An Overview of Liver Failure

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Liver failure occurs when the liver cells cease to function. This condition can progress slowly without any symptoms until there is substantial liver damage. Eventually, liver failure can cause a variety of symptoms, including fatigue, jaundice (a yellowish appearance of the skin and eyes), itching sensations, and confusion.

Liver failure also causes diminished immunity and makes it hard to efficiently metabolize food and medications. There are many different causes of liver failure, and the most common are alcohol and viruses.

If you have signs, symptoms, or risk factors for liver failure, your diagnostic testing will include blood tests and imaging examinations. Treatment depends on the cause. Additionally, you may be instructed to adjust your diet and avoid certain medications, such as Tylenol (acetaminophen). In some situations, a liver transplant is necessary.

Symptoms

Liver failure usually affects adults and only rarely affects children. Acute liver failure causes severe nausea and vomiting that can begin within a few days and up to several weeks after exposure to a virus. However, many diseases that affect the liver may not cause any symptoms in the early stages—causing slowly progressive or sudden liver failure years later—with life-threatening effects.

Symptoms of Acute Hepatitis

Acute hepatitis produces sudden liver failure and often resolves on its own. Rarely, acute hepatitis can be fatal if untreated.

Common symptoms of acute hepatitis include:

  • Nausea
  • Vomiting
  • Stomach upset
  • Loss of appetite
  • Jaundice
  • Fevers
  • Chills
  • Fatigue
  • Dehydration—sunken eyes, lethargy, decreased urination
  • Confusion

Symptoms of Chronic Liver Disease

Chronic liver disease may cause gradually worsening effects of liver failure.

Common symptoms and effects include:

  • Jaundice
  • Fatigue
  • Abdominal swelling
  • Decreased appetite
  • Abdominal discomfort or pain
  • Yellow or dark urine
  • Stools that float
  • Diarrhea

Chronic liver disease causes a number of health problems, including impaired immunity, and a predisposition to infections. It has also been associated with kidney disease, hypertension, and an increased risk of stroke.

Symptoms of Acute Liver Failure

Chronic liver disease may cause liver failure, which is often described as acute liver failure because it develops quickly. The effects progress rapidly, and acute liver failure caused by chronic liver disease can be fatal.

Symptoms of acute liver failure caused by chronic liver disease include:

  • Confusion
  • Agitation
  • Behavioral changes
  • Trouble walking
  • Loss of consciousness
  • Seizures

Causes

Liver failure can be caused by a variety of conditions. Hepatitis, which is inflammation of the liver, is the most common cause of liver failure. There are many types and causes of hepatitis.

Hepatitis can be caused by infections, toxicity, or autoimmune disease (when the body's immune system fights its own liver cells).

Cancer in the liver can cause liver failure as well. Cancer can begin in the liver or it can spread to the liver from other areas of the body, impairing liver function.

The liver metabolizes nutrients, medications, and alcohol and detoxifies the body's waste material. When the liver fails, it cannot carry out these functions.

Infectious Hepatitis

There are five types of infectious hepatitis—hepatitis A, B, C, D, and E. They are all contagious, and each has a different mode of transmission from person to person.

Hepatitis A and E are generally spread through food or contaminated water. This is described as fecal-oral transmission—the virus is present in the feces and can be spread to other people through contaminated food.

Hepatitis B, C, and D are spread through contaminated blood. Sharing needles for tattoos, body piercings, or drug use can spread these viruses. Additionally, hepatitis B is sexually transmitted. Hepatitis D can only be transmitted along with hepatitis B.

Hepatitis A, B, and C are the most common types of infectious hepatitis.

Toxicity

Alcohol and certain medications can be harmful to the liver, causing damage. Alcoholic liver disease includes alcoholic hepatitis and fatty liver. These complications can occur after years of alcoholism, and some people who consume heavy amounts of alcohol do not develop hepatitis.

Some medications can cause liver failure after short term use or chronic use. Not everyone develops liver failure from taking these medications and is hard to predict who will develop it.

Medications that can cause liver failure include:

Keep in mind that natural supplements can also cause liver failure, so it is important to obtain as much information about side effects as you can when taking supplements.

Medical Conditions

There are a number of medical illnesses that cause liver failure. These conditions can be hereditary and each of them is also characterized by other effects in addition to inflammation of the liver.

Medical conditions that cause liver failure include:

Effects of infectious hepatitis A and E typically begin within a few weeks of exposure, producing acute hepatitis.

Alcoholic hepatitis, fatty liver, genetic liver disease, and hepatitis B, C, and D generally do not cause symptoms right away and produce slowly progressive liver damage—which eventually results in the effects of chronic hepatitis.

Diagnosis

If you have risk factors, such as exposure to infectious hepatitis, you may need a screening test. If you have already developed signs of liver failure, your diagnostic evaluation may include blood tests, imaging tests, and possibly a liver biopsy.

Physical Signs

Jaundice is the most obvious sign of liver failure. Your skin and the white part of your eyes may appear yellow. Sometimes, this can happen gradually—so you and your family may not notice it right away.

Often, confusion, agitation, and problems walking are noted as well.

Blood Tests

There are several blood tests that can help in the assessment of liver failure and can help identify the cause.

Imaging Tests

You may need to have imaging tests that can visualize the structure of your liver, such as abdominal computerized tomography (CT), magnetic resonance imaging (MRI), or ultrasound.

Biopsy

If there is a concern about cancer in your liver, or if the cause of your liver failure is not diagnosed by non-invasive tests, you may need a biopsy. This is an interventional procedure in which your doctor would take a sample of your liver (usually with ultrasound or CT guidance) so that its characteristics can be examined under a microscope.

Treatment

You can have treatment for liver failure, and while you should expect to experience some improvement with treatment, you may have some residual effects.

If you have acute liver failure due to hepatitis A or E infection, you may need hydration with oral (by mouth) or intravenous (IV) fluids to prevent dehydration. You may also need medication to reduce your fever as your infection resolves.

Other infections, hepatitis B, C, and D, do not resolve on their own. If you have one of these infections, you may benefit from antiviral medications. Sometimes, anti-inflammatory medications or immunosuppressants are beneficial as well—however, since these medications can harm the liver, the decision is made on a case by case basis.

Precautions

When you have liver failure, you need to avoid medications that cause liver failure. You should also meet with a dietitian, as you may need a low fat and low protein diet because the liver is essential to metabolizing these nutrients.

Liver Transplant

If your liver failure is not likely to resolve, you may need to have a liver transplant. This is a major surgical procedure that involves the removal of your own liver and replacement of a human donor liver. The donor liver must be sutured in place so that it receives blood from your blood vessels.

A liver transplant procedure entails that you use immunosuppressive medication to help in avoiding rejection and failure of the donor's liver.

Recovery may take months, but if you have a successful transplant, you can expect to have many healthy years ahead of you—with a functioning liver.

Prevention

If you have hepatitis, you need to be careful to avoid spreading it to others. Hand washing and sanitary food preparation are essential.

And if you have hepatitis B, C, or D, you must tell sexual partners about your virus. It is vital that you use protection to avoid transmitting it to sexual partners. Sharing needles for any reason—whether for recreational drugs, for tattoos, or for medical care—is very dangerous and can spread your virus to others.

A Word From Verywell

Liver failure is a condition that has many causes and effects. You may not realize that you are developing liver failure until it has progressed to a late stage. Getting regular medical check-ups can help identify early signs of liver failure.

If you are diagnosed with liver failure, it is very important that you follow through with your medical treatment, as this condition can advance rapidly and it may be fatal. Avoiding medications that cause liver toxicity, following a liver friendly diet, and possibly taking prescription treatments or having a liver transplant will improve your quality of life and prolong your survival,

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