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Diagnosis & Treatment of Liver Conditions

If your liver isn’t functioning well, you may experience a range of symptoms that may slow you down or interfere with your daily activities. Symptoms may include fatigue, weakness, nausea, vomiting, jaundice and dark urine. Our highly skilled hepatology team provides comprehensive diagnosis, evaluation and treatment for liver disorders. Together we can determine the cause of your symptoms and help you find treatment for liver disorders.

Diagnosing liver conditions

After completing a physical exam and reviewing your medical history, your hepatologist (liver specialist) may order the following tests to determine the cause of your symptoms:

  • Blood tests may be ordered to measure liver function, check blood clotting levels and identify specific causes of liver damage.
  • Imaging tests such as an ultrasound, computed tomography (CT) or magnetic resonance imaging (MRI) scan may be ordered to view the liver and blood vessels.
  • A FibroScan® exam is a noninvasive test used to measure hardening or stiffening of the liver. This exam involves lying on your back with your right arm raised behind your head. A clinician applies a water-based gel to your skin and places the FibroScan probe on your chest with slight pressure. 
  • MR elastography is an additional option for noninvasive testing that, through MR technology, allows us to quantify the percentage of fat in your liver and the degree of fibrosis or scarring. This test is free of pain, IV contrast and radiation.
  • A liver biopsy is performed by injecting a thin needle through your abdominal skin (percutaneously) and into the liver to remove a small sample of liver tissue. The area of the puncture is numbed first with a local anesthetic. A liver biopsy may be helpful to understand why there is inflammation or damage to the liver and in grading and staging the disease.

Compassionate care for liver cancer

Our multidisciplinary team of surgeons, radiologists, oncologists, nurses and nutrition experts work together to deliver high-quality, integrated care for liver cancer. Liver cancer cases are reviewed by a multidisciplinary liver cancer tumor board—one of only a few in Washington state—where recommendations are made about individualized treatment. We focus on minimizing symptoms while you undergo aggressive treatment and prioritizing quality of life in every phase of treatment. 

Treating liver conditions

The experts and specialists at Virginia Mason Franciscan Health develop a unique plan of treatment that addresses the unique aspects of your liver condition, which may include:

Lifestyle changes

Your doctor may recommend lifestyle changes to help you avoid further damage to your liver, such as:

  • Avoid or limit alcoholic beverages: Alcohol is absorbed and metabolized by the liver and can make symptoms worse. Giving up alcohol is important, as heavy drinking can severely hinder all types of therapy for liver disease. If stopping alcohol use is difficult, your doctor may recommend a treatment program for alcohol use disorder.
  • Lose weight or maintain a healthy weight: Losing weight and controlling blood sugar levels can help protect your liver from further damage, especially if you have fatty liver disease.
  • Take care of yourself: Eating a healthy diet and staying active can benefit your liver.


Certain liver conditions are treatable and even curable with medication. For example, we can treat hepatitis B to the point where the virus is suppressed and no longer found in the blood stream, and we can cure hepatitis C with a short course of oral therapy. We can treat conditions like hemochromatosis, Wilson's disease, autoimmune hepatitis and primary biliary cholangitis to reduce liver inflammation and prevent progression of liver scarring. We are actively researching novel agents that can even help reverse liver fibrosis and damage.

Liver transplant

If you have a severely compromised liver (from scarring or inflammation) or liver failure, you may be a candidate for a liver transplant. Our team works closely with experts to determine the need for liver transplant and will refer you to a transplant specialist to review all of your options for treatment.

Liver disorders we treat

  • Acute liver failure is loss of liver function that occurs quickly, usually in just days or weeks. It’s typically a medical emergency that requires hospitalization due to mental confusion, multi-organ failure, bleeding, infection and increased pressure in the brain. Acute liver failure often occurs in a person with no known pre-existing liver disease. Depending on the cause, it may be reversible with aggressive medical care or may require a liver transplant. Learn more

  • Autoimmune hepatitis occurs when the body's own immune system attacks the liver, causing inflammation or hepatitis. Like other autoimmune disorders, this form of hepatitis may be triggered by a bacterial or viral infection, environmental factors or medications in genetically susceptible individuals. Untreated, autoimmune hepatitis can lead to cirrhosis (scarring) and liver failure. Learn more

  • Cirrhosis is a condition in which scar tissue (fibrosis) replaces normal healthy cells in your liver. The scar tissue makes your liver, normally like a sponge, become hard and lumpy. A scarred liver prevents it from carrying out its many functions such as detoxifying harmful substances in your body, cleaning your blood and making vital nutrients. There are a number of causes of cirrhosis. The most common are hepatitis C, nonalcoholic fatty liver disease and chronic alcoholism. Early cirrhosis may be reversible with prompt and effective treatment. Learn more

  • Fatty liver disease is a serious condition that occurs when too much fat builds up within the liver. Hepatologists classify the disease as either nonalcoholic fatty liver disease or fatty liver disease caused from alcohol abuse. Often, fatty liver disease has no symptoms. But in some individuals, the accumulation of fat causes inflammation—called steatohepatitis—that damages the liver. Learn more

  • Hemochromatosis is a common inherited disorder in which the body is unable to break down iron, resulting in too much iron building up in the body. The extra iron is stored in tissues and organs, primarily the joints, skin, liver, heart and pancreas. Untreated, the accumulation of iron—also called "iron overload"—can cause organ failure. Learn more

  • Hepatitis B is irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV). A hepatitis B infection can be spread through contact with the blood or body fluids (semen, vaginal fluids and saliva) of a person who has the virus. Learn more

  • Hepatitis C is a viral disease caused by the hepatitis C virus (HCV) that leads to swelling (inflammation) of the liver. Many people are unaware of the disease until they are diagnosed with liver damage. Learn more

  • Surgery, radiation, chemotherapy and targeted therapies are all options in the treatment of liver cancer. A multidisciplinary team of specialists create a plan of care that’s personalized for you, and this treatment plan is consistently evaluated and adjusted as needed. Learn more

  • Primary biliary cholangitis (PBC) is a progressive autoimmune disease of the liver. Over time, the small ducts that carry bile from the liver to the rest of the body become inflamed, gradually scarring and collapsing. As a result, bile and toxins can build up in the liver, leading to a condition called cholestasis. If untreated, cholestasis can lead to further damage to the liver, causing cirrhosis, an irreversible scarring of the liver, which may eventually lead to liver failure. Learn more

  • Wilson's disease is a rare genetic disorder that causes copper to accumulate in the liver, brain and other vital organs. Copper plays a key role in the development of healthy nerves, bones, collagen and melanin. Normally, it is absorbed from your food, and any excess is filtered by your liver and eliminated via bile. In people with Wilson's disease, the copper is not eliminated properly and can reach poisonous levels. Learn more

Find a specialist near you

If you have symptoms of a liver disorder, such as fatigue, nausea, dark urine or yellowing of the skin and eyes, our hepatologists can help.