What are The Symptoms, Signs and Stages Of Liver Failure?

What is Liver Failure?

Liver failure occurs when the liver fails to perform its functions, such as producing bile to digest food and removing toxic substances from the blood. Liver failure can be chronic or acute. In the case of acute liver failure, the liver loses its functioning rapidly, while in chronic liver failure, the liver loses its functioning gradually.

Chronic liver failure occurs due to liver damage caused by liver diseases. While the acute liver failure can occur in individuals without a history of liver disease, overdose or reaction of specific medicines and viral hepatitis are among the few known causes. Liver failure is a life-threatening situation and needs immediate medical treatment.

How Common Is Liver Disease Overall?

In a study conducted in 2015, India contributed to 18.3% of the two million cases of liver disease globally. Worldwide, there are about 1 million cases of complications of cirrhosis and another million due to viral hepatitis and hepatocellular carcinoma. Worldwide, liver deaths occur primarily due to liver cirrhosis, liver failure, and liver cancer.

What are The Signs and Symptoms of Liver Failure?

The signs of liver failure are similar to those of other major health conditions. They worsen as the liver deteriorates.

Here is the common symptoms of Liver Failure?

• Fatigue and Weakness
• Abdominal Swelling and Pain
• Bruising and Bleeding Easily
• Itchy Skin

1. Fatigue and Weakness:

Fatigue and weakness are common liver failure symptoms. Low blood oxygen levels and waste accumulation cause fatigue in people with liver failure. Nutritional deficiencies and disturbance in fluid balance also cause fatigue. Fatigue can be mild or severe, constant or erratic. Liver cirrhosis commonly leads to sleep-wake disturbances. It causes insomnia and difficulty in falling asleep and waking up refreshed, which increases daytime sleepiness and fatigue.

Fatigue can affect the quality of life, job performance, and daily activities. Fatigue due to sleep disturbances also increases the possibility of depression in people with liver disease.

2. Abdominal Swelling and Pain:

Pain in the abdomen is common in people with cirrhosis. Pain in the liver causes a dull, stabbing pain in the right upper abdomen. Fluid retention and enlargement of the spleen in cirrhosis also lead to abdominal pain and swelling. Liver disease causes inflammation in the entire body which can lead to pain.

3. Bruising and Bleeding Easily:

Liver disease can cause the liver to stop the production of proteins that aid in blood clotting. Therefore, when the blood does not clot properly, it leads to instant bruising and bleeding.

4. Itchy Skin:

Itchy skin is another common liver failure symptom. High levels of bile salt accumulate under the skin in liver disease and cause itchiness. High serum alkaline phosphatase (ALP) levels also cause itchiness in people with liver disease. ALP is an enzyme found in the liver. Liver disease affects its levels, which leads to itchiness.

What are The Causes Of Liver Failure?

When the cells of the liver are damaged, it affects the functioning of the liver. Causes of liver failure range from health conditions to medications and genetics. The primary causes of liver failure are,

Here is the common Causes of Liver Failure?

• Heat Stroke
• Prescription Medications
• Acetaminophen Overdose
• Metabolic Disease

1. Heat Stroke:

Heat stroke is a serious condition that can cause multiple organ failure. It can cause mild to moderate hepatocellular (liver cells) injury. Thus, extreme physical activity in intense heat can cause acute liver failure.

2. Prescription Medications:

Certain prescription medications, such as non-steroidal anti-inflammatory drugs (NSAIDs), anticonvulsants used to treat epilepsy and seizures, and antibiotics, can cause liver failure. The liver helps the body break down medications. Large doses of such drugs can damage a normal liver and cause liver conditions such as hepatitis.

3. Acetaminophen Overdose:

Acetaminophen is the main ingredient in several over-the-counter drugs for pain and fever. Commonly known as paracetamol, it is combined with other ingredients to treat colds, coughs, flu, allergies, and sleeplessness. Taking high doses of paracetamol daily for several days can cause acute liver failure.

4. Metabolic Disease:

Certain rare metabolic diseases, such as acute fatty liver in pregnancy (AFLP) and Wilson's disease, involve the liver. In Wilson's disease, copper accumulates in the liver and other organs, which leads to cirrhosis or acute liver failure. Similarly, acute fatty liver disease is a liver problem in pregnancy. Here, the liver cells have too much fat, which damages the liver.

What Are The 5 Liver Cirrhosis Stages?

The progression of liver disease occurs in four stages. Doctors consider these liver cirrhosis stages to measure the extent of liver disease. These stages are:

Here is the Stages of Liver Failure?

1. Inflammation
2. Scarring
3. Cirrhosis of The Liver
4. End-Stage Liver Disease (ESLD)
5. Liver Cancer

1. Inflammation:

The liver cleanses the blood of toxic substances. However, when it does not perform this function efficiently, the body reacts to the imbalance of toxins with inflammation. Inflammation around the liver results in swelling or tenderness. Inflammation is a sign of hepatitis, non-alcoholic fatty liver or alcoholic fatty liver.

2. Scarring:

If left untreated, inflammation leads to scarring. Scarring affects the functioning of the liver. This process is called fibrosis, which can overtake the liver leading to a build-up of toxins. As the liver becomes fibrotic, it loses its ability to perform its function. Scarring also hampers the blood flow to the liver. Due to the lack of blood flow, the tissue becomes necrotic, and the liver enters the next stage of the disease.

3. Cirrhosis of The Liver:

Cirrhosis of the liver is the third stage. When the liver reaches this stage, it is severely scarred and difficult to heal. With a growing infection, the area around the liver becomes itchy. The patient develops jaundice. They experience discomfort, fatigue, loss of appetite, and oedema. It also increases the risk of developing liver cancer.

4. End-Stage Liver Disease (ESLD):

This is the final stage of liver disease. Here, the liver stops functioning and is unable to heal itself. Acute liver failure occurs quickly, within 48 hours, and chronic liver failure develops over time due to alcohol poisoning.

5. Liver Cancer:

Cancer occurs when unhealthy cells multiply. Liver cancer can develop during any stage of liver disease, but people with cirrhosis of the liver are more at risk of liver cancer.

Diagnosis and Treatment of Liver Failure

Consulting a doctor on experiencing any of the liver failure symptoms is crucial. Finding the cause and the extent of damage will help the doctor decide on the line of treatment.

1. Physical Exam And Medical History

To find the underlying reasons and risk factors, the doctor will ask about alcohol consumption and medication use. They will also ask about past medical history to know if the patient has had viral hepatitis and immunizations against infectious hepatitis. A physical exam will also help detect jaundice, abnormal skin blood vessels (spider angiomata), muscle wasting, a yellowish tinge to the skin, thinning hair, and an enlarged liver felt in the abdomen.

2. Blood Tests And Imaging

Blood tests to diagnose liver failure are called liver function tests. These include,

• Serum bilirubin test
• Serum albumin test
• Serum alkaline phosphatase test
• Serum aminotransferase
• Prothrombin time test (PTT)
• Alanine transaminase test (ALT)
• Aspartate transaminase test (AST
• Gamma-glutamyl transferase (GGT)
• Lactate dehydrogenase test (LDH)
• Total protein test

Imaging tests include,

• Liver ultrasonography (US)
• Computed tomography (CT)
• Magnetic resonance imaging (MRI)

3. Medications And Lifestyle Changes

A healthy diet and lifestyle are crucial in the treatment of liver disease. Doctors suggest the following changes for chronic liver failure:

• Include plenty of fruits and vegetables
• Reduce salt and fat intake
• Increase fluid intake for better detoxification
• Avoid processed foods
• Quit alcohol and smoking
• Manage stress
• Exercise regularly to maintain a healthy weight

Treatment for acute liver failure includes:

• Laxatives or enemas to flush out the toxins
• Intravenous fluids to maintain the blood pressure
• Blood sugar monitoring

4. Liver Transplantation

Liver transplantation is the solution for people with liver failure as it helps long-term survival. It includes replacing the damaged liver with a healthy one from a donor. Doctors prescribe medications to prevent the body from rejecting the new organ.

Conclusion

Long-term alcohol consumption, chronic liver infections like hepatitis B or C, and medical conditions like non-alcoholic fatty liver disease and autoimmune disease increase the risk of liver failure. Contacting a doctor on experiencing signs of liver failure is crucial in reducing complications and getting timely medical treatment.

Importance of Early Detection and Treatment

Early detection of fibrosis or cirrhosis can help provide timely treatment. Along with lifestyle changes, medication can halt the progression of the disease and improve the chances of recovery. Therefore, it is essential to consult a doctor on noticing signs of liver failure, like jaundice, oedema, blood in the stools or itchy skin.

Frequently Asked Questions

1. What is The Lookout for Patients After Treatment for Liver Failure?

Liver failure treatment helps many people recover. Acute liver failure can be reversed based on its cause. With the help of a liver transplant, people can resume their daily activities within six months. After a transplant, people require medications to prevent the body from rejecting the new organ.

2. Can Liver Failure Be Prevented?

While liver failure can not be prevented, chances of liver failure can be reduced in the following ways:

• Reduce alcohol consumption
• Maintain a healthy weight
• Follow a healthy lifestyle
• Regularly check for high cholesterol, diabetes, and high blood pressure
• Get vaccinated for Hepatitis B
• Follow the instructions for medications like acetaminophen

3. What Complications are Associated With Liver Failure?

Complications associated with liver failure are:

• Infections like UTI (Urinary Tract Infections) and pneumonia
• Kidney failure
• Blood clotting issues
• Cerebral oedema or excess fluid in the brain

4. How Do I Know If My Liver Function Is Worsening?

Liver failure symptoms can help you know if your liver function is worsening. These are:

• Jaundice
• Swelling in the legs and feet or oedema
• Fluid build-up in the abdomen
• Brown or orange-coloured urine
• Blood in the stools
• Easy bruising
• Redness of the palms
• Itchy skin
• Low sex drive
• Premature menopause

5. Can A Damaged Liver Repair Itself?

The liver can develop new cells and regenerate itself after damage and regrow to its normal size even after 90% of it has been removed. However, liver conditions, such as hepatitis and fatty liver disease and drug overdose and excessive alcohol consumption can damage the liver beyond repair.