The liver is the body’s largest internal organ. Its functions include removing waste from the body, making proteins, processing food into a form the body can use, helping the body maintain a balance of hormones and fighting infections.

Liver disease can be difficult to detect with the untrained eye. The symptoms may not be obvious, but if left untreated liver disease can lead to irreversible damage.

“When a liver cannot perform some or all of its functions, the body’s lungs, kidneys and circulatory and immune systems are affected,” said Dr. Saul Karpen, director of Texas Children’s Liver Center. “Symptoms of an unhealthy liver include a predilection for infections, delayed growth, jaundice, bleeding tendencies, an inability to metabolize a wide variety of drugs and even subtle behavioral disturbances.”

Certain behaviors in children can be related to liver disease. For example, frequent lethargy may be a sign of a vitamin deficiency caused by liver disease that makes it difficult for the body to absorb vitamins. Because an unhealthy liver cannot flush the body of toxins, a child may become disoriented or confused from the toxic buildup in his or her body. Growth also may be delayed in a child with liver disease.

“Parents should pay close attention to whether their child is playing, eating and growing normally,” said Karpen. “If a child is always acting clingy or is too tired to play, that can signal a potential liver problem. Bruising easily and bleeding are other signs to watch for.”

There is a wide variety of liver diseases, and their severity varies. Properly managing liver disease can help prevent cirrhosis (scarring of the liver) or the need for a transplant later in life.

While medication or surgery can cure some liver ailments, certain liver diseases have no cure. However, with proper management, most children with chronic liver disease can grow to be energetic, active teens and adults.