Liver failure is characterized by loss of liver function that renders the organ unable to perform its metabolic and synthetic duties. The chronic form of the condition may develop slowly over many years, while the rapid loss of liver function — acute liver failure — can occur over a few weeks. The treatment options and efficacy for either type depend on when the condition is detected. Early diagnosis can sometimes reverse the effects, but some people require medical procedures including transplants, for recovery.

Nausea

One of the early signs of liver failure is recurring nausea, especially following meals. This symptom occurs because the liver plays a significant role in digestion, especially the digestion of fats. When the liver falters in its metabolic duties due to the onset of liver failure, indigestion produces nausea. Usually, in the early stages, nausea does not lead to actual vomiting spells but as liver failure progresses, vomiting may occur. In the later stages, fluid can build up in the abdominal cavity, a condition known as ascites.

Appetite Loss

Loss of appetite is an early symptom of liver failure. With the body’s metabolic function compromised, individuals experience a decrease in the desire to eat, and meals may become smaller and smaller over time. Severe or prolonged loss of appetite results in a shortage of nutrients, which can lead to complications in and of itself, and should therefore not be ignored.

Diarrhea

Liver failure also makes people more prone to diarrhea. Metabolic functions are compromised due to decreased liver functionality, and resulting indigestion can cause bowel distress in addition to nausea and lack of appetite. When diarrhea occurs repeatedly, it can lead to dehydration and nutrient deficiencies.

Jaundice

The onset of liver failure causes signs of jaundice — the skin and whites of the eyes may be tinged with yellow. The stool of an individual with liver failure may also become pale in color and the urine darker. This occurs due to excess bilirubin in the system; a healthy liver will filter this substance and help remove it from the body, but when the organ is failing, the quantity of bilirubin in the body increases.

Swollen Abdomen

There are several possible reasons a person’s abdomen may swell during liver failure. In the later stages, loss of liver functionality leads to a build-up of fluid in either the liver, spleen, or abdominal region. This fluid retention manifests outwardly as swelling, which may or may not be externally apparent. A physical examination usually leads to the discovery of the abdominal swelling.

Bleeding Easily

People with liver disease may bleed more frequently and excessively. This is because the liver cannot produce enough clotting factors to control bleeding promptly. As a consequence, the smallest lesion may bleed profusely, and bleeding noses or gums are more common and frequent. In rare cases, even internal bleeding in regions like the gastrointestinal tract may occur. Bleeding excessively is most common in advanced liver failure.

Mental Confusion

In cases where a liver failure causes hepatic encephalopathy, people may experience problems with mental function and activity. Psychological confusion develops due to metabolic abnormalities. A person may experience a decreased ability to perform mental tasks, engage in abstract thinking, and maintain attention. In some cases, speech may become incomprehensible, as well. This is due to the build-up of toxic chemicals in the brain. The liver is the body’s primary detoxifying organ, and when it can’t do its job, toxins build up in the body, including the brain.

Sleepiness

Typically, sleepiness is an early sign of hepatic encephalopathy provoked by the onset of liver failure. Excessive fatigue is more common in people with advanced or chronic liver failure. However, extreme drowsiness in combination with other symptoms suggestive of liver disease could indicate acute liver failure.

Coma

In very advanced stages of both chronic and acute liver failure, patients can become comatose. Coma occurs when liver damage impacts brain function. A lot of people with advanced liver disease exhibit irrational and unusual behavior such as fits of rage, extreme mental incomprehension, marked disorientation, and paranoia before finally falling into a coma. This typically happens in the late stages of liver failure as toxins build up in the brain.

Malaise

People with liver failure often complain of fatigue, weakness, and general feelings of ill-health or malaise. Failed metabolic function produces this symptom when it affects both energy levels and brain function. Medication and treatment may help relieve malaise, though, in advanced stages of chronic or acute liver failure, fatigue and feelings of illness are usually persistent.