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Liver Failure Symptoms - Diagnosis, Treatment, and Complications

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Liver Failure Symptoms - Diagnosis, Treatment, and Complications

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Liver failure happens when the liver is unable to perform its functions normally due to an underlying disease or condition. Read to know more.

Written by

Dr. Janani R S

Medically reviewed by

Dr. Jagdish Singh

Published At August 8, 2022
Reviewed AtNovember 17, 2023

Introduction:

The liver is the largest internal organ in the body. The liver removes waste substances from the body, stores glucose (blood sugar), produces a protein (fibrinogen) that helps in blood clotting (thickening of the blood), and produces bile that helps in digestion and processes fats into energy required by the body. Liver failure occurs due to an overdose of medications like Acetaminophen, too much alcohol drinking, nonalcoholic fatty liver disease, autoimmune hepatitis, and viral infections like hepatitis B or C.

What Is Liver Failure?

Liver failure is the result of liver diseases. The function of the liver is to remove harmful (toxic) wastes from the body. The liver processes food that one consumes for easy digestion. It also removes toxins from alcohol and medications. When there is a liver disease, these functions are not carried out by the liver properly. This leads to the accumulation of toxins in the liver and damages the liver cells. This further results in liver dysfunction or disease. If not detected and treated early, liver disease leads to liver failure. Liver failure can be acute or chronic.

  • Acute Liver Failure: It can happen quickly, within a few days to weeks. It occurs due to viral hepatitis, or an overdose of drugs like Acetaminophen, consuming herbal medicines, consuming wild mushrooms, autoimmune disease, and exposure to some chemicals used in cleaning and degreasing.

  • Chronic Liver Failure: It occurs gradually over some time from months to years. The causes of chronic liver failure can be due to long-term alcohol consumption, taking medications that contain Acetaminophen for a long time, consuming certain prescribed medications like NSAIDs (nonsteroidal anti-inflammatory drugs), viral hepatitis B or C, autoimmune hepatitis (when the immune system attacks the healthy liver cells), and hemochromatosis (an inherited condition when the body stores too much iron).

What Are the Liver Failure Symptoms?

  • Abdominal Pain: Pain in the right upper region above the stomach due to the inflamed (swollen) liver.

  • Ascites: Enlargement of the stomach due to fluid accumulation. Fluid accumulates when there is a backflow of fluids into the stomach. This is due to increased pressure in the veins due to a block or if the liver does not function properly.

  • Jaundice: Yellowish discoloration of the skin and eyes. This is due to an increase in the bilirubin levels in the blood. Bilirubin is a byproduct that processes red blood cells. It is then excreted by the liver from the circulation. When there is liver dysfunction, the bilirubin is not removed from the body completely. Bilirubin is a yellowish-orange bile pigment; when there is excess bilirubin in the circulation, jaundice results.

  • Pedal Edema: Fluid accumulation in the legs. Due to liver damage, there is increased pressure in the veins, which leads to fluid accumulation in the extremities.

  • Vomiting: Vomiting blood is a result of intestinal bleeding, as the gastrointestinal tracts are inflamed and damaged due to alcohol consumption. This damage causes bleeding and hence blood in vomiting occurs.

  • Feeling Weak and Tired: When the liver does not function properly, the toxins are not removed, and the food is not absorbed properly. This leads to tiredness and feeling weak.

  • Bleeding or Easy Bruising: When the blood-clotting protein (fibrinogen) is not produced by the liver, there is a delay in blood clotting. This leads to prolonged bleeding and easy bruising (bleeding under the skin due to trauma).

  • Loss of Appetite: The liver plays an important role in digestion. When the liver does not function properly, the food consumed is not processed. This results in loss of appetite and weight loss.

  • Hepatic Encephalopathy: The toxins in the blood reach the brain cells and cause damage. This results in confusion, slurred speech, and disorientation, collectively called hepatic encephalopathy.

How Is Liver Failure Found?

  • Liver Function Tests (LFT): These are a group of tests that screens liver enzymes and proteins. Liver enzymes like alanine transaminase (ALT), aspartate transaminase (AST), alkaline phosphatase (ALP), gamma-glutamyl transferase (GGT), and proteins like albumin, globulin, fibrinogen, bilirubin, and prothrombin time are screened for changes in liver function.

  • Complete Blood Count: Components of blood like white blood cells, red blood cells, and platelets are screened. Any changes in these parameters will help detect infection.

  • Ultrasound Abdomen: This imaging technique uses a high-frequency sound wave to capture images of the internal structures.

  • CT Scan: Computerized tomography captures a series of X-ray images at different angles with the help of a computer. This gives a detailed view of the internal structures and organs.

  • MRI Scan: Magnetic resonance imaging (MRI) uses a combination of high-frequency radio waves in a magnetic field to capture images of internal organs. It gives a more detailed view of the internal structures and tissues.

  • Liver Biopsy: A liver biopsy is a confirmatory test. A small portion of the liver is removed and viewed for pathological changes at a microscopic level. It reveals the type of the disease.

How Is Liver Failure Treated?

1. Acute Liver Failure: Treatment is done according to the cause of the disease.

  • Intravenous fluid therapy to maintain normal blood pressure levels.

  • N-acetylcysteine is a drug that is used in treating Acetaminophen overdose.

  • Activated charcoal is also given in Acetaminophen overdose. It reduces the absorption of the medication in the intestinal tract.

  • Glucose administration to keep the blood sugar levels normal.

  • Medications like Laxative (a medicine to relieve constipation) will be given to flush the toxins from the body.

  • Depending on the type of viral hepatitis, medications will be administered accordingly.

  • In autoimmune hepatitis, steroid medications will be the choice of treatment.

  • The liver tends to self-heal. If a part of a liver is damaged, the liver will regenerate (form new cells) on its own, and the condition will be reversed.

  • A liver transplant in severe cases might be recommended.

2. Chronic Liver Failure:

  • Alcohol consumption has to be stopped.

  • Stop taking medications that damage the liver.

  • Try to lose weight and avoid consuming red meat.

  • A low-sodium diet has to be followed.

  • A liver transplant will be considered when the liver is damaged and if medications do not improve the condition.

Who Is at Risk of Getting Liver Failure?

  • People who take too many painkillers containing Acetaminophen.

  • Too much alcohol consumption.

  • People with hepatitis (inflammation of liver cells), Wilson's disease (inherited disease due to accumulation of excess copper), and viral liver diseases like hepatitis B or C.

What Are the Complications of Liver Failure?

  • Cerebral Edema: Fluid accumulation in the brain.

  • Bleeding: Since the liver is damaged and does not function properly, the clotting mechanism will not happen properly. This results in bleeding.

  • Infections: A damaged liver has a poor immune response, which leads to acquiring more infections.

  • Kidney Failure: Acetaminophen overdose damages both the kidney and the liver.

How Can Liver Failure Be Prevented?

  • By vaccinating against hepatitis B.

  • Stop consuming alcohol.

  • Medications should not be taken more than the prescribed dose or time.

  • Follow a healthy lifestyle by exercising regularly.

  • Follow a healthy diet by including proteins, carbohydrates, vitamins, and fibers in equal proportions.

  • Follow safe sex practices.

  • Do not share needles; use a sterile needle.

  • Have an annual health check.

Conclusion:

Liver failure is a severe medical condition. If not treated early, it can be fatal. Since the liver has self-healing properties, with early detection and proper treatment, the damage can be reversed. In severe liver damage cases where a liver transplant cannot be done, the situation becomes fatal. The prognosis is good for liver failure with proper treatment. People with liver transplants resume their everyday routine in six months. They need medical attention for a long time. By detecting the disease early, undergoing appropriate treatment, and following a healthy lifestyle, the severity of the disease can be reduced and reversed.

Dr. Jagdish Singh
Dr. Jagdish Singh

Medical Gastroenterology

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liver failureliver dysfunction
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