The liver is the most important metabolic site in the human body. When this vital organ loses its ability to perform normal functions and shuts down completely, this condition is known as liver failure. The symptoms of liver failure are initially silent and may appear when it is too late.
Please read this article in order to recognize the different stages of liver failure, their symptoms, and the best treatment and management of end-stage liver failure.
What is Liver Failure?
When your liver shuts down due to irreversible damage, this is called a liver failure or end-stage liver failure. When your liver fails, it may be unable to do its job properly, i.e., it cannot perform some crucial functions in the body, including:
- Metabolism of macronutrients
- Bile production
- Synthesis of angiotensinogen
- Production of albumin
- Vitamin and mineral storage
- Immunological function
- Absorbing and metabolizing bilirubin
- Formation of clot
All body functions will be unable to function if the liver fails, eventually leading to death.
Symptoms of liver disease and failure
When liver damage or disease is in its earliest stages, inflammation and fibrosis rarely cause noticeable symptoms. As the disease progresses, symptoms appear.
In the early stages of liver disease, symptoms may include:
- Weakness or fatigue
- An inability to eat
- Unexplained weight loss
- A mild stomachache
When this disease progresses to the end-stage liver disease, it may show the following functions
- Anxiety or confusion
- Irritation of the skin
- Bleeding or bruising easily
- Pain or discomfort in the abdomen
- A lack of appetite
- Urine becomes darker
- Pale stools
- Blood in your vomit or stool
- Nausea or vomiting
The symptoms may appear if you have chronic liver disease, cirrhosis, or hepatitis C.
Liver Failure Stages
To understand the difference between liver disease and liver failure, it is important to know that any condition that causes liver damage or affects its function is considered a liver disease.
It is called liver failure, when the liver stops functioning entirely or partially. In many cases, liver failure is caused by liver disease.
The American Liver Foundation reports that liver disease can progress through several stages before liver failure occurs.
Inflammation may occur in the early stages of liver disease. During the inflammation stage, it is common not to feel discomfort or notice other symptoms. Inflammation can cause permanent damage to the liver, however, if left untreated.
An inflamed liver may develop scarring without treatment. Fibrosis occurs when too much scar tissue builds up in the liver. A liver’s healthy tissue is replaced by excess scar tissue over time. When scar tissue accumulates, the liver may begin to function less efficiently. Furthermore, scar tissue can prevent blood from flowing through the liver. Human livers can still heal if they seek medical attention and treatment at this stage.
At this stage, the liver’s soft, healthy tissue has been replaced by hard scar tissue. Symptoms typically begin to appear at this stage. Cirrhosis can cause liver cancer and other complications. Cirrhosis can worsen if left untreated. Consequently, the liver may cease to function properly or at all. Cirrhosis cannot be reversed even if treatment stops or delays liver damage.
End-stage liver disease (ESLD)
At the end stage of liver disease, the liver function has deteriorated to such an extent that it cannot survive without an organ transplant.ESLD patients’ survival rates depend on their symptoms and complications. In the case of ascites, a buildup of fluid in the abdomen, the survival rate is six months if treatment is unsuccessful. Hepatic encephalopathy, which affects brain function, is also a complication of ESLD. Those who receive ineffective treatment for this condition live for 12 months.
Acute vs. Chronic Liver Failure
Following are the major types of liver failure:
Chronic Liver Failure
In chronic liver failure, liver function decline is slowly accompanied by cirrhosis or severe liver scarring. This type can develop over months and years. Here are several causes of cirrhosis, including:
- Alcohol abuse
- NAFLD (Nonalcoholic fatty liver disease)
- Bile duct disorders, etc.
Treatment for cirrhosis involves lifestyle changes, medicines, and other therapies aimed at controlling or slowing its progression. Cirrhosis can gradually degrade liver function, leading to liver failure. To detect liver failure, doctors may perform routine tests to detect liver failure. As cirrhosis progresses to liver failure, liver transplantation is highly recommended. Therefore, it is important to consult a doctor in order to detect any signs of cirrhosis leading to liver failure.
Acute liver failure
Acute liver failure occurs when liver failure occurs rapidly and over a short period, usually between a few days and a few weeks. The condition rarely occurs in people without a history of liver disease. The following causes can lead to acute liver failure:
In acute liver failure, the liver fails rapidly for several reasons:
- Overdosing on acetaminophen can damage your liver
- There are various viruses, including hepatitis A, B, and E, and the Epstein-Barr virus
- Cytomegalo and herpes simplex viruses both can damage the liver or cause cirrhosis
- The liver can die from reactions to certain prescription and herbal medications. A few of them damage the duct system in which bile is transported.
- Amanita phalloides, which is known as the death cap, contain toxins that damage liver cells and cause liver failure within a few days of eating them
- Acute liver failure can result from autoimmune hepatitis, in which your body attacks your liver.
- In Wilson’s disease, your body cannot remove copper from the body. It accumulates in your liver and damages it.
- During pregnancy, excess fat gathers on your liver and causes damage
- You can lose your liver function due to septic shock, a serious infection in your body
- Budd Chiari Syndrome: The liver’s blood vessels narrow and block due to this rare disease
- Various industrial chemicals, such as carbon tetrachloride, can damage your liver.
Acute liver failure is a medical emergency. The ICU provides intensive care for patients with acute liver failure. The treatment for your liver failure depends on the cause—medications for hepatitis, acetaminophen overdoses, poisonings, and other conditions may be prescribed by your doctor. A liver transplant may be recommended if other treatment options aren’t effective.
Acute-on-chronic liver failure
Clinically stable patients with chronic liver failure can suddenly develop rapid liver failure. Medications could adversely affect the liver. Therefore, discussing with a doctor before taking medicines is highly recommended. Drinking should be avoided as it worsens liver damage. Preventing stress and living a healthy lifestyle can protect the liver.
Conditions Lead to Liver Failure
The following are the conditions that can lead to liver failure:
Primary sclerosing cholangitis: This disease slowly damages your bile ducts.
Oxalosis: When your kidneys can’t remove calcium oxalate crystals, they may accumulate in the liver and cause damage.
Alpha-1 antitrypsin deficiency can cause lung or liver problems.
Liver cancer often happens to people with chronic hepatitis B or C.
Liver adenoma: When benign liver tumors grow on a healthy liver, This is most common in women between the ages of 20 and 40.
Fatty liver disease: When your liver gets excessive fat accumulation, it becomes fatty. Nonalcoholic fatty liver disease can be caused by obesity and high cholesterol. Heavy drinkers are prone to fatty liver disease.
Alcoholic hepatitis: liver inflammation caused by drinking too much or too long.
Alagille syndrome: A genetic disorder resulting in fewer bile ducts than normal
Primary biliary cholangitis (PBC): As the disease progresses, it destroys your small bile ducts. In some cases, it is still referred to as primary biliary cirrhosis.
Galactosemia: The sugar galactose, found in many foods, cannot be processed by people with this condition. As a result, liver damage can occur.
Lysosomal acid lipase deficiency (LAL-D): Lysosomal acid lipase (LAL) is an enzyme that breaks down fats and cholesterol. Due to genetic disorders, your body lacks this enzyme. Therefore, fats remain in your liver and damage it.
Complications of Liver Failure
Several complications can be a consequence of acute liver failure, such as:
Kidney Failure: Liver failure can alter the way your kidney works; therefore, kidney failure occurs, especially if you overdose yourself with acetaminophen, which is extremely harmful to the health of both the kidney and the liver.
Cerebral edema: Excessive amounts of fluid can result in pressure in your brain, leading to high blood pressure, delirium, and seizures.
Infections: People afflicted with last-stage acute liver disease may get conditions in the blood, respiratory, and urinary tracts like pneumonia and UTIs.
Blood Clotting Disorders: The liver has the important function of synthesizing blood-clotting protein so that blood does not flow too freely; a failed liver cannot perform this function, and there is a high risk of bleeding in the gastrointestinal tract, which is a common condition in this situation.
Liver Disease and Failure Diagnosis
It is important to discover the causes and scope of liver damage to cure it. The doctor will most likely start by physically examining you and asking about your medical history. They may also require the following tests:
Imaging Tests: These tests take pictures of your liver and let the doctor visualize its condition and unravel the reasons behind the deteriorating health of your liver. The doctor might recommend you do the following imaging tests:
- CT Scan (Abdominal Computerised Tomography)
- Magnetic Resonance Imaging-MRI
Biopsy: During this test, the doctor will use a long needle to extract a sample of tissue from your liver, which will then be sent to a lab for testing to look for signs of liver damage and disease.
Blood Tests: These blood tests will comprise liver function tests that will rate the levels of several proteins and enzymes in your blood. These results will show how well your liver is functioning. The doctor may also perform other blood tests for conditions that can be a possible reason behind liver damage, such as genetic conditions or viral hepatitis.
Treatment for Liver Failure
Treatments for liver damage and liver failure are as follows:
Medication: An acetaminophen overdose that results in acute liver damage will be treated with acetylcysteine poisoning, which will play an integral role in reversing the negative effect. Various drugs may also cure mushroom poisoning during the process, which will lower the damage to the liver caused.
Liver Transplant: If your liver has failed, the doctor will try to save some part that is still functioning. If this goes unsuccessful, a liver transplant will be mandatory, and this procedure is successful in most cases.
The doctor may advise you to make some lifestyle changes in the ways you will spend your life, such as avoiding alcohol, losing weight, and abstaining from certain medicines that will be harmful to the health of your liver.
When to Consult a Doctor?
There are a lot of people who have liver disease who don’t feel or look sick. When the liver disease progresses, damage can become irreversible and cause liver failure, liver cancer, or even death.
Your liver may be protected from damage if you receive an early diagnosis. You might be able to regenerate your liver if you get diagnosed before scar tissue has already formed. As a result, well-managed liver disease treatment can often reverse liver damage.
Your doctor will advise you on the right treatment after diagnosing the stage and severity of the disease.
Your Doctors online have a panel of professional medical doctors that can help you with the right and early diagnosis of liver disease and its progression to failure. Moreover, they will prescribe the best treatment to eliminate this disease and its progression.
FAQs About Liver Failure Answered by Your Doctors Online Team
Liver failure can lead to death within minutes or may take months, depending on the severity of the disease and the patient’s immunity. There are three risk categories for end-stage liver failure cases:
Patients at high risk of liver failure death within 90 days have a 40 percent. For moderate-risk patients, death within 90 days is about 11 percent; for low-risk patients, it is about 4.3 percent.
Yes, liver disease can be cured depending on the stage of the disease and its severity.
If it rapidly progresses to liver failure, a liver transplant is the only option to deal with the emergency.
Following are some early signs of a bad liver:
1. An odorous, pale poop
3. A backache, side pain, thigh pain, and abdominal pain
5. An abdominal rash or itchiness
6. Fluid retention is poor or high
8. Gastrointestinal discomfort
9. Cramping in the stomach
10. Ulcers or sores
It effectively reduces fever (antipyretic) and relieves pain (analgesic). Overdosing on Tylenol can also result in liver failure. Taking Acetaminophen as directed is very safe, even for people with liver disease.