When diagnosing liver disease, the physician looks at the patient's symptoms and conducts a physical examination. Urine is usually dark because of the bilirubin excreted through the kidneys. High levels of bilirubin may be attributed to inflammation or other abnormalities of the liver cells or blockage of the bile ducts. Sometimes jaundice is caused by the breakdown of a large number of red blood cells, which can occur in newborns. Jaundice is usually the first sign, and sometimes the only sign, of liver disease.
Cholestasis is reduced or stopped bile flow.
Bile flow may be blocked inside or outside the liver. Portal hypertension is abnormally high blood pressure in the portal vein, which supplies the liver with blood from the intestine. Portal hypertension may be due to increased blood pressure in the portal blood vessels or resistance to blood flow through the liver. Portal hypertension can lead to the growth of collateral vessels that connect to the general circulation, bypassing the liver. When this occurs, substances that are normally removed by the liver pass into the general circulation.