What happens when the liver stops working? (Liver Failure) | Nirogi Lanka

We all know that our bodies have certain organs that are absolutely essential for survival. Your liver is exactly one of them. You can think of it as a massive, high-functioning factory within your body, performing hundreds of vital tasks every single day. So, imagine what would happen if this factory suddenly—or even gradually—stopped working. This is what we call liver failure. In simple terms, it means your liver is no longer capable of performing the tasks necessary to keep your body running properly. This is a very serious medical condition, so let’s take a closer look at what it involves.

What is liver failure?

Liver failure is rarely an overnight event; it is usually a progressive process. In some cases, it can occur rapidly, over a matter of days or weeks. In other cases, it develops slowly over months or even years. As your liver’s function gradually declines, you will begin to notice corresponding symptoms.

Acute Liver Failure

This is what we refer to as acute liver failure. It happens when the liver is subjected to sudden, overwhelming damage or stress, such as severe poisoning or a sudden, aggressive viral infection. Because the liver loses its ability to function almost instantly, symptoms appear rapidly. This is a critical medical emergency that requires immediate professional care at the nearest hospital or emergency department (call 911).

Chronic Liver Failure

This is the more common form. Chronic liver failure occurs when the liver has sustained damage over a long period, eventually reaching a point where that damage is irreversible. This typically follows significant scarring of the liver, a condition known as cirrhosis. These scar tissues prevent the liver from performing its vital functions effectively.

What are the stages of liver failure? (Specifically in chronic cases)

Most medical experts view chronic liver failure as the final stage of long-term liver disease. Liver disease often progresses through several stages, though keep in mind these stages can sometimes overlap. For example, someone with liver scarring (fibrosis) might simultaneously have active inflammation (hepatitis).

What are the symptoms of liver failure?

Symptoms will vary depending on the severity of the failure and the specific complications that have developed.

Early symptoms:

These may appear in both chronic and acute liver failure:

• Abdominal pain (particularly in the upper right side)
• Severe fatigue and a general sense of feeling unwell (malaise)
• Nausea, vomiting, and loss of appetite

Symptoms specific to liver disease:

As the liver struggles, bile and various toxins begin to build up in the blood, leading to specific signs:

• Jaundice (yellowing of the skin and the whites of the eyes)
• Hepatic Encephalopathy (cognitive changes such as confusion, forgetfulness, or behavioral shifts)
• Skin itching (Pruritus) (without a visible rash)
• Dark-colored urine and/or pale-colored stools

Other symptoms of chronic liver failure:

These signs can develop more subtly:

• Coagulopathy: Easy bruising and bleeding.
• Visible small, spider-like blood vessels on the skin.
• Small, yellow fatty deposits on the skin or eyelids.
• Digestive issues, particularly with fatty foods.
• Unexplained weight loss and muscle wasting.
• Musty-smelling breath.

Severe symptoms:

The following are signs of serious medical complications:

• Ascites (Fluid buildup causing abdominal swelling)
• Edema (Fluid retention leading to swelling in your ankles, legs, arms, or face)
• Vomiting blood or material that looks like coffee grounds
• Muscle control issues (such as tremors or twitching)
• Decreased urine output
• Difficulty breathing

Do symptoms differ by gender?

Yes, liver failure can impact your sex hormones. Because your liver processes hormones like estrogen and testosterone, its failure can lead to imbalances, causing different symptoms for men and women.

• In women, menstrual cycles may become irregular or stop entirely.
• In men, you may experience testicular shrinkage and breast tissue enlargement.

How does liver failure feel?

When your liver fails, toxins build up in your bloodstream, making you feel profoundly unwell. Because your liver can no longer effectively filter these toxins, you may experience nausea, extreme fatigue, and weakness. Furthermore, these toxins can impact your brain (hepatic encephalopathy), leading to confusion, irritability, anxiety, excessive sleepiness, or muscle control problems.

What causes liver failure?

While acute and chronic liver failure progress differently, both result from excessive stress on the liver. Depending on the severity, certain toxins or diseases can cause damage either suddenly or gradually over a long period.

What are the complications of liver failure?

Because your liver performs many vital functions, its failure impacts your entire body. For example:

• General weakness, fatigue, mental fog, and decreased mental alertness.
• Toxins affecting your brain, nervous system, and muscle function.
• Digestive issues, poor nutrient absorption (malabsorption), and malnutrition.
• Reduced blood clotting ability, leading to easy bruising and bleeding.
• A weakened immune system, increasing susceptibility to infections.

It is important to remember that Portal Hypertension (high blood pressure in the liver's portal vein) caused by cirrhosis is a leading reason for hospitalizations and mortality in patients with chronic liver failure. This is often the underlying cause of complications like ascites and internal bleeding.

How is liver failure diagnosed?

If you show symptoms of liver failure, your doctor will perform tests to confirm the diagnosis, which may include:

• Blood Tests: Liver Function Tests (LFTs) measure various proteins and enzymes to assess your liver's health. Blood tests also help identify the cause of failure and detect complications like anemia or clotting disorders.
• Imaging Tests: Ultrasound scans or MRIs can detect swelling, scarring, or fluid accumulation (ascites) in the abdomen. Elastography is a specialized imaging technique used during an ultrasound or MRI to measure the stiffness or amount of scarring (fibrosis) in your liver.
• Liver Biopsy: A small tissue sample is taken, often using a hollow needle, for laboratory analysis. A biopsy is essential for confirming cirrhosis and determining the root cause of the liver damage.

How is liver failure treated?

Nirogi Lanka doctors prioritize the following strategies in treatment:

• Managing complications.
• Treating the underlying cause whenever possible.
• Assessing the need for a Liver Transplant.

Supportive care to stabilize your condition may include:

• Intravenous (IV) fluids
• IV nutrition
• Monitoring and managing blood glucose levels
• Antibiotics or antivirals
• Plasma or blood transfusions
• Oxygen therapy or mechanical ventilation
• Vasopressor medications to support blood pressure
• Medications or interventions to control internal bleeding
• Dialysis if your kidneys are also failing

Treatments for specific underlying causes may include:

• Treatment for overdose: While many toxicities do not have a specific antidote, Acetaminophen toxicity can be treated with Acetylcysteine. Other emergency interventions for poisoning may include gastric lavage (stomach pumping) or activated charcoal.
• Medications for chronic conditions: If your failure is due to chronic disease, medications can help slow the damage. For example, corticosteroids and immunosuppressants are used to manage autoimmune-related liver issues.

Your medical team will closely monitor your progress. If they determine that your condition is failing to recover and your health is declining, they may place you on a priority list for a liver transplant.

How can you prevent liver failure?

Acute liver failure is a rare but serious condition. Even a single unfortunate event can trigger it. You can protect yourself by following these simple preventive measures:

• Protect yourself from toxins: When handling hazardous chemicals such as pesticides, fungicides, cleaning agents, paints, or aerosol sprays, always use protective gloves and face masks.
• Avoid exposure to blood: Never share personal items that may carry blood, such as needles, razors, or toothbrushes. Avoid direct contact with others' open wounds.
• Prioritize food safety: Avoid eating wild mushrooms unless you are an expert in identifying them. When traveling abroad, be cautious with raw food. Always wash your hands thoroughly before preparing meals.
• Get vaccinated against Hepatitis: Vaccines are available for Hepatitis A and Hepatitis B. Discuss these with your healthcare provider.
• Use medications as prescribed: Never exceed the recommended dosage, even for over-the-counter pain relievers. Avoid mixing alcohol with medications.
• Stay in close contact with your doctor during pregnancy: While complications leading to liver failure are rare, do not hesitate to seek medical advice if you experience any unusual symptoms.

Preventing chronic liver failure largely depends on your lifestyle choices. Chronic liver disease progresses over a long period. If you are diagnosed with liver disease, early lifestyle changes can slow down, halt, or sometimes even reverse the process.

• Schedule regular check-ups: Many people are unaware they have liver disease until symptoms appear. Regular screenings can help detect issues early.
• Manage your metabolic health: High blood sugar, elevated cholesterol, and a high Body Mass Index (BMI) put significant pressure on the liver. A healthy diet and regular exercise are your best defenses.
• Be cautious with over-the-counter drugs: Excessive use of pain relievers like NSAIDs or acetaminophen can damage the liver. Consult your doctor if you suffer from chronic pain.
• Reduce or eliminate alcohol and tobacco: Both are toxic to the liver. If you have any form of liver disease, total abstinence is the healthiest choice.

Can you recover from liver failure?

Recovery from acute liver failure is possible, though outcomes vary based on individual circumstances. Chronic liver failure cannot be fully reversed, but because it progresses slowly, medical intervention can significantly slow its advancement. Generally, if a specific treatment exists for your condition and you seek care promptly, the chances of improvement are much higher.

How long can someone live with liver failure?

Acute liver failure can be life-threatening within days, weeks, or months. Chronic liver failure may persist for months to years. The progression depends on several factors:

• The severity of the underlying cause of liver damage.
• The effectiveness of treatments in slowing or reversing the damage.
• The extent of the existing liver damage.
• Your overall health status and access to medical resources.

What should I do if I have liver failure?

Acute liver failure is a medical emergency. If you suspect you are experiencing this, seek help at the nearest emergency room immediately. While chronic liver failure is not always an immediate emergency, it is a serious long-term condition. If you have been diagnosed, you can support your liver through a healthy diet and disciplined lifestyle.

• Minimize substance use: Avoid alcohol and tobacco, take only prescribed medications, and consult your doctor before using any herbs or supplements.
• Maintain a balanced diet: High blood sugar and fat levels stress the liver. If you suffer from nutritional deficiencies due to liver dysfunction, consult a nutritionist to create a tailored long-term plan.
• Protect your immunity: Liver failure weakens your immune system, making you more susceptible to viral and bacterial infections. Protect yourself during flu seasons and consult your doctor about recommended vaccinations.