatomegaly, your doctor may order a variety of tests, such as:
- a complete blood count to check for an abnormal number of blood cells
- liver enzymes to evaluate liver function
- abdominal X-ray, a noninvasive X-ray study to evaluate abdominal organs
- CT scan for high-resolution images of the abdomen
- MRI for high-resolution images of specific abdominal organs
- ultrasound, the use of sound waves to evaluate the liver and other abdominal organs
If a doctor suspects a more serious condition, they may recommend a liver biopsy. A liver biopsy is a surgical test where your doctor takes a small sample of your liver for microscopic examination.
The likelihood of feeling an enlarged liver is unlikely. But because damage to your liver can cause an accumulation of fluid within your abdomen, you may notice that your stomach sticks out more than usual.
You could also experience other symptoms like jaundice, loss of appetite, and stomach pain. Make an appointment with a doctor if you think you may have signs or symptoms of hepatomegaly.
Your liver is a vital organ. The best way to manage your liver’s health is to follow your doctor’s instructions regarding healthy practices. This could include exercising more, drinking less alcohol, and eating a balanced diet.
Your treatment options depend upon the underlying disorders that cause your liver enlargement. Some of the treatments your doctor will recommend may include:
- 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
Once your doctor confirms hepatomegaly, they’ll usually recommend lifestyle changes for your liver health. These include:
- refraining from drinking alcohol
- eating a healthy diet
- engaging in regular exercise
- losing weight if you’re overweight
There are many lifestyle factors that can cause hepatomegaly. Managing these factors can decrease your risk for an enlarged liver.
Here are some things you can do:
- Follow a healthy lifestyle and maintain a healthy weight.
- Manage your blood sugar if you have diabetes.
- Limit alcohol consumption or consider not drinking at all. Your doctor will be able to tell you if your intake is excessive.
- Talk to your doctor before taking vitamin supplements, as they may interact with your liver.
- Discuss with your doctor any herbal supplements you’re considering. Many herbs marketed for anxiety prevention, weight loss, or muscle building can damage your liver.
- Always follow your employer’s recommendations for safe handling if you work around chemicals, such as insecticides or aerosolized cleaners.
The outlook for recovery and reduction of symptoms depends on the underlying cause of your hepatomegaly. You may have a better outcome if your doctor discovers hepatomegaly in its early stages.
Medications are available to reduce the symptoms of conditions, like congestive heart failure and liver failure.
At times, the symptoms of hepatomegaly don’t appear until the later stages. Severe liver damage can lead to lifelong complications.