The liver works quietly every day to keep the body healthy.
It removes harmful substances from the blood, processes nutrients, stores energy, makes proteins that help blood clot, and produces bile to digest fats.
Because it performs so many important jobs, serious liver damage can affect almost every part of the body.
Liver failure usually develops slowly after years of ongoing damage. Common causes include long-term alcohol use, chronic hepatitis B or C infection, and non-alcoholic fatty liver disease.
In the early stages, many people have few symptoms, so liver disease may go unnoticed until it becomes severe.
When liver damage reaches its final stage, called end-stage liver disease, the symptoms become much more obvious.
One of the best-known signs is jaundice, which causes the skin and the whites of the eyes to turn yellow. This happens because the liver can no longer remove bilirubin, a yellow waste product, from the bloodstream.
Many people also develop ascites, a build-up of fluid inside the abdomen. The stomach may become swollen, tight, and uncomfortable.
Swelling can also appear in the feet, ankles, and legs because damaged liver tissue affects blood flow and reduces the production of proteins that normally keep fluid inside blood vessels.
Another serious complication is hepatic encephalopathy. When the liver cannot remove toxins such as ammonia, they travel to the brain. This may cause confusion, memory problems, personality changes, poor concentration, sleepiness, or even coma in severe cases.
Digestive symptoms are also common. Many people lose their appetite, feel nauseated, vomit, and gradually lose weight. Extreme tiredness often develops because the liver can no longer support normal metabolism and energy production.
The liver also produces clotting proteins. As liver function declines, bruising and bleeding become more common. Some people notice nosebleeds, bleeding gums, or blood in vomit or stools.
Another symptom is intense itching caused by bile salts building up beneath the skin. The itching can become severe enough to interfere with sleep and daily activities.
In advanced cases, the kidneys may also begin to fail, leading to hepatorenal syndrome, a life-threatening complication that requires urgent medical care.
According to liver specialists and the American Liver Foundation, treatment depends on the underlying cause.
Medicines, lifestyle changes, symptom management, and in some patients a liver transplant may be needed. Recognizing these warning signs early can improve quality of life and may increase survival.
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