10 Signs of Liver Failure

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By shirley
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Reviewed: dr. vanta
Article Sources Article Sources
  • 1. 'Liver Failure: Causes, Symptoms, Diagnosis, Treatments & Prevention.' _Cleveland Clinic_, my.clevelandclinic.org/health/diseases/17819-liver-failure.
  • 2. 'Articles.' _Cedars-Sinai_, www.cedars-sinai.org/health-library/diseases-and-conditions/a/acute-liver-failure.html.
  • 3. 'The Progression of Liver Disease.' _Liver Foundation_, February 1, 2021, liverfoundation.org/for-patients/about-the-liver/the-progression-of-liver-disease/.
  • 4. 'Acute Liver Failure.' 21 Oct. 2020, _Mayo Clinic_, October 21, 2020, www.mayoclinic.org/diseases-conditions/acute-liver-failure/symptoms-causes/syc-20352863.
  • 5. 'Acute Liver Failure.' _Cincinnati Children's Hospital_, www.cincinnatichildrens.org/health/a/acute-liver-failure.
  • 6. Liver Failure By Danielle Tholey, et al. 'Liver Failure - Liver and Gallbladder Disorders,' _Merckmanuals_, www.merckmanuals.com/home/liver-and-gallbladder-disorders/manifestations-of-liver-disease/liver-failure.
  • 7. 'Malaise: MedlinePlus Medical Encyclopedia,' medlineplus.gov/ency/article/003089.htm.
  • 8. 'Adult Jaundice: Symptoms, Causes, Diagnosis, Treatment & Prevention.' _Cleveland Clinic_, my.clevelandclinic.org/health/diseases/15367-adult-jaundice.
  • 9. Portal Hypertension By Danielle Tholey, et al. 'Portal Hypertension - Liver and Gallbladder Disorders.' _Merck Manuals_, www.merckmanuals.com/home/liver-and-gallbladder-disorders/manifestations-of-liver-disease/portal-hypertension.
  • 10. 'Ascites.' _Hopkins Medicine_, www.hopkinsmedicine.org/health/conditions-and-diseases/ascites.
  • 11. Lam, Katrina, and Vinicio de Jesus Perez. 'Pulmonary Vascular Complications of Liver Disease.' 2018, www.thoracic.org/patients/patient-resources/resources/liver-disease.pdf.
  • 12. 'URGENT: COVID-19 Vaccine News.' www.piedmont.org/transplant/conditions-diseases/transplant-acute-liver-failure.
Medical Expert Medical Expert

The liver removes harmful substances from the body, processes fat, stores sugar and manufactures bile to aid digestion. It makes blood proteins that help transport oxygen, aid in blood clotting and support the immune system. Liver failure occurs when the liver can no longer carry out its functions properly.1‘Liver Failure: Causes, Symptoms, Diagnosis, Treatments & Prevention.’ Cleveland Clinic, my.clevelandclinic.org/health/diseases/17819-liver-failure.

Liver failure may occur suddenly due to poisoning, medicine overdose or diseases, such as hepatitis. This is called acute liver failure.2‘Articles.’ Cedars-Sinai, www.cedars-sinai.org/health-library/diseases-and-conditions/a/acute-liver-failure.html. The liver may also lose its functionality over time as a result of viruses, poor nutrition, obesity, genetics and overuse of alcohol.3‘The Progression of Liver Disease.’ Liver Foundation, February 1, 2021, liverfoundation.org/for-patients/about-the-liver/the-progression-of-liver-disease/. Signs of liver failure are similar, regardless of the cause.

1. Digestive Issues

Early signs of liver failure may be similar to those of viral infections or other maladies. Digestive issues are common. These may begin with a loss of appetite and may include nausea, vomiting and diarrhea. As the condition worsens, blood may be present in the stool, and the person may vomit blood.1‘Liver Failure: Causes, Symptoms, Diagnosis, Treatments & Prevention.’ Cleveland Clinic, my.clevelandclinic.org/health/diseases/17819-liver-failure.

Proper evaluation and identification of the cause of these symptoms is critical. With early diagnosis and treatment of liver disease, the liver can repair and regenerate itself. At a certain point, the damage is irreversible and may lead to death.3‘The Progression of Liver Disease.’ Liver Foundation, February 1, 2021, liverfoundation.org/for-patients/about-the-liver/the-progression-of-liver-disease/.

2. Pain in Upper Right Abdomen

Pain in the upper right quadrant is another sign of liver failure. The person may notice tenderness or a feeling of fullness just under the ribs.4‘Acute Liver Failure.’ 21 Oct. 2020, Mayo Clinic, October 21, 2020, www.mayoclinic.org/diseases-conditions/acute-liver-failure/symptoms-causes/syc-20352863.

A baby or a young child who doesn’t have the ability to communicate may exhibit irritability or cry excessively due to the pain, and caregivers may find it difficult to soothe them. An older child may seem angry or have difficulty falling asleep due to abdominal pain.5‘Acute Liver Failure.’ Cincinnati Children’s Hospital, www.cincinnatichildrens.org/health/a/acute-liver-failure.

Liver Failure

3. Fatigue

A symptom of many conditions and diseases, both minor and serious, fatigue is a possible sign of liver failure. Fatigue may be relatively minor at first, but as liver failure progresses, the person may feel overwhelmingly sleepy.1‘Liver Failure: Causes, Symptoms, Diagnosis, Treatments & Prevention.’ Cleveland Clinic, my.clevelandclinic.org/health/diseases/17819-liver-failure.

Extreme fatigue and other symptoms are more likely to occur when a large portion of the liver sustains damage. Physical examinations and tests to check liver enzymes and bilirubin levels help physicians diagnose liver failure.6Liver Failure By Danielle Tholey, et al. ‘Liver Failure - Liver and Gallbladder Disorders,’ Merckmanuals, www.merckmanuals.com/home/liver-and-gallbladder-disorders/manifestations-of-liver-disease/liver-failure.

4. Malaise

People suffering from liver failure may exhibit malaise. They generally do not feel well.4‘Acute Liver Failure.’ 21 Oct. 2020, Mayo Clinic, October 21, 2020, www.mayoclinic.org/diseases-conditions/acute-liver-failure/symptoms-causes/syc-20352863. A person with malaise may lack the energy to perform their normal activities. Malaise may develop over time or occur suddenly.7‘Malaise: MedlinePlus Medical Encyclopedia,’ medlineplus.gov/ency/article/003089.htm.

Malaise is a vague sign that accompanies a range of ailments. A physician takes this sign into consideration, along with other symptoms, to select and perform relevant tests before arriving at a diagnosis.

Liver Failure

5. Jaundice

When the liver doesn’t function properly, it can no longer process bilirubin, a waste product derived from the breakdown of old red blood cells that is normally excreted from the body. As bilirubin accumulates in the blood, jaundice occurs, turning the skin and whites of the eyes yellow.7‘Malaise: MedlinePlus Medical Encyclopedia,’ medlineplus.gov/ency/article/003089.htm.

Yellowing of the skin and eyes usually indicates an issue with the liver, gallbladder or pancreas. It’s a sign that may occur as liver failure advances, and it may be accompanied by itching.1‘Liver Failure: Causes, Symptoms, Diagnosis, Treatments & Prevention.’ Cleveland Clinic, my.clevelandclinic.org/health/diseases/17819-liver-failure.,8‘Adult Jaundice: Symptoms, Causes, Diagnosis, Treatment & Prevention.’ Cleveland Clinic, my.clevelandclinic.org/health/diseases/15367-adult-jaundice.

6. Bruising and Bleeding Easily

As liver failure progresses, the person may bruise and bleed more easily and more frequently. This occurs because the liver is no longer able to produce the proteins needed for proper blood coagulation.6Liver Failure By Danielle Tholey, et al. ‘Liver Failure - Liver and Gallbladder Disorders,’ Merckmanuals, www.merckmanuals.com/home/liver-and-gallbladder-disorders/manifestations-of-liver-disease/liver-failure.

Liver failure may cause new blood vessels to develop that allow blood carrying toxins to bypass the liver. These blood vessels become enlarged and fragile, and they bleed easily. This may contribute to bleeding in the digestive tract.9Portal Hypertension By Danielle Tholey, et al. ‘Portal Hypertension - Liver and Gallbladder Disorders.’ Merck Manuals, www.merckmanuals.com/home/liver-and-gallbladder-disorders/manifestations-of-liver-disease/portal-hypertension.

Liver Failure

7. Confusion and Disorientation

Significant confusion and disorientation, along with poor balance and coordination and slurred speech may suggest a condition called encephalopathy. This occurs due to reduced brain function caused by the liver’s inability to remove toxins from the blood.6Liver Failure By Danielle Tholey, et al. ‘Liver Failure - Liver and Gallbladder Disorders,’ Merckmanuals, www.merckmanuals.com/home/liver-and-gallbladder-disorders/manifestations-of-liver-disease/liver-failure. Physicians who suspect a patient has liver failure check the person’s mental alertness.2‘Articles.’ Cedars-Sinai, www.cedars-sinai.org/health-library/diseases-and-conditions/a/acute-liver-failure.html.

In babies and very young children experiencing liver failure, it may be difficult to detect encephalopathy, and physicians may need to rely on observation of other symptoms.5‘Acute Liver Failure.’ Cincinnati Children’s Hospital, www.cincinnatichildrens.org/health/a/acute-liver-failure.

8. Ascites

People with liver failure often develop ascites, a buildup of fluid in the abdomen. This causes the abdomen to swell, leading to discomfort, bloating, swelling of the lower legs, hemorrhoids and weight gain. Ascites may also exacerbate other liver failure symptoms, such as nausea and vomiting.

Imaging tests can help physicians identify ascites. In severe cases, a doctor may insert a needle into the abdomen to remove some of the fluid.10‘Ascites.’ Hopkins Medicine, www.hopkinsmedicine.org/health/conditions-and-diseases/ascites.

Liver Failure

9. Breath Odor and Breathing Problems

The breath of a person with liver failure may smell musty or sweet.4‘Acute Liver Failure.’ 21 Oct. 2020, Mayo Clinic, October 21, 2020, www.mayoclinic.org/diseases-conditions/acute-liver-failure/symptoms-causes/syc-20352863. In addition, the buildup of fluids in the body may compress the lungs and make breathing more difficult. This may cause the person to experience shortness of breath.10‘Ascites.’ Hopkins Medicine, www.hopkinsmedicine.org/health/conditions-and-diseases/ascites.

Changes may also occur in the blood vessels in the lungs as a result of the liver’s inability to filter out toxins from the blood. The blood vessels may become narrow or enlarged, leading to breathing issues.11Lam, Katrina, and Vinicio de Jesus Perez. ‘Pulmonary Vascular Complications of Liver Disease.’ 2018, www.thoracic.org/patients/patient-resources/resources/liver-disease.pdf.

10. Kidney Failure and Infections

The buildup of fluids in the abdomen that may occur with liver failure sometimes leads to kidney failure. If this happens, the body produces less urine and excretes fewer toxins from the body, compounding the buildup of toxins in the body due to the decreased liver function.6Liver Failure By Danielle Tholey, et al. ‘Liver Failure - Liver and Gallbladder Disorders,’ Merckmanuals, www.merckmanuals.com/home/liver-and-gallbladder-disorders/manifestations-of-liver-disease/liver-failure.,10‘Ascites.’ Hopkins Medicine, www.hopkinsmedicine.org/health/conditions-and-diseases/ascites.

In addition to fungal and bacterial infections, low blood sugar may occur in people with liver failure. The brain may swell as well.12‘URGENT: COVID-19 Vaccine News.’ www.piedmont.org/transplant/conditions-diseases/transplant-acute-liver-failure.

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