Chronic Liver Failure & End-stage Liver Disease (ESLD)

The liver is a large and meaty organ. It lies in the right upper abdomen below the diaphragm and the rib cage. The liver’s main job is to clear your blood from harmful substances and secrete bile. Also, it converts food and fluids into nutrients and energy. The liver makes coagulation factors.

The inability of your liver to do its jobs means that you have liver failure. We talked about the liver to know what its failure means.

Liver failure happens when the disease destroys a large portion of your liver. If the liver failure occurs gradually over a long period, it will be chronic. Chronic liver failure is a critical illness that requires urgent medical care.

Causes of chronic liver failure:

  • Alcohol abuse is the most frequent cause of chronic liver disease.
  • Non-alcoholic fatty liver disease: obesity and hyperlipidemia are risk factors for liver disease.
  • Chronic viral hepatitis: Hepatitis B and C are common causes of chronic liver disease in East Asia and Africa.
  • Genetic causes like Wilson’s disease (copper accumulation in your body)
  • Autoimmune hepatitis
  • Drugs like amiodarone, isoniazid, methotrexate, and phenytoin
  • Vascular problem: Bud-Chiari syndrome

You are risky for cirrhosis of you:

  • Drink excess alcohol for many years
  • Have viral hepatitis
  • Have diabetes
  • Are obese

Mild liver cirrhosis may not cause any symptoms at all. You will notice symptoms when the underlying disease damages most healthy liver cells.

Early symptoms include:

  • Weakness and fatigue
  • Loss of appetite
  • Weight loss
  • Nausea and vomiting
  • Itching
  • Abdominal pain

Late symptoms and complications include:

  • Jaundice (yellow skin and eyes)
  • Ascites (fluid accumulation in the abdomen)
  • Oesophageal varices: bleeding from blood vessels in the oesophagus
  • Encephalopathy occurs due to the presence of toxins in the blood.
  • Edema in the lower limb
  • Splenomegaly
  • Liver cancer

The diagnosis of cirrhosis depends on the presence of a risk factor for cirrhosis. Your doctor will ask about your past medical history and do a physical examination to observe signs of the disease. Your doctor may need blood tests and imaging of your liver to confirm the diagnosis. Your doctor may also need a liver biopsy to confirm the diagnosis.

Management depends on the cause of your liver cirrhosis and how much damage exists. Although there is no cure to reverse cirrhosis, treatment can stop its progression and reduce its complications. Complications may require hospitalization.

To prevent liver cirrhosis, you should:

  • Get a vaccination for hepatitis B and C
  • Stop alcohol intake
  • Maintain a healthy weight and a good lifestyle
  • Have a physical examination every year with screening for obesity, high cholesterol, and diabetes.

Chronic liver failure

Chronic liver failure is progressive liver cell damage that occurs over a long time. Chronic liver failure results from cirrhosis. Chronic liver failure is an end-stage liver disease (ESLD). Chronic liver failure is the most frequent cause of death, especially in developing countries.

Written by Martin Davis