Liver Failure
Dr. Mayank Agarwal

Liver failure occurs when your liver isn’t working well enough to perform its functions (for example, manufacturing bile and ridding the body of harmful substances). Symptoms include nausea, loss of appetite, and blood in the stool. Treatments include avoiding alcohol and avoiding certain foods

What is liver failure?

The liver performs many important functions, including:

  • Making blood proteins that aid in clotting, transporting oxygen and supporting the immune system
  • Manufacturing bile, a substance needed to help digest food
  • Helping the body store sugar (glucose) in the form of glycogen
  • Ridding the body of harmful substances in the bloodstream, including drugs and alcohol
  • Breaking down saturated fat and producing cholesterol

Liver failure occurs when your liver isn’t working well enough to perform these tasks.

What causes liver failure?

Many different diseases and conditions cause liver failure, including Hepatitis B and C, non-alcoholic fatty liver disease, alcohol abuse and hemochromatosis.

In many cases, chronic liver failure results from cirrhosis. Cirrhosis is the scarring of the liver from repeated or long-lasting injury, such as from drinking alcohol excessively over a long period of time or chronic hepatitis infection. As scar tissue replaces healthy liver tissue, the liver loses its ability to function.

Acute liver failure is most often caused by:

  • Viral infections, such as Hepatitis B.
  • The overuse of certain drugs or toxins, like acetaminophen (Tylenol®), and the use of other medications (including certain antibiotics, antidepressants, anti-seizure medications, man-made hormones and antifungal drugs) and herbs (green tea extract and kava).
  • Metabolic (biologic) or vascular (vessels that carry fluids, such as arteries) disorders, such as Wilson disease and autoimmune hepatitis.

What are the symptoms of liver failure?

Liver failure can take years to develop. The symptoms of liver failure often look like symptoms of other medical conditions, which can make it hard to diagnose in its early stages. Symptoms get worse as your failing liver continues to get weaker.

Chronic liver failure, or liver failure that occurs over many years, may cause:

  • Fatigue
  • Nausea
  • Loss of appetite
  • Diarrhea
  • Vomiting blood
  • Blood in the stool

As liver failure advances, symptoms become more severe. In later stages, symptoms of liver failure may include:

  • Jaundice (yellowing of the skin and eyes)
  • Extreme tiredness
  • Disorientation (confusion and uncertainty)
  • Fluid buildup in the abdomen and extremities (arms and legs)

Sometimes, the liver fails suddenly, which is known as acute liver failure. People with acute liver failure may have the following symptoms:

  • Bleeding
  • Changes in mental status
  • Musty or sweet breath odor
  • Movement problems
  • Loss of appetite
  • General feeling of being unwell
  • Jaundice

How is liver failure diagnosed?

The doctor diagnoses liver failure based on your symptoms, your medical history and the results of tests (blood tests, urine tests, abdominal imaging).

MANAGEMENT AND TREATMENT

How is liver failure treated?

Liver disease and liver failure are usually treated by specialists called hepatologists.

Treatment of liver failure depends on whether it is acute or chronic. For chronic liver failure, treatment includes changes to the diet and lifestyle, including:

  • Avoiding alcohol or medications that can harm the liver
  • Eating less of certain foods, including red meat, cheese and eggs
  • Weight loss and control of metabolic risk factors, including high blood pressure and diabetes
  • Cutting down on salt in the diet (including not adding salt to food)

For acute (sudden) liver failure, treatment includes:

  • Intravenous (IV) fluids to maintain blood pressure;
  • Medications such as laxatives or enemas to help flush toxins (poisons) out;
  • Blood glucose (sugar) monitoring; glucose is given to the patient if blood sugar drops.

You may also receive a blood transfusion if you are bleeding excessively, or a breathing tube to help you breathe.

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