I'm going to give you a big picture, that you can read about
and then, you might see a connection somewhere in this:
When the liver cells become damaged, the immune system
of the body responds to this and causes inflammation inside
the liver. (The liver cells make enzymes, and when they are
damaged, these enzymes are released from the cell and go
higher on the blood tests results ). Inflammation causes the
liver to enlarge in size and takes on a spongy texture.
There are many causes of liver cell damage: alcohol
consumption, medication toxification, chemical exposure,
mushroom poisoning, biliary obstruction/malformation/infection,
cardiac/vascular problems, auto immune disease,
hereditary condition (like too much iron or copper),
metabolic disorders (liver doesn't make certain enzyme or may
not handle glucose well, etc), viral infection (like hepatitis A,B,C,ETC)
parasite infection, fatty liver disease, cancer/growth/cysts/tumors,
and much more.
If the cause is found and stopped, then the problem can be reversed.
However, once it progresses to the point of the liver cells dying
off, it may not be reversable because scar tissue forms inside the
liver and cannot be removed. Scar tissue can build up as more
cells die off (lessening any functions they do...known as liver failure)
which will block the flow of blood through the liver on its way back
to the heart and also to any functioning cells of the liver itself.
This is then the progressive disease of Cirrhosis of the liver.
Now, to look at something else: the liver makes bile. The bile
flows through tube like structures (known as ducts) from the
inside of the liver to the gallbladder to be stored and
concentrated. When food reaches the first part of the intestines,
hormones are released that cause the gallbladder to contract,
this pushes the bile/bilirubin into the Common bile duct, where
it flows to the intestines to emulsify the fats we consume, so
they can be absorbed into the body from the intestines.
Bilirubin is a substance that is made from our dead red blood
cells. A Pigment because it colors other things (greenish,
yellowish/brownish substance). The liver takes the bilirubin
from the blood and converts it to a soluble form to become
part of the bile. (you already see that bile/bilirubin flows to
the intestines). So what causes Jaundice...
(which is the yellowing of the whites of the eyes and skin
caused by excess bilirubin levels in the blood and can
also be picked up by the kidneys to make the urine darker).
1. If the liver cannot convert bilirubin to a soluble form.
2. if too many red blood cells have died off
3. If there is an obstruction of the ducts from a stone moving
into the ducts, infection blocking, malformation or twisting of
the ducts, or destruction of the ducts due to auto immune disease
If the bilirubin is not reaching the intestines to color the
bowel movement a brownish color, then the bowel movements
will become lighter in color: from tan, orange, to almost a
grayish white. (note: if someone has diarrhea, it may bypass
the area where it would obtain this bilirubin, too fast to pick up
this pigment, also)
There is a hereditary condition where a person naturally have
higher bilirubin levels, known as Gilberts disease.
If the liver and spleen are enlarged and you have swelling of
the glands in your neck area...this might be mono.
You are so right not to take paracetamol now unless you are
told to by your doctor. You should be seeing a
The gallbladder is located right below the liver. Gallstones
Pain from this can come/go or remain constant.
It may start in this area and refer to the upper back and
shoulder area. The bile backing up into the liver from
an obstruction can damage the liver cells.
If you had pain in the upper middle of the abdomen and
when into the back in the same area...it may be
pancreatitis. Or the opening of the common bile duct
into the intestines may need to be stretched.
I hope this information helps you understand what they
might be looking for. It is not a diagnosis, but something
to consider and may bring up questions you could ask
the doctors about. Best wishes
caregiver to a liver transplant patient