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Addiction and Substance Abuse

Liver

09/07/2004

Question:

what does it mean to have a large liver? My live enzines were elevated? What causes it? I constantly have severe heartburn and difficult to breathe sometimes. there`s pain and pressure in esophegus (not sure how to spell) I`m taking prevacet and maylox but only eases alittle.

Answer:

In general, an enlarged liver is due to an inflammation of the liver cells. Elevated liver enzymes mean that liver cells have been damaged. These symptoms can have many causes, and one common cause is drinking too much alcohol. When alcohol causes liver swelling, this is known as alcoholic hepatitis.

A swollen liver can mean inflammation from any cause.  Alcohol is one of the causes but others include viruses, such as Hepatitis A, B, and C.  Alcohol at regular high intake (2 drinks for men and 1 for women is recommended maximum daily consumption) will result in liver damage in time.  This happens faster for women than for men due to different enzyme systems.

Hearburn means that acid in the stomach is washed upwards into the esophagus.  The esophagus lining is not made to handle acid and when acid refluxes into it, pain results.  There are many causes of this.  Three of the most common are alcohol, nicotine and caffeine.  Mints, onions, tomatoes and spicy foods also cause it.  An isolated incident occasionally when eating real spicy food is nothing to be overly concerned about. 

However, regular heartburn  may be a sign of something else wrong in the esophagus, for example, a tumor or narrowing of the esophagus.  This requires evaluation and management by your doctor.  At times it requires having an upper endoscopy to evaluate it and get biopsies.  In an endoscopy, the doctor puts a long thin instrument down your throat with a light and a camera to get a direct look at the lining of the esophagus and stomach. 

For further information, please contact a healthcare provider who specializes in liver and digestive disorders.

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Response by:

Christina M Delos Reyes, MD Christina M Delos Reyes, MD
Assistant Professor of Psychiatry
School of Medicine
Case Western Reserve University

Edna M Jones, MD, MRO Edna M Jones, MD, MRO
Clinical Assistant Professor of Family Medicine
College of Medicine
The Ohio State University