"Ask the Doctor": Liver Disease

February 1, 2000

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Blueyes: I am concerned about my husband - he takes Tylenol and aspirin by the handful. I have heard this is dangerous to the liver. Is this true? And if so, can it heal itself if he stops?

Dr Woods: You raise a very good and important issue. While Tylenol, in normal doses as prescribed on the bottle, is a very safe and effective medication, it is not meant to be abused. The fact that a little Tylenol is good does not necessarily mean that a lot is better. No one should exceed the recommended dose, and it is especially important to note whether you are taking regular strength Tylenol, or the so-called Extra Strength, which merely means an increased dose. It is especially important for people with any degree of liver disease to consult their physician before taking any medication, especially those that may contain Tylenol. As far as aspirin goes, it does not have as great a potential for hurting the liver, but may be very toxic to a patient's kidneys; it may also inhibit the ability of a patient to make blood clots by blocking the function of platelets. In answer to the last part of the question, certainly if the person described stops taking the Tylenol, provided that the injury to the liver is not yet severe, the liver should be able to fully recover.

Vgalgerud: What does milk thistle do for hepatitis people?

Dr Woods: Milk thistle is a common, natural substance that many people with liver disease come to me already taking. I don't believe that anybody truly understands why, in some patients, this seems to have a beneficial effect. As important to me is that it does not seem in any way harmful to patients. So, I don't know the answer to the participant's question; but in general, we do not recommend milk thistle, but we are certainly not opposed to using it.

Jessie: So having a liver condition can cause a fluid build up?

Dr Woods: As I mentioned earlier, one of the common symptoms of moderate to severe liver dysfunction is a buildup of fluid in a patient, either in their lower legs, and this is called edema, or in the abdomen, and this is termed ascites. Both of these problems are directly related to the liver being damaged and not processing salt and water correctly. Many patients with significant liver disease have to be maintained on increasing doses of water pills as their disease progresses.

Raphaelone: I have Hepatitis C with cirrhosis of liver and have been having pain shooting across my lower abdomen. How can I tell if this is just the normal progression of disease or something to be concerned about?

Dr Woods: The most important thing for anyone who has significant liver disease is to be followed by a physician who specializes in the management of patients with liver disease. Only your doctor, through his examination of you and the performance of lab tests or x-ray studies, can determine if your pain is related to your liver problem, or something completely independent.

Chicora1: If your liver was affected by Tylenol and it fully recovered could you have problems down the road?

Dr Woods: The answer quite clearly on that is no. Once the liver is fully recovered, there should be no residual damage to the liver.

Charisma: If I repeated kidney stones, is there any risk to my liver? Or is that in no way related to liver problems?

Dr Woods: There are some liver diseases which result in build up of certain products in the body that can lead to the development of kidney stones. However, in most cases, the kidney stones are related directly to problems with the kidney as opposed to problems with the liver, but in rare cases the stones can be due to a problem with the liver, rather than a problem with the kidney. The most common disease that causes kidney stones because of a bad liver is called oxalosis.

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