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How to Spot Warning Signs of Liver Disease in Children

What’s the most important thing you need to know about serious liver disease in children? It’s very rare. Keith Hazleton, MD, PhD, a pediatric liver specialist at Banner - University Medical Group in Arizona, said, “Most of the diseases I deal with happen in fewer than one in a thousand children.” He pointed out that the entire state of Arizona only needs two pediatric liver specialists to care for all the cases that crop up.

That said, when liver problems do develop in children, they can be serious. Children who have chronic liver disease can:

  • Have trouble growing and learning properly
  • Develop bleeding in their stomach
  • Collect fluid in their belly

Watch for these telltale signs

If your child has liver problems, you might notice that their skin or eyes look yellow, which is a condition called jaundice. They may also bruise or bleed easily. But don’t panic if you spot bruises or blood.

“It is really important to remember that bruising on the knees and shins in kids that have been playing is fairly common, and that most kids pick their noses, which can cause bleeding,” Dr. Hazleton said. “However, if bruises are popping up in odd places, or nose bleeds are all of a sudden more common, talking to your PCP is a good idea.” In children with liver problems, you may also notice fatigue, confusion, severe itching, or a swollen belly.

The top liver disease in children is preventable

The most common liver disease in children is non-alcoholic fatty liver disease. “About 30% of overweight and obese children over the age of 9 have fatty liver disease,” Dr. Hazleton said. Fatty liver disease develops when extra calories are stored as fat in the liver. This fat irritates the liver.

Children with fatty liver disease don’t usually develop serious symptoms as children, but 20% of them will develop scarring of the liver (cirrhosis) as adults, Dr. Hazleton said. “Fatty liver disease is a growing problem and will cause serious problems for children as they become adults,” he said.

You can help prevent fatty liver in your children by making sure they eat a healthy diet and by helping them maintain a healthy weight. “Red meat and sugar are two foods that make fatty liver worse. Eating a diet rich in whole grains, fruits, and vegetables and low in processed foods is a great way to keep your children—and their livers—healthy,” Dr. Hazleton said.

Weight loss is the only proven treatment for fatty liver disease. “Studies in children and adults have shown that achieving a healthy weight is over 90% effective in reversing fatty liver disease. Working closely with your doctor and a nutritionist on a healthy lifestyle can be very helpful in getting to a healthy weight,” Dr. Hazleton said.

Other liver diseases are uncommon

Fatty liver disease isn’t the only liver disease that can affect children. Although infrequent, other liver diseases that can strike children are:

  • Genetic diseases such as alpha-1-antitrypsin deficiency, Wilson’s disease, and hemochromatosis
  • Infections such as hepatitis B and C
  • Autoimmune disease

Treating these conditions depends on their cause. Some don’t have treatments yet. In those cases, children need to be monitored regularly for signs of complications. Some respond to daily medication. And rarely, if the liver no longer works well, a child will need a liver transplant.

The bottom line

It’s unlikely that children will develop serious liver problems, but if you notice jaundice or unexplained bruising or bleeding, talk to your child’s doctor. And help your child choose a healthy diet and maintain their weight to help reduce their risk of fatty liver disease.

For more information on children’s health issues, check out:

Children's Health

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