What Causes an Enlarged Liver?
If your doctor tells you that you have an enlarged liver, also called hepatomegaly, it means your liver is larger than normal. This doesn’t always indicate something serious, but it’s an important signal that deserves attention. Your liver plays a central role in keeping you healthy by filtering toxins, aiding digestion, storing energy, and regulating hormones. When it becomes enlarged, it’s often because it’s working harder than usual due to inflammation, fat buildup, infection, or circulatory issues.
In this guide, you’ll learn what causes an enlarged liver, the most common signs and symptoms to watch for, how it’s diagnosed and treated, and what practical steps you can take at home to support your liver health.
What are the most common causes of an enlarged liver?
There are many possible causes. Some are temporary and reversible; others may need long-term care.
Below are the main categories explained in clear, simple terms.
1. Fatty liver disease (the most common cause)
When too much fat builds up inside your liver cells, it causes swelling and inflammation.
There are two main types:
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Nonalcoholic fatty liver disease (NAFLD): Linked to weight gain, insulin resistance, or high cholesterol.
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Alcoholic fatty liver disease: Caused by frequent or heavy drinking.
If not managed early, both can lead to scarring (fibrosis) or cirrhosis over time.
2. Viral or autoimmune hepatitis
Viral infections such as hepatitis A, B, or C can cause inflammation and swelling of the liver.
Autoimmune hepatitis when your immune system attacks liver cells can also result in hepatomegaly.
3. Cirrhosis and chronic liver damage
In later stages of liver disease, your liver tries to heal itself by forming scar tissue.
That process, called cirrhosis, can make the liver firm, uneven, and sometimes larger before it eventually shrinks. Cirrhosis can result from chronic hepatitis, long-term alcohol use, or fatty liver disease.
4. Heart and blood vessel conditions
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Congestive heart failure: When the heart can’t pump blood effectively, fluid backs up into the liver, causing congestion and enlargement (known as congestive hepatomegaly).
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Hepatic vein obstruction (Budd–Chiari syndrome): A blockage of the veins that drain blood from the liver can cause swelling and pain in the upper right abdomen. This condition prevents normal blood flow out of the liver, leading to increased pressure, inflammation, and in severe cases, liver damage if not treated promptly.
5. Infections and inflammation
Certain infections can temporarily enlarge your liver, such as:
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Mononucleosis (“mono”)
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Cytomegalovirus (CMV)
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Malaria or parasitic infections in some regions
These usually resolve once the infection is treated.
6. Cancer or benign growths
Sometimes, the liver enlarges because of:
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Liver cancer (hepatocellular carcinoma)
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Metastatic cancer (cancer that spreads from another organ)
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Benign growths like hemangiomas or adenomas
Your doctor may order imaging tests if cancer is suspected.
7. Metabolic and inherited conditions
Some people inherit conditions that cause their liver to store excess substances:
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Hemochromatosis: Iron buildup
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Wilson’s disease: Copper buildup
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Glycogen storage disorders: Extra sugar storage
These are less common but can cause the liver to enlarge significantly.
8. Medication or toxin exposure
Certain drugs and supplements can stress your liver.
These include:
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Too much acetaminophen (Tylenol)
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Anabolic steroids
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Some antibiotics and antifungal medicines
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Herbal remedies like kava or comfrey
Always talk with your doctor or pharmacist before taking new supplements especially if you already have liver concerns.
If you’re curious about safe at-home options, you can learn about how our Ribbon Checkup Urine Test helps monitor early organ function changes.
What symptoms should you watch for?
Many people don’t feel anything at first.
But as the liver grows or its function declines, you might notice:
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A feeling of fullness or pressure under your right ribs
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Fatigue or low energy
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Nausea or loss of appetite
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Yellowing of the skin or eyes (jaundice)
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Abdominal bloating or swelling
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Itchy skin
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Dark urine or pale stools
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Unexplained weight loss
If you notice any of these symptoms, especially yellowing or pain, it’s best to get checked soon. You can also read about related urinary changes, like Understanding Glucose in Urine: Causes, Symptoms, and Treatment.
How is an enlarged liver diagnosed?
Your healthcare provider will likely take a few steps to confirm what’s happening.
1. Physical exam and medical history
They’ll gently press on your abdomen to feel tenderness or a liver edge below your ribs.
They’ll also review your alcohol use, medications, family history, and any risk factors for liver disease.
2. Blood tests
These can show whether your liver is inflamed or struggling to filter properly.
Common tests include:
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Liver function tests (LFTs) for enzymes like ALT, AST, and bilirubin
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Viral hepatitis screening
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Iron, copper, or antibody levels depending on your history
To better understand how to monitor your liver function at home, explore our guide on At-Home Liver Tests: A Comprehensive Guide.
3. Imaging tests
You may have:
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Ultrasound: The first-line tool to check size and texture
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CT scan or MRI: For detailed images or if cancer is suspected
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FibroScan: Measures liver stiffness to check for scarring
4. Liver biopsy
If needed, your doctor might take a tiny sample of liver tissue to find the exact cause.
This is done with a thin needle under local anesthesia.
How is an enlarged liver treated?
The best treatment depends on what’s causing it. The good news: many causes are reversible with care and consistency.
1. Addressing lifestyle factors
You can often make a big difference at home.
Try to:
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Eat a balanced diet rich in vegetables, fruits, whole grains, and lean protein
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Limit processed and fried foods
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Avoid alcohol completely if you have liver disease
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Exercise regularly, aiming for at least 150 minutes per week
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Stay hydrated with water and limit sugary drinks
Small, steady changes can reduce liver fat, inflammation, and strain.
2. Medical treatment
Your doctor may recommend:
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Antiviral medications for hepatitis
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Immunosuppressants for autoimmune hepatitis
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Chelation therapy or phlebotomy for iron or copper overload
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Heart medication if heart failure is contributing
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Surgery or ablation for liver tumors or cysts
3. Monitoring and follow-up
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Regular blood tests and imaging track progress.
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Early intervention improves long-term outcomes.
Can you prevent liver enlargement?
Yes—prevention is possible and powerful. Here’s how you can keep your liver healthy long term:
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Maintain a healthy weight
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Stay active daily
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Limit alcohol use
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Avoid unnecessary medications
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Get vaccinated for hepatitis A and B
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Practice safe hygiene (avoid needle sharing or unprotected sex)
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Manage conditions like diabetes or high cholesterol with your doctor’s help
When should you see a doctor?
You should reach out to a healthcare provider if you notice:
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Yellowing of the skin or eyes
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Persistent fatigue
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Pain or fullness under your ribs
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Unexplained swelling or weight loss
If you have a history of heavy alcohol use, fatty liver, or metabolic syndrome, regular liver checkups can help catch problems early.
How can you support your liver health at home?
Adopt these habits to keep your liver healthy:
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Start your day with water and fresh fruits.
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Choose grilled or baked foods over fried.
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Incorporate short walks or regular movement.
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Prioritize sleep and stress management, as both impact liver function.
Final Thoughts
An enlarged liver, or hepatomegaly, is a clinical sign that warrants thorough evaluation rather than immediate alarm. Identifying the underlying cause whether metabolic, infectious, vascular, or toxic is essential for guiding appropriate management. Early detection through physical examination, laboratory testing, and imaging can significantly improve outcomes. In most cases, addressing contributing factors such as alcohol use, metabolic syndrome, or viral hepatitis, combined with evidence-based lifestyle modifications, can prevent progression to advanced liver disease. Ongoing monitoring and collaboration with a healthcare provider remain key to maintaining optimal liver function and overall health.
Ready to take the next step?
Check out Ribbon Checkup’s at-home liver test kit to learn more about your liver enzyme levels all from the comfort of home.
Related resources
References
Clinic, C. (2018, August 27). Hepatomegaly (Enlarged Liver): Symptoms, Causes & Treatment. Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/17937-hepatomegaly-enlarged-liver
Enlarged liver-Enlarged liver - Symptoms & causes - Mayo Clinic. (2025). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/enlarged-liver/symptoms-causes/syc-20372167
Hepatomegaly. (2022). Patient.info. https://patient.info/doctor/history-examination/hepatomegaly
Sherrell, Z. (2020, June 29). What causes hepatomegaly? Medicalnewstoday.com; Medical News Today. https://www.medicalnewstoday.com/articles/hepatomegaly-enlarged-liver
Stuart, A. (2011, January 27). Hepatomegaly. WebMD. https://www.webmd.com/hepatitis/enlarged-liver-causes
