Liver: Anatomy, Function, Common Diseases, and Foods

11 MINUTES

Where is the liver?

The liver is a large organ located in the upper-right portion of the abdomen, just below the diaphragm and to the right of the stomach. It is the largest internal organ in the body and weighs about 3 pounds in adults. The liver is partially protected by the rib cage and is divided into two main lobes, known as the right and left lobes. The liver receives blood from the hepatic artery and the portal vein, which carry oxygen-rich blood and nutrient-rich blood from the digestive system, respectively.

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What is the anatomy of liver?

The liver is a large, reddish-brown organ that is located in the upper-right side of the abdomen, just below the diaphragm. It is the largest internal organ in the body and is divided into two main lobes: the right lobe and the left lobe. The right lobe is much larger than the left lobe and makes up about two-thirds of the liver’s mass.

The liver receives blood from two sources: the hepatic artery, which carries oxygen-rich blood from the heart, and the portal vein, which carries nutrient-rich blood from the digestive system. These two blood vessels enter the liver at the porta hepatis, which is located on the underside of the liver.

Inside the liver, the blood flows through a network of small tubes called sinusoids. These sinusoids are lined with liver cells called hepatocytes, which perform many of the liver’s vital functions. The hepatocytes are arranged in small groups called lobules, which are roughly hexagonal in shape.

The liver also has a complex system of ducts that carry bile, a digestive fluid that is produced by the liver and stored in the gallbladder. The bile ducts within the liver eventually join together to form the common hepatic duct, which carries bile out of the liver and into the small intestine.

In addition to the hepatocytes, the liver also contains several other types of cells, including Kupffer cells, which are specialized immune cells that help remove bacteria and other foreign particles from the blood. The liver also contains stellate cells, which store vitamin A and play a role in liver fibrosis, a condition where scar tissue forms in the liver due to damage or disease.

Couinaud classification of liver anatomy

The Couinaud classification is a system used to divide the liver into 8 functional segments based on its vascular and biliary anatomy. It was developed by French surgeon Claude Couinaud in the 1950s, and has since become a widely used method for describing liver anatomy in surgical and radiological settings.

Each of the 8 segments is defined by its own portal triad (which consists of a portal vein branch, hepatic artery branch, and bile duct branch), as well as its own hepatic vein. The segments are numbered I to VIII in a clockwise direction, starting from the caudate lobe.

The Couinaud classification is useful in surgical planning, as it allows surgeons to precisely target specific areas of the liver for resection or other procedures. It is also important in radiology, as it allows radiologists to accurately identify the location of lesions or other abnormalities within the liver.

Overall, the Couinaud classification provides a useful framework for understanding the complex vascular and biliary anatomy of the liver, and has contributed to improved surgical and radiological outcomes for patients with liver disease.

What is the liver function?

The liver is an extremely important organ that performs many vital functions in the body. Some of the main functions of the liver include:

  1. Metabolism: The liver is responsible for processing nutrients and medications that are absorbed by the digestive system. It also helps regulate the body’s metabolism by converting food into energy and storing excess energy as glycogen.
  2. Detoxification: The liver is the body’s main detoxifying organ, breaking down harmful substances such as drugs, alcohol, and metabolic waste products, and removing them from the body.
  3. Synthesis: The liver plays a key role in synthesizing important substances such as bile, which is necessary for the digestion of fats; blood clotting factors; and albumin, a protein that helps maintain fluid balance in the body.
  4. Storage: The liver stores important nutrients such as vitamins, minerals, and glycogen, which can be released into the bloodstream as needed.
  5. Immune function: The liver also plays a role in the body’s immune system, producing immune factors and removing bacteria and foreign particles from the blood.

In short, the liver is essential for many of the body’s metabolic processes and plays a crucial role in maintaining overall health and wellbeing.

What is the centrilobular area of liver?

The centrilobular area of the liver, also known as the zone 3, is the region of the liver lobule that is located closest to the central vein. It is the area of the liver that receives the least amount of oxygenated blood and is therefore the most susceptible to damage from toxins and other harmful substances.

The centrilobular area is responsible for several important functions, including the breakdown of drugs, alcohol, and other toxins, as well as the synthesis of certain proteins and enzymes. It is also involved in the metabolism of carbohydrates and lipids, and the production of urea, which is a waste product of protein metabolism.

Damage to the centrilobular area of the liver can result in a range of symptoms and health problems, depending on the extent of the damage. Common causes of centrilobular liver damage include excessive alcohol consumption, viral hepatitis, exposure to environmental toxins, and certain medications. In severe cases, damage to the centrilobular area of the liver can lead to liver failure and other life-threatening complications.

What are the causes of acute liver failure?

Acute liver failure, also known as fulminant liver failure, is a rare but serious condition that occurs when the liver rapidly loses its ability to function properly. Acute liver failure can develop over a period of days or weeks, and can be caused by a variety of factors, including:

  1. Viral hepatitis (hepatitis A, B, or C)
  2. Overdose of medications, such as acetaminophen (paracetamol)
  3. Autoimmune hepatitis
  4. Wilson’s disease (a rare genetic disorder that causes copper accumulation in the liver)
  5. Acute fatty liver of pregnancy (a rare condition that can occur during pregnancy)
  6. Budd-Chiari syndrome (a rare condition that involves the blockage of blood vessels in the liver)
  7. Toxins, such as poisonous mushrooms or industrial chemicals

Symptoms of acute liver failure may include jaundice (yellowing of the skin and eyes), abdominal pain, nausea and vomiting, confusion, and coma. Treatment for acute liver failure may involve hospitalization, medication, or liver transplant, depending on the underlying cause and severity of the condition.

It is important to seek medical attention immediately if you experience any symptoms of acute liver failure, as early diagnosis and treatment can improve the chances of recovery.

What are the causes of chronic liver disease?

Chronic liver disease is a condition that develops over time, and is characterized by ongoing damage to the liver. There are several potential causes of chronic liver disease, including:

  1. Hepatitis B and C: These are viral infections that can cause inflammation and damage to the liver over time, leading to chronic liver disease.
  2. Alcohol consumption: Excessive alcohol consumption can cause liver damage, inflammation, and cirrhosis, which can ultimately lead to chronic liver disease.
  3. Nonalcoholic fatty liver disease (NAFLD): This condition is characterized by the accumulation of fat in the liver, and can be caused by obesity, insulin resistance, and metabolic syndrome.
  4. Autoimmune hepatitis: This is a condition in which the body’s immune system attacks the liver, causing inflammation and damage over time.
  5. Hemochromatosis: This is a genetic condition in which the body absorbs too much iron, leading to the accumulation of iron in the liver and other organs, and potentially causing chronic liver disease.
  6. Primary biliary cholangitis: This is a condition in which the bile ducts in the liver become inflamed and damaged, leading to chronic liver disease.
  7. Primary sclerosing cholangitis: This is a condition in which the bile ducts in the liver become scarred and narrowed, leading to chronic liver disease.

There are also other less common causes of chronic liver disease, including drug and toxin-induced liver injury, viral infections other than hepatitis B and C, and inherited liver diseases. It is important to identify the underlying cause of chronic liver disease in order to properly manage and treat the condition.

What foods are good for the liver?

There are several foods that are considered beneficial for liver health. These include:

  1. Leafy greens: Leafy greens such as spinach, kale, and arugula are high in antioxidants and other nutrients that can help protect the liver from damage.
  2. Cruciferous vegetables: Vegetables such as broccoli, cauliflower, and Brussels sprouts contain compounds that can help stimulate the liver’s detoxification processes.
  3. Fatty fish: Fatty fish such as salmon, sardines, and tuna are rich in omega-3 fatty acids, which can help reduce inflammation and improve liver function.
  4. Nuts: Nuts such as almonds and walnuts are a good source of healthy fats, which can help reduce inflammation and improve liver function.
  5. Olive oil: Olive oil is high in antioxidants and healthy fats, and has been shown to improve liver function and reduce the risk of liver disease.
  6. Green tea: Green tea is rich in antioxidants called catechins, which can help protect the liver from damage.
  7. Garlic: Garlic contains compounds that can help stimulate the liver’s detoxification processes and reduce inflammation.
  8. Berries: Berries such as blueberries, strawberries, and raspberries are high in antioxidants and other nutrients that can help protect the liver from damage.

In addition to a healthy diet, there are several other lifestyle changes that can help support liver health. These include:

  1. Maintaining a healthy weight: Being overweight or obese can increase the risk of liver disease. Losing weight through a healthy diet and exercise can help improve liver function and reduce the risk of liver damage.
  2. Exercising regularly: Regular physical activity can help improve liver function and reduce the risk of liver disease. Aim for at least 30 minutes of moderate exercise, such as brisk walking or cycling, most days of the week.
  3. Limiting alcohol consumption: Alcohol is processed by the liver and excessive drinking can cause significant damage to liver cells. It’s important to limit alcohol consumption or avoid it altogether to protect liver health.
  4. Avoiding or reducing exposure to toxins: Exposure to environmental toxins, such as pesticides and industrial chemicals, can damage the liver. Taking steps to avoid or reduce exposure to these toxins can help protect liver health.
  5. Getting vaccinated: Vaccines are available for certain types of viral hepatitis, which can cause significant liver damage. Getting vaccinated can help reduce the risk of developing viral hepatitis and protect liver health.
  6. Managing underlying health conditions: Certain health conditions, such as diabetes and high blood pressure, can increase the risk of liver disease. Managing these conditions through lifestyle changes and medication can help protect liver health.

What foods are bad for the liver?

There are several foods that can be harmful to the liver and should be consumed in moderation or avoided altogether. Some examples include:

  1. Alcohol: Alcohol is processed by the liver and excessive drinking can cause significant damage to liver cells, leading to inflammation, scarring, and liver disease.
  2. Sugar and refined carbohydrates: Consuming large amounts of sugar and refined carbohydrates, such as white bread and pasta, can lead to an increase in blood sugar levels and insulin resistance, which can contribute to liver damage and fatty liver disease.
  3. Fried and fatty foods: Fried and fatty foods can be difficult for the liver to process and can contribute to inflammation and liver damage.
  4. Processed foods: Processed foods, such as chips, crackers, and processed meats, are often high in unhealthy fats, salt, and sugar, which can contribute to liver damage and other health problems.
  5. Salt: Consuming too much salt can lead to fluid retention and swelling, which can put extra strain on the liver.
  6. Red meat: Consuming large amounts of red meat has been linked to an increased risk of liver disease.
  7. Soda and sugary drinks: Drinking large amounts of soda and sugary drinks has been linked to an increased risk of fatty liver disease and other liver problems.

A diet high in these types of foods, along with a sedentary lifestyle and other unhealthy habits, can increase the risk of liver disease and other health problems over time.

Fructose and liver disease

Fructose is a type of sugar found naturally in fruits and honey, and is also commonly used as a sweetener in processed foods and beverages. Consuming excessive amounts of fructose has been linked to an increased risk of liver disease, particularly nonalcoholic fatty liver disease (NAFLD).

When we consume fructose, the liver metabolizes it into glucose, which can be used for energy or stored as glycogen. However, excessive amounts of fructose can overwhelm the liver’s capacity to metabolize it, leading to the accumulation of fat in the liver and the development of NAFLD.

Research has shown that high-fructose diets can also lead to an increase in insulin resistance, a key risk factor for NAFLD and other metabolic disorders such as diabetes and obesity.

Fructose consumed from whole fruits and vegetables is generally considered safe and does not appear to increase the risk of liver disease. However, consuming large amounts of fructose from processed foods and sugary drinks can be harmful to liver health and should be consumed in moderation. A balanced and healthy diet that limits processed foods and added sugars, including fructose, can help reduce the risk of liver disease and other health problems.

Is coffee beneficial to liver?

Yes, coffee has been shown to have several potential benefits for liver health. Research has suggested that regular coffee consumption may help reduce the risk of liver disease, including liver cancer, cirrhosis, and nonalcoholic fatty liver disease (NAFLD).

One of the ways in which coffee may benefit the liver is by reducing inflammation and oxidative stress, which can contribute to liver damage and disease. Coffee contains a variety of compounds, including caffeine and antioxidants, that have been shown to have anti-inflammatory and antioxidant properties.

Studies have also suggested that coffee consumption may help improve liver function and reduce the risk of liver cancer. For example, a 2019 meta-analysis of 18 studies found that higher coffee consumption was associated with a lower risk of liver cancer, with each additional cup of coffee per day associated with a 27% reduction in risk.

Excessive coffee consumption may have negative effects on health, including insomnia, anxiety, and heart palpitations. As with any dietary change, pleases consult with a gastroenterologist to determine what amount of coffee is appropriate for you based on your individual health needs and circumstances.

How can I contact gastroenterologist Dr. Zavos for an appointment?

Dr. Chris Zavos is a board-certified gastroenterologist and hepatologist, located in Thessaloniki Greece, and specifically in Kalamaria suburb, about 7 kilometres (4 miles) southeast of downtown Thessaloniki. His private office is at: Fanariou 8 street (near Aigaiou and Adrianoupoleos avenues), Kalamaria (Thessaloniki), Greece.

Thessaloniki International Airport is only 10 km away from his private office in Kalamaria and can be reached by taxi within 13 minutes from the airport.

Dr. Chris Zavos performs endoscopies at Bioclinic private hospital in downtown Thessaloniki (Mitropoleos 86 street).

You can contact Dr. Zavos at phone numbers: (+30)-6976596988 and (+30)-2311283833, or you can email him at czavos@ymail.com. Dr. Zavos responds to Greek and English languages.

Last update: 26 September 2023, 18:59

DR. CHRIS ZAVOS, MD, PHD, FEBGH

Gastroenterologist - Hepatologist, Thessaloniki

PhD at Medical School, Aristotle University of Thessaloniki, Greece

PGDip at Universitair Medisch Centrum Utrecht, The Netherlands

Ex President, Hellenic H. pylori & Microbiota Study Group