March 19, 2026 Author : Armando de Carvalho (internal medicine) Liver diseases have a significant impact on public health and clinical practice. They affect an increasing number of people ; They have multiple causes ; They are complex , particularly due to their relationship with various systems and functions of the body; In Portugal, they are one of the main causes of morbidity and mortality . In recent decades, advances in scientific knowledge and new therapeutic options have enabled earlier diagnosis and more effective treatments. Simultaneously, a structured and differentiated clinical approach is necessary, based on medical specialization and multidisciplinary collaboration, both in diagnosis and treatment. Main causes of liver disease Among the most frequent causes of liver diseases are: Alcohol consumption; Metabolic disorders associated with steatotic liver disease, commonly known as fatty liver; Hepatitis viruses; Autoimmune diseases, such as autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis; Hereditary metabolic diseases, including hemochromatosis, Wilson's disease, and alpha-1 antitrypsin deficiency; Drug toxicity; Hepatic vascular disorders; Benign or malignant liver tumors. Many of these causes are potentially preventable or controllable , which reinforces the importance of regular health monitoring and timely intervention. Silent progression, risk factors, and early diagnosis Many liver diseases progress slowly and chronically, but can lead to cirrhosis, which is the terminal stage of liver disease characterized by severe fibrosis (scarring) and regenerative nodules. The delay in diagnosis due to slow and silent progression compromises the treatment efficacy. Therefore, it is essential to identify and value known risk factors , such as: Excessive consumption of alcoholic beverages, which means, on average, more than two drinks per day in women or more than three drinks per day in men; Overweight; Diabetes; Dyslipidemia; Hypertension; Risk behaviors for viral hepatitis. Given these factors, health surveillance may indicate the need to perform tests such as, for example, targeted blood tests (aminotransferases, gamma-glutamyltransferase, alkaline phosphatase, hepatitis markers) and abdominal ultrasound. In more advanced stages of liver disease , warning signs may appear such as persistent fatigue, jaundice (yellowing of the skin and eyes), abdominal swelling, or changes in general condition , situations that should prompt immediate medical evaluation. Specialized approach of liver diseases In the presence of risk factors or alterations in diagnostic tests focused on liver diseases, more in-depth clinical follow-up is essential. In Portugal, there are doctors with specialized training in liver diseases , which is recognized as a medical subspecialty: the subspecialty of Liver Diseases in Internal Medicine , and the subspecialty of Hepatology in Gastroenterology . These specialists use different complementary diagnostic and disease severity assessment methods, after a careful individual clinical evaluation, to determine the most appropriate approach for each case, considering the disease, stage of evolution and individual characteristics of each person. Liver diseases in the Hospital da Luz network Specialized consultations for liver diseases are available at the hospitals and clinics of the Hospital da Luz network, both in the area of Internal Medicine and Gastroenterology, as well as most of the areas and resources necessary for the study and treatment of liver pathology, including clinical analyses, diagnostic and interventional radiology, digestive endoscopy, hepatobiliary surgery, medical oncology, working in a multidisciplinary way. Thus, liver disease patients can access the necessary care to clarify their condition, provided in an integrated manner, all in one place. Meet the internal medicine and gastroenterology clinical teams from Hospital da Luz network. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
