Liver Failure: Causes, Symptoms, Diagnosis, Treatment, and Prevention
When the liver, an essential organ that carries out several bodily activities, ceases to operate correctly, it can lead to a dangerous illness called liver failure. Acute (sudden) or chronic (gradual) liver failure can result in potentially fatal side effects such bleeding, infection, coma, and death. Numerous factors, including poisons, infections, genetic disorders, and cancer, can result in liver failure. Liver failure may be curable with medication or necessitate a liver transplant, depending on the underlying cause and stage of the illness.
Causes
Liver failure can be caused by many different factors, such as the following:
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Viral hepatitis, such as hepatitis A, B, C, D, or E, which are infections that inflame and damage the liver
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Alcohol abuse, which can cause cirrhosis (scarring) of the liver and impair its function
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Drug overdose, especially of acetaminophen (Tylenol), which can cause severe liver damage or death if taken in large doses
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Medications, such as antibiotics, antifungal drugs, anticonvulsants, or statins, which can cause liver toxicity or allergic reactions
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Herbal supplements, such as kava, comfrey, or pennyroyal, which can contain harmful substances or interact with other drugs and damage the liver
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Toxins, such as mushrooms, industrial chemicals, or environmental pollutants, which can poison the liver and cause necrosis (cell death)
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Autoimmune diseases, such as autoimmune hepatitis or primary biliary cholangitis, which are conditions where the immune system attacks the liver and causes inflammation and scarring
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Metabolic diseases, such as Wilson’s disease, hemochromatosis, or alpha-1 antitrypsin deficiency, which are genetic disorders that affect the metabolism of copper, iron, or protein and cause accumulation of these substances in the liver
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Cancer, such as liver cancer or bile duct cancer, which can grow and spread in the liver and impair its function
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Shock, sepsis, or ischemia, which are conditions that cause a sudden drop in blood pressure, blood flow, or oxygen supply to the liver and result in tissue damage or death
Symptoms
The symptoms of liver failure may vary depending on the cause, type, and stage of the disease. Some common symptoms include:
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Jaundice, which is a yellowing of the skin and eyes due to the buildup of bilirubin, a waste product of red blood cells, in the blood
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Ascites, which is a swelling of the abdomen due to the accumulation of fluid in the abdominal cavity
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Varices, which are enlarged veins in the esophagus or stomach that can rupture and bleed due to the increased pressure in the portal vein, which carries blood from the digestive organs to the liver
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Hepatic encephalopathy, which is a mental confusion, mood changes, or coma due to the accumulation of toxins, such as ammonia, in the brain
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Coagulopathy, which is a bleeding disorder due to the reduced production of clotting factors by the liver
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Edema, which is a swelling of the legs and ankles due to the retention of fluid in the tissues
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Pruritus, which is an itching of the skin due to the accumulation of bile salts in the skin
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Fatigue, weakness, loss of appetite, nausea, vomiting, or weight loss
Diagnosis
A patient's medical history, physical examination, blood tests, and imaging studies can all be used to detect liver failure. The patient's symptoms, risk factors, medicines, and family history will all be questioned by the doctor. Additionally, the physician will look for symptoms of liver injury including as encephalopathy, varices, ascites, or jaundice. The results of the blood tests will indicate if autoimmune antibodies or viral hepatitis are present, as well as the amounts of liver enzymes, bilirubin, albumin, clotting factors, and ammonia. The size, shape, and structure of the liver as well as any tumors, cysts, or abscesses will be visible on imaging tests like ultrasound, CT, or MRI. To confirm the diagnosis and identify the source and degree of liver damage, a liver biopsy—a technique that entails extracting a tiny sample of liver tissue and analyzing it under a microscope—may also be performed.
Treatment
The treatment of liver failure depends on the cause, type, and stage of the disease, as well as the patient’s condition and preferences. The treatment options may include:
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Medications, such as antibiotics, antivirals, steroids, or diuretics, to treat infections, inflammation, fluid retention, or hepatic encephalopathy
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Intravenous fluids, blood transfusions, or plasma exchange, to correct dehydration, bleeding, or electrolyte imbalance
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Liver dialysis, which is a machine that filters the blood and removes toxins, similar to kidney dialysis
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Liver transplant, which is a surgery that replaces the damaged liver with a healthy one from a donor
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Palliative care, which is a type of care that focuses on relieving the symptoms and improving the quality of life of patients with terminal illnesses
Prevention
Some cases of liver failure may be prevented or delayed by taking some preventive measures, such as the following:
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Avoiding alcohol abuse or limiting the intake of alcohol to moderate amounts
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Avoiding or limiting the use of medications that can harm the liver, such as acetaminophen, and following the doctor’s instructions and dosages
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Avoiding or limiting the exposure to toxins that can damage the liver, such as mushrooms, chemicals, or pollutants
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Getting vaccinated against viral hepatitis, especially hepatitis A and B, which are preventable with vaccines
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Practicing safe sex and avoiding sharing needles or other personal items that may carry blood-borne infections, such as hepatitis B, C, or D
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Eating a healthy and balanced diet that is low in fat, sugar, and salt, and high in fiber, fruits, and vegetables
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Maintaining a healthy weight and exercising regularly to prevent obesity, diabetes, and nonalcoholic fatty liver disease
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Seeking medical attention promptly if there are any signs or symptoms of liver disease or failure
