A health condition in which the liver no longer functions properly, or fails to perform essential functions, is called liver failure. This condition may occur suddenly or gradually, and it causes symptoms that may affect different major body systems. Moreover, liver failure can be fatal without a liver transplant.
In normal circumstances, the liver is a vital organ that performs hundreds of bodily functions. When it no longer performs its functions, or it does not meet the body’s needs, liver failure occurs. Healthcare professionals have divided this condition into 2 types based on how they occur. For example:
Acute Liver Failure
This type of the condition happens quickly, and it is often caused by a large toxic load (such as poisoning). However, it may also happen due to a viral infection or other causes. Most of the time, the acute form of this condition is a medical emergency that requires immediate medical attention.
Chronic Liver Failure
This is the end-stage of chronic (long-term) liver disease, and it occurs when something causes damage to your liver for a long time. In this case, the damage cannot be reversed, which may lead to cirrhosis (severe scarring of the liver tissues). Therefore, they prevent the liver from functioning properly.
Liver Failure Stages
Almost all medical authorities define chronic liver failure as the end stage of liver disease. However, liver disease often progresses through several stages, which are not discreet each other. For instance, a person with fibrosis may still have inflammation (hepatitis). Check the stages below:
- Hepatitis – This condition occurs when there is inflammation in the liver. While chronic liver disease causes chronic hepatitis, the process of long-term damage starts. Inflammation also causes the healing process in the liver, but constant inflammation causes scarring (fibrosis).
- Fibrosis – This is a form of scarring in the tissues that is caused by inflammation. Moreover, fibrosis is a progressive condition in which the liver gradually stiffens. Sometimes, this condition can be reversed. Afterward, liver cells begin to regenerate.
- Cirrhosis – This is a serious and even life-threatening condition that most of the time cannot be reversed. It happens when the amount of scar tissue is too much.
- Liver failure – Cirrhosis negatively affects the ability of the liver to work. When it fails, you may experience complications throughout the body. Most people with chronic liver failure require a liver transplant. Otherwise, it may lead to death.
What Are The Symptoms of Liver Failure?
Usually, people with liver failure experience different symptoms based on the severity of the condition, existing health problems, age, and sex. Check some symptoms below:
- Abdominal pain
- Nausea
- Vomiting
- Appetite changes
- Malaise
- Extreme tiredness (fatigue)
- Altered mental status (hepatic encephalopathy)
- Pruritus
- Dark-colored urine
- Yellowing of the skin and eyes (also known as jaundice)
However, chronic liver failure may also cause additional symptoms in some people. These include:
- Digestive issues
- Coagulopathy (easy bleeding or bruising)
- Visible blood vessels that look similar to spiders (such as a rash of tiny dots)
- Yellow and small bumps of fat deposits on the skin or eyelids
- Abdominal swelling with fluid (ascites)
- Bloody vomit
- Edema (fluid buildup in the ankles, feet, hands, or face)
- Motor dysfunction (tremors, twitching, and others)
- Low urine output
- Dyspnea (shortness of breath)
If you experience any of the previous symptoms, immediately visit a doctor for a diagnosis and treatment. Otherwise, it may lead to serious complications. In addition, this condition may also cause hormonal problems. For example, an imbalance of Estrogen and Testosterone, which may lead to different symptoms in men and women. Some of them include irregular or a lack of menstrual cycle, testicle shrinkage, and enlarged breast tissue in men.
What Does Liver Failure Feel Like?
When this condition occurs, toxins begin to flood the bloodstream, which often feels terrible. The inability of the liver to filter toxins from the blood may cause nausea, tiredness, and weakness. In rare cases, these toxins may enter the brain and cause confusion, irritability, anxiety, drowsiness, and motor dysfunction.
Causes
There are a lot of causes of liver failure. Sometimes, the same toxins and disorders can negatively affect your liver all at once or gradually over time. Check some causes of liver failure below that occur suddenly or gradually:
Acute Liver Failure Causes
Usually, this form of liver failure occurs in people with no previous history of liver disease. Mostly, it happens when something damages the liver (such as an overwhelming toxic load). Check for other causes of acute liver failure below:
- Viral infections – These include hepatitis A, B, C, and E, Epstein-Barr virus, cytomegalovirus (CMV), varicella zoster virus, and herpes simplex virus.
- Drug overdoses – Acetaminophen overdose is one of the most common causes of acute liver failure in the United States. However, there are some NSAIDs (nonsteroidal anti-inflammatory drugs) and antibiotics that may also cause acute liver failure.
- Pregnancy complications – In rare cases, acute fatty liver of pregnancy, preeclampsia, and HELLP syndrome may cause acute liver failure.
- Genetic disorders – Some inherited liver disorders may also cause this form of liver failure, especially if they are left untreated. These include autoimmune hepatitis, Wilson disease, and others.
- Miscellaneous causes – For example, metastatic cancer, septic shock, mushroom poisoning, and heatstroke.
Chronic Liver Failure Causes
Most of the time, this form of liver failure occurs due to cirrhosis. This condition causes scarring of the liver tissue, which prevents it from functioning properly. However, cirrhosis can be caused by multiple health conditions and factors. Examples include:
- Long-term alcohol use – People who drink alcoholic drinks in large amounts (alcohol-induced hepatitis) may also develop cirrhosis and eventually liver failure.
- Chronic infections – Viral infections that become chronic can cause chronic hepatitis (including hepatitis B and C).
- Toxic hepatitis – Continuous exposure to toxins (including industrial chemicals and drugs) may cause chronic hepatitis.
- Metabolic dysfunction-associated steatohepatitis
- Bile duct obstruction – Certain congenital (present at birth) conditions that obstruct the bile ducts may cause a buildup of bile and cause damage to the liver. These include atresia and cystic fibrosis. However, there are some non-congenital causes, including biliary stricture and gallstones.
- Autoimmune disorders – For example, primary biliary and sclerosing cholangitis.
- Inherited metabolic disorders – Some of them include glycogen storage disease, Wilson disease, hemochromatosis, and Gaucher disease. These conditions may cause toxic substances to build up in the blood and cause chronic liver damage.
- Cardiovascular disorders – This group of health conditions negatively affects blood flow to and from the liver. For example, arterial diseases, Budd-Chiari syndrome, right-sided heart failure, and others.
What Are The Potential Complications of Liver Failure?
People with liver diseases (such as cirrhosis) or liver failure may experience some complications. Check some examples below:
- General toxicity – This complication may cause fogginess or confusion, tiredness, and other symptoms.
- Digestive problems (including malnutrition and malabsorption)
- Decreased blood clotting that may lead to easy bruising and bleeding
- Weakened immune system caused by frequent infections
- Problems with the brain, nerves, and motor functions
Most people with liver failure also have complications of cirrhosis. Some of them include:
- Enlarged or overactive spleen
- Chronic kidney failure
- Hepatorenal or hepatopulmonary syndrome
- Reduced oxygen levels in the blood
- Portal hypertension (high blood pressure)
- Edema and ascites, which significantly increase the risk of peritonitis
- Gastrointestinal varices or acute gastrointestinal bleeding
It is very important to call 911 or go to the nearest emergency room (ER) if any of the previous complications occur.
Is There a Way to Prevent Liver Failure?
Healthcare professionals may recommend some options that will help prevent acute liver failure triggers. These include:
- Get protection against toxins – You should wear gloves and a mask when getting in contact with toxic chemicals (including insecticides, fungicides, cleaning products, paint, and others)
- Avoid blood exposure – It is not allowed to share needles or personal items because you may be exposed to blood. You should also not touch other people’s open wounds.
- Food safety – Avoid eating wild mushrooms that you cannot identify because they can cause poisoning.
- Vaccines – Doctors may also recommend getting vaccines against hepatitis A and hepatitis B.
- Administer medicines exactly as recommended by your doctor – It is very important to follow the doctor’s instructions. Otherwise, it may lead to serious outcomes.
Preventive measures for chronic liver failure are more about general lifestyle choices. For example:
- Get regular checkups
- Take care of metabolic health
- Do not administer too many over-the-counter (OTC) medicines
- Limit or avoid alcoholic drinks
- Stop smoking – If you have problems with smoking cessation, discuss it with your healthcare professional.
Diagnosis
When doctors suspect liver failure, they will perform the following tests and procedures to confirm or rule out this condition. Check some of them below:
- Blood tests – These tests are done to measure different products in the blood, which often help doctors determine liver function. In some cases, blood tests can help detect the cause of liver failure and some of its complications (such as anemia and reduced blood clotting).
- Imaging tests – Doctors usually perform these tests to get detailed images of different structures and organs in the body. In this case, they will perform an elastography. This is a type of imaging test that uses ultrasound or MRI (magnetic resonance imaging) to determine the degree of fibrosis or stiffness in the liver.
- Liver biopsy – During this procedure, physicians will remove a sample of the liver for testing. They will check for cirrhosis.
Treatment
Healthcare professionals usually recommend options to manage complications, treatment for the liver disease cause, and liver transplantation (when necessary) for people with liver failure. They may also recommend some options to relieve the symptoms and prevent worsening of the condition. These include:
- IV (intravenous) fluids and nutrition
- Blood glucose monitoring and supplementation
- Plasma or blood transfusions
- Antibiotics or antivirals
- Oxygen therapy or mechanical ventilation
- Vasopressor medicines
- Dialysis for kidney failure
Check below also some treatments often recommended by doctors to treat the cause of liver disease:
- Options for toxic overdose – Doctors often prescribe Acetylcysteine (used to treat Acetaminophen poisoning), laxatives, activated charcoal, and others.
- Medicines for chronic (long-term) health conditions – Examples include corticosteroids, immunosuppressants, and other specific medicines.
In more severe cases, physicians recommend an organ transplant. For more details, discuss it with your doctor.
Frequently Asked Questions
Can liver failure be reversed?
It depends on the type and cause. Acute liver failure may be reversible if treated promptly, and the underlying cause is addressed. Chronic liver failure, especially when caused by cirrhosis, is usually irreversible, although treatment can help slow disease progression and manage complications.
What is the difference between liver disease and liver failure?
Liver disease refers to any condition that damages the liver. Liver failure is an advanced stage in which the liver can no longer perform its essential functions properly. Not all people with liver disease develop liver failure.
Is liver failure painful?
Liver failure itself is not always painful, but some people experience discomfort or pain in the upper right abdomen due to liver inflammation or enlargement. Other symptoms, such as fatigue, nausea, confusion, and swelling, are often more noticeable than pain.
Who is at the highest risk of developing liver failure?
People with chronic hepatitis B or C, heavy alcohol use, metabolic dysfunction-associated steatotic liver disease (MASLD), autoimmune liver diseases, inherited liver disorders, obesity, diabetes, and those who misuse certain medications are at greater risk of developing liver failure.
Can Acetaminophen cause liver failure?
Taking more than the recommended dose of Acetaminophen is one of the most common causes of acute liver failure. Always follow dosage instructions carefully and avoid combining multiple medications that contain Acetaminophen.
What foods should people with liver failure avoid?
People with liver failure should generally avoid alcohol, raw or undercooked seafood, highly processed foods, excessive salt, and foods high in saturated fats. A healthcare provider or dietitian can recommend a nutrition plan based on the individual’s condition.
Can someone live with liver failure without a transplant?
Some people with mild or treatable acute liver failure recover without a transplant. However, many people with advanced chronic liver failure eventually require a liver transplant to survive. The need for transplantation depends on the severity of liver damage and the person’s overall health.
How long does it take for chronic liver failure to develop?
Chronic liver failure usually develops over many years as ongoing liver damage leads to fibrosis and eventually cirrhosis. The rate of progression varies depending on the underlying cause, lifestyle factors, and whether treatment is received.
What are the warning signs that liver failure is becoming an emergency?
Seek immediate medical attention if you experience severe confusion, extreme drowsiness, vomiting blood, black or bloody stools, severe jaundice, difficulty breathing, seizures, or loss of consciousness. These symptoms may indicate life-threatening complications that require emergency treatment.
Can liver failure be prevented?
Many cases can be prevented by limiting or avoiding alcohol, maintaining a healthy weight, getting vaccinated against hepatitis A and B when appropriate, practicing safe behaviors to reduce the risk of viral hepatitis, avoiding toxic substances, and taking medications only as directed by a healthcare professional. Ask your healthcare professional if you have additional questions.
