What happens when your liver fails

The liver is the largest solid organ in our body and performs over 500 essential functions to keep us alive. — TNS

My uncle just died of liver failure. That is what the doctor said. I don’t understand. How can a liver just fail?

Let us understand what our liver does first.

Our liver is a reddish-brown organ that sits predominantly on the right side of our upper abdomen, just below our ribs.

It is shaped like a wedge.

It is the largest solid organ in our body.

It is also said to be our body’s most important organ because it performs many essential functions that we cannot live without.

In fact, our liver performs over 500 essential functions!

What functions does our liver perform?

These are just a few functions of our liver:

• Produces albumin

  Albumin is a protein that keeps the fluids in our bloodstream from leaking into surrounding tissue.

  Albumin also binds and carries hormones, vitamins and enzymes throughout our body.

• Produces bile

  Bile is a fluid that aids the digestion and absorption of fats in our small intestine.

• Regulates blood clotting

  Blood-clotting coagulants are created utilising vitamin K, which can only be absorbed with the help of bile.

• Filters blood

  All the blood leaving our stomach and small intestines have to pass through the liver, which then extricates and removes toxins, by-products and harmful substances such as bacteria.

• Regulates amino acids

  Our liver ensures that amino acid levels in our bloodstream remain optimal.

  Amino acids are the building blocks of protein.

• Regulates glucose

  Our liver removes excess glucose from our bloodstream and stores it in the form of glycogen.

  If our body needs extra energy, it converts the glycogen back into glucose.

• Stores essential vitamins and minerals

  The liver stores vitamins A, D, E, K and B12, as well as iron and copper.

What happens when my liver fails?

If your liver fails, then all these functions that it performs will cease or diminish progressively.

There is acute liver failure and chronic liver failure.

Acute liver failure symptoms occur within six months.

But chronic liver failure can take years and years to develop.

The symptoms that arise from liver failure can be non-specific and similar to other diseases.

That is why it can be difficult to diagnose in its early stages.

What are the symptoms of liver failure?

Ascites is one of the signs of severe chronic liver failure, where there is build-up of fluid in the abdomen. — Filepic

In chronic liver failure, you may feel fatigue, nausea and a loss of appetite.

You may have diarrhoea, blood in your stools, and also vomiting.

This is the stage that many doctors mistake for other diseases if they do not run liver function tests.

As the liver failure advances, your symptoms become more severe. You may get:

• Jaundice – due to build-up of too much bilirubin in your blood.
• Extreme fatigue
• Disorientation, confusion and changes in sleep pattern – due to liver encephalopathy.

  This signifies significant liver deterioration.

  There is also a sign called the “hepatic flap”, where someone with significant liver deterioration has tremors and the inability to keep his wrists extended when the arms are outstretched.

• Ascites (fluid build-up in your abdomen) and oedema (excessive fluid, typically in the legs)
• Weight loss
• Itchiness
• Bruising and bleeding – due to lack of blood-clotting factors.
• Red palms (palmar erythema) and spider naevi on your skin – due to blood vessel malformations
• A large spleen – due to increased pressure in the portal vein because there is increased resistance to blood flow in a damaged liver.

Why does the liver fail?

Chronic liver failure is commonly caused by:

• Hepatitis B and C

  These infectious viral diseases can lead to liver cirrhosis – a condition of massive damage and scarring of your liver.

  When scar tissue replaces your normal liver cells (hepatocytes), the cells can no longer perform their normal function.

• Long-term alcohol consumption

  This can lead to alcoholic liver cirrhosis.

• Haemochromatosis

  This is a genetic condition that causes your body to absorb and store too much iron.

  It can also cause cirrhosis.

Acute liver failure can be caused by:

• Hepatitis B

  This infection can cause acute swelling of the liver.

• Drugs and toxins

  Examples include an overdosage of paracetamol, certain antibiotics and certain antidepressants.

• Autoimmune hepatitis

If I get liver failure, is there any hope for me? Or am I doomed to die like my uncle?

The treatment for liver failure depends on whether it is acute or chronic.

For chronic liver failure, you have to change your diet and lifestyle, such as avoiding alcohol completely, as well as medications that can harm the liver.

You will also have to reduce your consumption of salt, red meat, cheese and eggs.

For acute liver failure, the treatment is very supportive, such as intravenous (IV) fluids to maintain your blood pressure, blood glucose monitoring, and blood transfusion if you bleed excessively.

There is a cure for both acute and chronic liver failure, and that is a liver transplant.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health, computers and entertainment. For further information, email [e-mail]. The information provided is for educational and communication purposes only, and it should not be construed as personal medical advice. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.