The liver is essential for filtering blood, metabolizing food and medications, and assisting in blood clotting.
Several conditions, such as excessive alcohol consumption, certain medications, nonalcoholic fatty liver disease (NAFLD), and chronic infections, can damage the liver.
However, liver damage often develops without noticeable symptoms in its early stages, making it hard to detect until the liver has sustained significant harm.
Common Signs of Liver Damage
- Abdominal pain
- Fatigue
- Itching
- Loss of appetite
- Nausea and vomiting
- Sexual dysfunction
Liver Damage vs. Liver Failure: Key Differences
Liver damage and liver failure are related but distinct.
Liver damage refers to harm to the liver tissue, which can be either acute (short-term) or chronic (long-term).
Chronic liver damage can lead to liver failure, a life-threatening condition in which the liver cannot perform its critical functions, such as filtering blood, aiding digestion, and producing blood-clotting proteins.
Causes of Liver Damage
Several factors and diseases can lead to liver damage, which may progress to cirrhosis (scarring of the liver) and eventually liver failure:
- Alcoholic liver disease: Resulting from long-term excessive alcohol consumption.
- Autoimmune hepatitis: Where the immune system attacks liver cells.
- Chronic heart failure: Leads to liver congestion and impaired blood flow.
- Inherited liver diseases: Such as Wilson’s disease and hemochromatosis.
- Long-term medication use: Including acetaminophen, aspirin, and antibiotics like tetracycline.
- Chronic viral infections: Like hepatitis B or C.
- Non-alcoholic fatty liver disease (NAFLD): Associated with obesity, diabetes, high blood pressure, and high cholesterol.
- Primary biliary cholangitis: A disease affecting bile ducts.
How Liver Damage Progresses
Liver damage can present in various ways depending on its cause.
Some conditions, such as hepatitis or other chronic liver diseases, may not show symptoms for years.
- As the liver becomes more damaged, especially with cirrhosis or liver failure, symptoms become more noticeable.
Early Stages of Liver Damage
Initially, inflammation (hepatitis) occurs, often without obvious symptoms.
Doctors typically detect liver damage through blood tests, such as liver function tests and a complete blood count.
As inflammation continues, scarring (fibrosis) may develop, impairing liver function. Early symptoms may include:
- Fatigue or weakness
- Itchy skin
- Nausea and vomiting
- Loss of appetite
- Abdominal discomfort or dull pain
- Unexplained weight loss
- Sexual dysfunction
- Spider-like blood vessels on the skin
Progressive Stages
As chronic liver damage advances, fibrosis may progress to cirrhosis, which is the most severe form of liver scarring.
At this stage, more serious symptoms can develop, such as:
- Ascites (fluid buildup in the abdomen)
- Mental confusion (hepatic encephalopathy)
- Easy bruising or bleeding
- Swelling in the legs (edema)
- Jaundice (yellowing of the skin or eyes)
- Dark urine or stools
- Vomiting blood or substances resembling coffee grounds
Advanced liver disease can lead to life-threatening complications like bleeding, infections, and organ failure.
Emergency Symptoms of Liver Damage
Seek immediate medical help or call 911 if you experience any of the following symptoms:
- Rectal bleeding, vomiting blood, or blood in urine
- Confusion or difficulty concentrating
- Severe diarrhea or watery stools
- Shortness of breath
- Fever (above 101°F)
- Sudden or worsening ascites
- Sudden or worsening jaundice
- Severe abdominal or chest pain
- Frequent vomiting
Monitoring Liver Health
Healthcare providers may use imaging tests, like X-rays, MRIs, or CT scans, to track liver damage. A biopsy may also be performed to assess the extent of liver inflammation and scarring.
Stages of Liver Disease (Graded by Biopsy)
- Liver disease can be graded based on liver tissue damage:
- Stage 0: Healthy liver with no inflammation or scarring.
- Stage 1: Inflammation present but no scarring.
- Stage 2: Scar tissue begins to form, but the liver still functions well.
- Stage 3: Widespread scarring (fibrosis) without cirrhosis.
- Stage 4: Cirrhosis, severe scarring, and complications like varices and ascites.
Recognizing Liver Damage in Others
Symptoms of liver damage may not be immediately noticeable. Be alert for signs in others, such as:
- Fatigue or changes in sleep patterns
- Mood or personality changes
- Confusion, forgetfulness, or difficulty with daily tasks
- Unexplained weight loss
- Red veins or “spider veins” on the skin
- Yellowing of the skin or eyes (jaundice), which may be less obvious in individuals with darker skin.