The liver is a large organ that performs hundreds of jobs needed to keep the body working.
It helps process nutrients from food, removes harmful substances from the blood, makes bile for digestion and produces proteins that help control bleeding.
When the liver becomes badly damaged and can no longer do these jobs properly, liver failure can develop. In many people, the damage builds slowly over years because the liver can continue working even after part of it has been injured.
Early liver disease may cause few obvious symptoms. A person might feel tired, weak or generally unwell, but these problems can have many causes and may be easy to overlook. As liver damage becomes severe, however, the warning signs are usually more noticeable.
One of the best-known signs is jaundice, which makes the skin and whites of the eyes look yellow. It develops when bilirubin, a yellow substance produced when old blood cells are broken down, builds up because the damaged liver cannot process it normally.
Another common problem is a swollen abdomen caused by fluid collecting inside the belly. Doctors call this ascites. The abdomen may become large, tight and uncomfortable, and the extra fluid can sometimes make breathing or eating more difficult.
Fluid may also collect in the legs, feet and ankles. Severe liver disease can change pressure in important blood vessels and reduce the liver’s ability to make proteins that help keep fluid in the bloodstream.
Changes in thinking can be another serious warning sign. A person may become confused, forgetful, unusually sleepy or behave differently. In severe cases, they can become difficult to wake or lose consciousness.
This happens when the damaged liver cannot remove certain waste products from the blood effectively. These substances can reach the brain and interfere with normal brain function, a complication known as hepatic encephalopathy.
People with advanced liver disease may also lose their appetite, feel sick or vomit. Poor appetite and changes in the way the body uses nutrients can lead to weight loss, muscle loss and increasing weakness.
Extreme tiredness is also common. As liver function worsens and other complications develop, everyday activities that were once easy may become exhausting.
Bleeding and bruising can become more frequent because the liver normally makes proteins needed for blood clotting. Advanced disease can reduce production of these proteins, while other changes linked to liver damage can further increase bleeding risk.
Some people may develop severe itching. Problems with the normal movement and processing of bile can cause substances associated with bile to build up in the body, contributing to persistent itching that may interfere with sleep and daily life.
Advanced liver disease can also affect other organs. One dangerous complication is hepatorenal syndrome, in which kidney function becomes severely impaired in a person with serious liver disease.
According to information from liver specialists and organizations such as the American Liver Foundation, many conditions can eventually cause severe liver damage. Major causes include long-term heavy alcohol use, chronic viral hepatitis and metabolic dysfunction-associated steatotic liver disease, previously widely known as non-alcoholic fatty liver disease.
Treatment depends on what caused the liver damage and how advanced it has become. Doctors may treat the underlying cause, control fluid buildup, manage confusion and other complications, improve nutrition and review medicines that could worsen the condition.
For some people with end-stage liver disease, a liver transplant may be the only treatment that can restore long-term liver function. Doctors consider many factors when deciding whether transplantation is appropriate.
Late-stage liver failure is a medical emergency when symptoms suddenly worsen. New confusion, vomiting blood, black or bloody stools, severe weakness, breathing problems or loss of consciousness require urgent medical attention.
Recognizing advanced liver disease early can give doctors more opportunities to manage complications and determine the best treatment. Anyone with known liver disease who develops new or worsening symptoms should seek medical advice promptly.
If you care about liver health, please read studies about a diet that can treat fatty liver disease and obesity, and coffee drinkers may halve their risk of liver cancer.
For more health information, please see recent studies that anti-inflammatory diet could help prevent fatty liver disease, and results showing vitamin D could help prevent non-alcoholic fatty liver disease.
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