Liver damage, including various types of inflammation of the liver (following hepatitis C, alcohol, etc.) eventually leads to liver failure and cirrhosis, and eventually end-stage liver disease or ESLD. In the following, we will talk more about the stages of liver failure and the final stage of liver cirrhosis.
What is liver failure?
When your liver is unable to function properly, we say liver failure has occurred.
The liver has important functions.
The liver is the main site of regulation of metabolism, vital enzymes in the liver are responsible for controlling metabolism.
The liver is the site of production of vital proteins in the body, including albumin and immune system proteins.
The liver is where bile is made, which is needed to digest food.
The liver is an important place to detoxify the bloodstream, many toxins and dangerous substances are cleared in the liver.
The liver is an important site for the production of blood coagulation factors.
Blood lipids are processed, made and modified by the liver.
In short, liver failure is a life-threatening disorder.
Liver failure can occur suddenly, which is called acute liver failure, , for example, in fulminant hepatitis, or it may have a chronic course, which is called chronic liver failure, such what happens in the course of chronic hepatitis C or alcoholic hepatitis.
Acute or chronic liver failure requires urgent action.
Causes of acute liver failure
- Infections: Hepatitis A; B; E viruses
- Acetaminophen overdose
- Reaction to herbal medicines such as ma huang and kava kava
- Metabolic diseases such as Wilson’s disease
- Diseases of the hepatic veins: Budd–Chiari syndrome
- Contact with industrial chemical toxins
- Toxic fungi
- Autoimmune disorders such as autoimmune hepatitis
- Response to medications: such as some antibiotics, NSAIDs and some antiepileptic drugs
Symptoms of acute liver failure
- Feeling unwell or malaise
- Feeling sleepy
- Nausea or vomiting
- Swelling of the abdomen
- Abdominal pain, Jaundice of the skin and Sclera
- Feeling confused
Causes of chronic liver failure
- Chronic hepatitis B
- Hepatitis C
- Alcoholic hepatitis
- Non-alcoholic hepatitis
- Cholangitis and diseases and disorders of the bile ducts
- Autoimmune hepatitis
Symptoms of chronic liver failure
- Fatigue and weakness
- Decreased or lack of appetite
- Nausea or vomiting
- Mild abdominal pain
- Dark urine
- Clear stools
What are the symptoms with increasing severity of liver failure?
With increasing severity of liver failure, the following symptoms occur:
- Severe itching of the skin
- Bruising occurs very easily
- Internal bleeding
The four main stages of liver failure
Here are four main stages of liver failure:
- Inflammation stage
This phase is the first stage of liver damage. The liver becomes swollen and enlarged. At this stage, the patient may not have any specific clinical symptoms.
Gradually, with the continuation of inflammation, liver damage progresses.
- Stage of fibrosis:
Liver tissue that has been damaged and inflamed, seeks to repair the damage, And the result of this repair is the scar tissue of the liver.
Gradually, the scar tissue replaces the normal and efficient tissue of the liver. Scar tissue cannot perform the functions of normal liver tissue.
At this stage, the patient has not yet shown specific clinical symptoms
- Cirrhosis stage:
In this phase, a very large scar tissue covers the liver and only a small amount of normal liver tissue remains that is unable to perform all the normal functions of the liver.
In this phase, other clinical symptoms have appeared.
- end stage over disease or ESLD:
People in this phase have a cirrhotic liver that has suffered a dramatic decline in the performance of its functions.
In this phase, the person suffers from massive diseases, bleeding and bruising very easily and due to the increase of toxic substances in the blood, he or she suffers from dizziness and drowsiness and loss of consciousness and coma or hepatic encephalopathy.
In this phase, it is impossible to restore liver function, and if a person fails to have a successful liver transplant, he or she will be sentenced to death.
In the final stages of liver cirrhosis or ESLD, the following symptoms will occur:
- Gastrointestinal bleeding due to rupture of large varicose veins of the esophagus and stomach wall, as well as decreased platelets and coagulation factors due to liver failure.
- Brain cell damage due to increased toxins in the bloodstream and dizziness, unconsciousness and coma (hepatic encephalopathy).
- Cirrhosis greatly increases the risk of hepatocellular carcinoma of the liver (HCC).
- Liver transplantation is the only way to save people with end-stage cirrhosis.
- Chronic hepatitis C is the most common cause of ESLD, which leads to liver transplantation. Most of these people survive up to five years after a liver transplant, but in almost all cases, the hepatitis C virus becomes active again.
- Newer therapies may be able to eradicate the virus in a number of patients, or at least prevent it from reaching ESLD.