What you need to know about Liver Failure

The liver is one of the most essential organs in your body. In fact, we cannot live without it. Like a big factory inside our body, the liver does hundreds of jobs. So imagine, what happens if this factory can't do its job properly? The whole body's functioning is disrupted, right? That's why we simply call it Liver Failure. It means that your liver can no longer function well enough to meet your body's needs.

Will this happen all at once? Or will it happen gradually?

Liver failure doesn't happen all at once. It's a process. It can happen quickly or slowly. Accordingly, we're talking about two main types.

• Acute Liver Failure: This is something that happens very quickly, over a few days or weeks. It usually happens when the liver is overwhelmed by something like severe poisoning. Sometimes it can also be caused by a severe viral infection. This is a serious condition that requires emergency medical treatment .
• Chronic Liver Failure: This is the most common type. It happens slowly, gradually, over months, sometimes years. It is caused by damage to the liver over a long period of time. Eventually, the damage becomes irreversible.

The journey to liver failure: 4 main stages

Chronic liver disease progresses through several stages leading to liver failure. It's like climbing a ladder. But remember, these stages are not strictly separate from each other. A person in one stage may also have symptoms of another stage.

What are the signs that the liver is in danger?

The symptoms of liver failure can vary depending on the severity of the disease and the complications that have occurred. Some symptoms appear first, while others appear after a while.

Common features that come first

These can also be seen in other diseases, so you may not be paying much attention to them.

• Stomach pain (especially in the upper, right side)
• Extreme fatigue and weakness
• Nausea, vomiting, and loss of appetite

Liver-specific warning signs

After the above symptoms, more specific symptoms of liver disease may appear. These indicate that toxins that the liver cannot filter out are accumulating in the blood.

• Jaundice: Yellowing of the whites of the eyes and skin.
• Changes in brain function (Hepatic Encephalopathy): Confusion, forgetfulness, drowsiness.
• Pruritus: Persistent itching of the skin without causing any damage.
• Dark urine and pale stools.

Other symptoms that may be seen in chronic liver failure

These may emerge gradually.

• Bleeding from even a minor injury and bruising easily.
• The appearance of spider-like blood vessels or small red dots on the skin.
• The appearance of small, yellow fatty lumps on the skin or eyelids.
• Digestive problems, especially with fatty foods.
• Weight loss and muscle wasting.
• A strange odor from the breath.

Symptoms in a serious case

These indicate that the situation is getting worse.

• Abdominal swelling (Ascites): Due to fluid buildup in the abdomen.
• Edema: Swelling of the ankles, feet, hands, or face, as if filled with water.
• Vomiting blood or vomit that looks like coffee grounds.
• Muscle control problems (tremors, twitching).
• Decreased urine output.
• Difficulty breathing.

Why is this happening? What are the reasons?

The causes of liver failure vary depending on whether it occurs suddenly (acute) or over time (chronic).

Causes of sudden liver failure (Acute Liver Failure)

This usually happens to someone who has never had any liver disease before. It is caused by something that suddenly causes severe damage to the liver.

• Viral infections: Viruses like Hepatitis A, B, D, and E.
• Drug Overdoses: Paracetamol overdose is the main cause of this. Also, taking too much of some painkillers (NSAIDs) and antibiotics is also harmful.
• Pregnancy complications: Some serious pregnancy complications occur very rarely.
• Poisons: Eating an unknown type of mushroom . If you suspect that you have ingested a poison, go to a hospital's Emergency Treatment Unit (ETU) immediately. If necessary, you can also call the National Poison Information Center at the Colombo National Hospital for advice.
• Other causes: Things like cancer, septic shock, or heatstroke.

Causes of chronic liver failure

This is a result of cirrhosis. These are the main causes of cirrhosis.

• Chronic viral infections: Hepatitis B and C viral infections persist for a long time.
• Excessive alcohol consumption: Excessive alcohol consumption over a long period of time can severely damage the liver.
• Fatty Liver Disease: Conditions such as obesity, diabetes, and high cholesterol can cause fat to accumulate in the liver, which can eventually progress to cirrhosis.
• Autoimmune Disease: Diseases in which the body's own immune system attacks the liver.
• Hereditary diseases: Some genetic diseases can also cause liver damage.

How does a doctor find out if this is the case?

If you have symptoms of liver disease, a doctor will order several tests to confirm the condition.

• Blood tests: Liver function tests can check how well the liver is working.
• Imaging tests: An ultrasound or MRI scan can check for swelling, scarring, or fluid in the liver.
• Liver Biopsy: This involves taking a small piece of tissue from the liver using a very small needle. This can confirm cirrhosis and find the cause of the disease.

Is there any treatment? What is being done?

Treatment depends on the extent of liver damage and the cause of the disease. There are three main goals:

1. Managing complications that have arisen.

2. Treating the underlying cause of the disease.

3. Liver transplantation, if necessary.

In an emergency, supportive care is provided in a hospital. This includes IV saline, nutrition, antibiotics for infections, and blood transfusions if necessary.

It is also very important to treat the cause of the disease. For example, for paracetamol poisoning, there is a specific antidote. If it is due to alcohol, alcohol should be stopped completely. If it is a viral infection, appropriate medications are given.

Things we can do to protect the liver

There are many things we can do to prevent liver failure, especially the chronic condition.

• Control your alcohol consumption: If possible, stop completely. If not, drink only in very limited quantities.
• Eat a healthy diet: Reduce foods high in oil, sugar, and salt. Eat more vegetables, fruits, and greens.
• Maintain a healthy weight: Controlling your body weight can help prevent fat from accumulating in your liver. Get regular exercise.
• Use medications with caution: Avoid taking unnecessary medications, such as painkillers, without medical advice. Take any medication only in the prescribed dosage.
• Get vaccinated against hepatitis: There are vaccines to protect against hepatitis A and B.
• Be careful: Do not share razors, needles, etc. These can spread blood-borne diseases (Hepatitis B, C).

Liver Failure, Liver Disease, Cirrhosis, Hepatitis, Fatty Liver, Jaundice, Liver Toxicity, Liver Transplant