Liver Failure Symptoms; What Happens When Liver Shuts Down?

We all have livers, but how often do we know about them?

The liver is the largest and heaviest organ in your body (1500 gm). It lies in the right abdomen under your diaphragm and behind the lower ribs. It has two lobes, the right and the left one. The liver gets its blood supply from two sources:

  • Oxygenated blood from the hepatic artery
  • Deoxygenated blood from the intestine and spleen by the portal vein

The liver plays an irreplaceable role in your body. It is essential for food digestion and converts it into energy. It detoxifies all blood of your digestive tract and clears it from harmful substances. Also, it produces bile -an alkaline fluid that contains cholesterol and bile acids-, which breaks down fat. The liver not only produces bile and makes proteins, but it also does more than 300 other functions.

Liver failure means that your liver has lost most of its functions that result from any liver disease. According to the duration of disease development, liver failure can be acute or chronic. Acute liver failure happens suddenly within weeks or days, while chronic liver failure happens slowly over a long period.

You should know the cause and risk factors of liver failure to avoid them and keep your liver healthy. Here are some causes:

  • Large doses of drugs like acetaminophen
  • Long-term alcohol intake
  • Viruses include (hepatitis B, C, and A_ herpes simplex virus_ Epstein-Barr virus). It is the most common cause of liver failure in developing countries.
  • Autoimmune hepatitis, in which your immune system attacks your liver cells
  • Wilson’s disease: this genetic disease prevents your body from eliminating copper.
  • Fatty liver disease: high amount of fat and cholesterol can damage your liver.
  • Hemochromatosis is when your liver stores a high too much iron. The increased amount of iron can build up in your liver and causes its failure.
  • Alpha 1 antitrypsin deficiency: this genetic condition cause liver or lung disease
  • Industrial toxins: many chemicals as carbon tetrachloride can damage your liver.

Liver failure passes through five stages:

  1. Inflammation in which the liver becomes large. Usually, this stage passes unnoticeably.
  2. Fibrosis in which scar tissue replaces healthy tissue in the inflamed liver. The scarred tissue can’t perform the same functions. Fibrosis is hard to detect because symptoms aren’t present yet.
  3. Cirrhosis in which the scar tissue has grown up on your liver, here you can be aware of symptoms.
  4. End-stage liver disease (ESLD) is when the liver can’t maintain its functions. Complications appear, such as ascites (fluid collection in the abdomen) and encephalopathy (confusion). Liver transplantation is the only option to reverse the disease.
  5. Liver cancer is the growth of unhealthy cells in your liver. Liver cancer may occur at any stage, so doctors order follow-up.

In the first stages, there are no noticeable signs or symptoms. Early symptoms of liver failure look like other medical conditions, which makes it hard to diagnose.

Early symptoms include:

  • Anorexia
  • Weakness and fatigue
  • Loss of appetite
  • Weight loss
  • Fever
  • Nausea and vomiting
  • Diarrhea
  • Abdominal pain

Late symptoms indicate advanced liver failure and require immediate care. These symptoms include:

  • Jaundice
  • Swelling in the feet and legs
  • Easy bleeding and bruising
  • Confusion
  • Sleepiness
  • Increased the size of the abdomen
  • Vomiting blood
  • Breath with a musty odor
  • Clubbing of nails
  • Dark urine
  • Skin itching
  • Tremors

You should seek immediate medical attention and make an appointment with your doctor if you have any symptoms that worry you.

Your doctor will ask you about your medical history and perform a physical examination. Your doctor will check for signs of hepatitis such as fatigue, jaundice, and pain in the abdomen.

You may also need:

  • Liver function tests to assess liver enzymes and proteins
  • Other blood tests as (CBC) to detect infections like viral hepatitis
  • Imaging tests, such as ultrasound, CT scan, and MRI
  • A biopsy to confirm the diagnosis

Treatment of liver failure depends on the source of the disease. For example;

  • Antiviral medications treat viral hepatitis infection.
  • Immunosuppressive drugs can treat autoimmune hepatitis.
  • Lifestyle changes have a role in the care of fatty liver by cutting down alcohol, losing weight, or avoiding certain drugs.
  • Early treatment can reverse the stages of inflammation and fibrosis.
  • In End-stage liver disease, liver transplantation is necessary.

In the following, we will focus on the symptoms of liver failure.

Written by Martin Davis