Last updated: February 21, 2017

Liver failure symptoms

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Liver failure symptoms: Introduction

Liver failure symptoms usually appear after years of heavy alcohol abuse. Although there are many different causes of liver failure symptoms, alcohol related liver failure symptoms are very common.  By the time alcoholics develop liver failure symptoms, they already have some irreversible damage to their liver. The liver failure symptoms in alcoholics most commonly present as end stage liver cirrhosis. This is somewhat different from acute liver failure symptoms in which a patient with normal liver develops liver failure within a very short amount of time. The most common cause of acute liver failure symptoms is Tylenol overdose.

Liver failure symptoms: 42 year old male construction worker with belly pain

Mr. H is a 42 year old male who has been working in construction for more than 20 years. He is always working hard and is very good at his job. He is usually very tired by the time he gets home from work. As soon as he gets home, he starts drinking beer. He usually drinks about 12 or 15 beers a day. He seems to have developed a high tolerance for beer drinking. He is very functional and can have normal conversation with his wife and his kids even after drinking that much beer. He mostly drinks at home and his co-workers are unaware of his heavy drinking problem. He had never thought about his drinking as a problem. It was just a habit for him.

For the last six moths, he had been gaining weight and he noticed his belly was getting larger. He was not thinking about liver failure symptoms but he somehow knew this was related to drinking too many beers. He thought he was finally beginning to develop a “beer belly” after so many years of drinking beer. Gradually, it grew so large it almost appeared like a pregnant woman’s belly. Slowly he started to get some pain with the distension. On day, it became really tender and called his doctor. He went to the doctor’s office and the doctor was concerned about possible liver failure symptoms. He called me as I was the on-call doctor taking new admissions in the hospital. I made arrangements to get the patient to the medical floor right away.

As soon as I examined him, I was concerned about liver failure symptoms. His belly seemed to be filled up with fluid. He had distended veins everywhere in his belly. His whole belly was tender. I ordered some work and they came back supporting the diagnosis of liver failure symptoms. His liver enzymes were elevated. His coagulation factors seemed to off which significantly increased his bleeding risks. It happens when the liver can not make the proteins needed for blood clotting. It is an important indicator of liver failure symptoms.

On top of liver failure symptoms, Mr. H seemed to have symptoms of infection. He had a low grade fever, had elevated white count indicating inflammation and he had the belly tenderness. We were worried about the infection of the fluid in his belly.

liver failure symptoms

Image courtesy of: The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)

There are many factors that explain why patients with liver failure symptoms develop fluid in the belly. I will tell you two simple ones. First, in patients with liver failure symptoms from cirrhosis, the liver becomes hard and fibroid. The blood that takes nutrition from the gut to the liver will have difficult time flowing into the hard liver. Some fluids escape from the blood vessels and accumulate in the belly. Secondly, patients with liver failure symptoms have very low albumin in the blood. Failing liver makes less albumin. Albumin acts as powerful water absorbent inside the blood vessels. It keeps water from leaking out from veins. With low albumin, fluids escape out into the belly specially when the veins are under pressure.

Mr. H probably developed liver failure symptoms from alcohol slowly over the years. Alcohol is directly toxic to liver and causes some damage to liver cells every time someone drinks alcohol. But, liver cells are very regenerative and repair themselves after the alcohol is gone. With hundreds of cycles of damage and repair, some fibrous tissue and scarring may occur which makes subsequent repairs less efficient. When, most of the liver has developed scars and fibrous tissue, liver failure symptoms from fibrosis appear. Some of the changes in early stages of alcoholic fibrosis may be partially reversible. If the patient stops drinking, a small proportion of liver cells that are normal may be able to repair and sustain some normal liver function and prevent liver failure symptoms from getting worse.

Mr. H had a procedure called paracentesis in which we took out 8 liters of fluid from his belly with a small needle and a catheter. The fluid was infected. It looked almost like dirty urine. We treated his infection with antibiotics. His pain improved. I convinced him to quit drinking. I told him frankly that if he continued to drink, his liver failure symptoms would get worse and he would soon die from end stage liver failure. Mr. H was not ready to die. He was a productive functional individual who had a very strong motivation to stay alive. That motivation was enough for him to quit drinking. He did it with the help of his family doctor and his behavioral counselor.

Not all patients with liver failure symptoms have this kind of happy ending. Some patients with liver failure symptoms from alcohol can not give up drinking despite warnings from their doctors and die from end stage liver failure. Others are only diagnosed at a very late stage and can not be saved even if they stop drinking. Some develop complications from infections and die prematurely. Overall, symptoms of liver failure can be really nasty and it is wise to avoid heavy drinking in the first place. That is the best way to avoid liver failure symptoms.

I hope the story of Mr. H helped you understand more about liver failure symptoms. Please check back soon as I will be uploading more stories about patients who had liver failure symptoms.