How Do You Know If Your Liver Is Failing?

Liver is the second largest and a vital organ of our body. It performs approximately 500 different functions in our body.¹ The liver is prone to damage by many causative agents. However, when liver is damaged beyond repair, where it cannot perform any of its functions, it is called liver failure. In case of liver failure, the liver is not able to regenerate itself.² This is a life threatening condition and requires immediate medical attention.

There are two types of liver failure, acute and chronic.

Acute Liver Failure (ALF) is sudden in onset and may not show any signs or symptoms indicative of liver damage. Acute liver failure is caused by overdose of medicines, wild mushroom poisoning, certain herbal supplements, hepatitis viruses, autoimmune hepatitis and harmful chemicals.

Chronic Liver Failure (CLF) is gradual in onset and takes months or years to show symptoms caused due to liver damage. It is mostly caused by excessive intake of alcohol³ and viral hepatitis C.⁴ Both of these cause inflammation and later scarring of the liver tissue resulting in liver failure due to cirrhosis. The other causes of chronic liver failure are viral hepatitis A and B, genetic inheritance, cancer and toxic chemicals.

Early symptoms of chronic liver failure are non-specific and often difficult to diagnose as a progression towards liver failure. The symptoms which help you in knowing if you are having a liver failure are:

The vital functions of liver are affected due to liver failure. This results in production of less bioenergy which causes tiredness and fatigue with liver failure. A person with hepatic problems is affected both physically and mentally due to fatigue. There is a general feeling of not being well (malaise).

The damaged liver leads to food indigestion which gives unpleasant feeling. This results in loss of appetite which leads to rapid loss of weight as well.

Liver damage often leads to indigestion and reflux of acids. The toxins are not processed and removed from the body. This causes stomach problems and leads to nausea and vomiting indicating it to be a symptom of liver failure.

Liver damage causes abdominal pain especially in the upper right quadrant of the abdomen. It is a throbbing pain which intermittently becomes intense.

Jaundice (hyperbilirubinemia) is a medical condition where the nails, skin and white of eyes turn to be yellow in color. This happens because of the increased levels of the bile pigment, bilirubin in the bloodstream. In case of liver failure, bilirubin (the end product of red blood cells) is not processed, does not get removed out of the body and gets accumulated in the blood. Increased amount of bilirubin deposits in the skin, nails and eyes; which gives them yellow color. Further, urine becomes dark yellow in color and stools are pale in color. This is one of the major sign of knowing whether your liver is failing or not.

Liver produces a variety of important proteins which helps in maintaining the osmotic balance. Liver failure leads to deficiency of these proteins. This progressively leads to excessive fluid retention within the body cavities and is known as Edema. The fluid retention in the legs, ankles and feet gives them a swollen appearance.

When fluid gets retained in the abdomen it is called ascites. It increases the abdomen size and appears as an abdominal swelling. Ascites is frequently seen in chronic cases. As the damage progresses towards cirrhosis of liver, the symptoms become more serious and include extreme fatigue, loss of appetite, itching, easy bruising etc.

Damage to liver affects its functions such as production of protein involved in blood clotting. Due to decrease in levels of blood clotting proteins, there is an increased tendency to bruise or bleed once it starts. In addition, there is low platelet count which further affects the process of blood clotting.

Itchy skin or irritated skin or pruritus is the common symptom of liver failure or damage. The skin surface becomes thick and itchy. This causes unusual patches of pale and dark skin spots in different areas of the body.

Liver cirrhosis prevents proper flow of blood through the liver. This builds pressure in the stomach and esophageal veins which causes bursting of veins, resulting in vomiting of blood.

The other symptoms are mood fluctuations, headache, foul breathe, bad body odor, and dark circles under the eyes, developing new allergies and development of spider angiomas.

Liver purifies blood by removing toxins from it. Due to liver failure, there is an increased retention of toxic substances in the blood. These substances accumulate in brain leading to decrease in its function. This condition is called hepatic encephalopathy. One such toxin is ammonia which when accumulates leads to short-term memory loss, confusion, loss of sleep and loss of consciousness.

The complications seen with hepatic encephalopathy are –

• Veins of the lower esophagus and stomach get enlarged
• Spleen gets enlarged (splenomegaly)
• Kidney failure
• Gallbladder and bile duct have stone –like particles
• Finally there is Liver cancer.

If symptoms of liver failure are seen and immediate diagnosis is done then specific treatment can be started for liver failure. Some of the ways to treat liver failure include:

• For treatment of viral hepatitis, vaccination is the solution.
• For hepatocellular cancer, early diagnosis is helpful followed with surgery, radiation and chemotherapy.
• For liver damage caused due to acetaminophen, medication can be given to reverse the effects. Internal bleeding can be stopped by medicines.
• If there is complete failure of liver, liver transplant is the only option. However, it works only in few cases.

As it is known, prevention is always better than cure; hence, one must take the following precautions to prevent liver failure from occurring:

• Lifestyle and diet changes are advised to prevent liver failure.
• The patient diagnosed with liver failure has to eat a very simple, non-spicy, healthy diet which is balanced. The diet has to be simple so that it does not give too much
• stress on the damaged liver during digestion.
• One should stop taking alcohol.
• Needles should not be shared during drug use and tattooing.
• Protection during sex with multiple partners should be taken.
• Protecting skin from toxic chemicals is a must.

Liver is an important organ of our body. Liver failure is a silent killer because many times the symptoms are observed very late. Therefore, when signs and symptoms are observed, it is important to treat damaged liver at its earliest and prevent its progression to liver failure.

Also Read:

• Hepatic Failure: Types, Causes, Symptoms, Treatment, Pathophysiology
• Liver Damage or Liver Failure: Causes, Signs, Symptoms, Prevention
• Treatment, Do’s & Don’ts of Liver Damage or Liver Failure
• What is Acute Liver Failure & How is it Treated?
• How Long Can You Live With Liver Cirrhosis?

References