The liver is an organ located in the upper right side of the abdomen, performing hundreds of functions including filtering blood, producing digestive bile, and making proteins essential for clotting and immunity. Liver failure represents a severe deterioration of these functions, meaning the liver can no longer adequately perform its vital tasks. This condition can manifest gradually over months or years, known as chronic liver failure, or, in rarer cases, rapidly within days or weeks, referred to as acute liver failure. When the liver shuts down, it impacts nearly every major body system and can be fatal without intervention; often, a liver transplant is required.
Recognizing Early Indicators
Early signs of liver problems can be subtle and easily mistaken for other common ailments. Individuals might experience persistent fatigue, a general feeling of being unwell, or malaise. Nausea, a general feeling of sickness, or a noticeable loss of appetite are also common initial symptoms, sometimes leading to unexplained weight loss. Additionally, some people might notice upper abdominal pain.
These non-specific symptoms often stem from the liver’s decreased ability to process toxins and support overall metabolism, affecting energy levels and digestive comfort. Because these indicators overlap with many other conditions, people may overlook them or attribute them to stress or dietary issues. Recognizing these initial changes is important, as they can be the first signals that the liver is struggling.
Understanding Advanced Signs
As liver failure progresses, more distinct and severe symptoms emerge, signaling significant liver dysfunction. Jaundice, a yellowing of the skin and the whites of the eyes, is a common indicator, resulting from a buildup of bilirubin in the bloodstream when the liver cannot process it effectively. This accumulation can also cause urine to appear unusually dark and stools to become pale or clay-colored. Easy bruising or bleeding occurs because the failing liver produces fewer proteins necessary for blood clotting.
Fluid retention becomes apparent through abdominal swelling, known as ascites, or swelling in the ankles, feet, and hands (edema). Mental confusion, disorientation, or changes in personality and behavior, collectively termed hepatic encephalopathy, can develop as toxins that the liver usually removes accumulate and affect brain function. Other advanced indicators include persistent itchiness without a rash, a musty-sweet breath odor, and muscle wasting.
When Immediate Medical Attention is Needed
Certain symptoms associated with liver failure warrant immediate medical evaluation or emergency care. A sudden onset of jaundice, where the skin and eyes rapidly turn yellow, requires urgent attention. Any significant changes in mental state, such as severe confusion, disorientation, excessive sleepiness, or personality alterations, signal a medical emergency.
Other serious signs include vomiting blood or passing black, tar-like stools, which can indicate internal bleeding from enlarged veins in the esophagus or stomach. Severe, unexplained abdominal pain, especially in the upper right quadrant, or a rapid increase in abdominal swelling requires prompt medical assessment.
How Liver Failure is Diagnosed
When a healthcare professional suspects liver failure, they typically begin with a physical examination to look for visible signs like jaundice, abdominal swelling, or tenderness. This initial assessment is followed by a series of diagnostic tests to evaluate liver function and identify the extent and cause of damage. Blood tests are a standard tool, including liver function tests that measure levels of liver enzymes, proteins, and bilirubin, which can indicate liver disease severity and the liver’s ability to function. These tests may also assess blood clotting times, as a failing liver often impairs clotting factor production.
Imaging tests offer visual insights into the liver’s condition. An abdominal ultrasound, CT scan, or MRI can reveal the liver’s size, shape, and texture, and help detect damage or specific causes of liver problems like tumors. Specialized imaging techniques such as elastography can measure liver stiffness, which helps assess scarring or fibrosis. In some cases, a liver biopsy, involving the removal of a small tissue sample for microscopic examination, may be performed to confirm cirrhosis, determine the underlying cause, or assess the disease’s progression.