Liver failure can cause swelling all over the body, especially around the abdomen, bleeding, and engorgement of blood vessels on the skin. Men can complain of a decreased libido, breast enlargement, and shrinking of the testes. Other symptoms of liver failure are:

• Jaundice or yellowing of the skin and eyeballs
• Pain in the upper right abdomen
• Ascites or swelling of the abdomen
• Confusion
• Nausea
• Vomiting
• Feeling unwell
• Sleepiness
• Tremors
• Musty or sweet odor in the breath

If you are concerned you are in liver failure, especially when experiencing any of the above symptoms, seek medical attention immediately.

Liver failure is traditionally classified into two types, acute (ALF) and chronic liver failure (CLF). Recently, a new classification has emerged known as an acute-on-chronic liver failure (ACLF).

Acute liver failure (ALF). Occurs when liver tissues become necrotic or die. This type of liver failure progresses rapidly and there is no underlying liver disease that causes the necrosis.

Chronic liver failure (CLF). This typically occurs over time with chronic progressive damage to the tissues of the liver. Alcohol-related liver failure is further classified as follows:

Alcoholic fatty liver disease. When fat cells deposit in the liver it causes alcoholic fatty liver disease. Obesity and drinking alcohol excessively are risk factors for this type of chronic liver failure.

Alcoholic hepatitis. Characterized by scarring, inflammation, and fat cell deposits in the liver.

Alcoholic cirrhosis. The most advanced stage of alcoholic liver disease is caused by heavy drinking. The toxic chemicals in alcohol cause inflammation and swelling and lead to permanent damage to liver tissues.

Acute-on-chronic liver failure (ACLF).  Occurs when a person with a chronic liver condition experiences an acute worsening of liver function that may lead to multiorgan system failure.

Acute liver failure. The failure of the liver cells to function in ALF occurs rapidly due to hepatitis, environmental factors, ingested substances, underlying health conditions (not liver-related), and metabolic diseases. Some cases of acute liver failure occur for unknown reasons.  Causes of ACL include: 

• Prescription medicines (i.e., antibiotics, NSAIDs, anticonvulsants)
• Toxins (industrial chemicals)
• Poisonous mushrooms
• Tylenol (acetaminophen) overdose
• Excessive alcohol
• Infections
• Herbal supplements
• Blood loss
• Cancer
• Heat stroke or extreme physical activity in a hot environment
• Shock (i.e., sepsis or an overwhelming infection)

Chronic

• Hepatitis viruses
• Long-term ingestion of alcohol
• Certain genetic conditions cause excessive minerals in the body (Wilson’s disease or hemochromatosis).

Acute on chronic liver failure. This liver failure can be caused by an acute event that injures the hepatocytes (liver cells) of a patient with a chronic liver condition. Some causes that may predispose a person to an acute decompensation of liver condition are:

• • Alcohol-related injury
  • Pre-existing liver condition
  • Viral hepatitis
  • Liver surgeries
  • Bacterial infection following liver surgeries

• Excessive alcohol use
• Intravenous illicit drug use
• Chronic liver disease
• History of hepatitis (any type)
• Eating wild mushrooms
• Excessive prescription drug use
• Unventilated exposure to chemical toxins
• Obesity (may lead to nonalcoholic fatty liver disease)
• Exposure to blood and body fluids (sharing needles, razor blades, etc.)

When your doctor is diagnosing if you have a liver failure you must be open about your alcohol usage or any types of medications you are taking. The first step in diagnosis is taking a thorough medical history. Your doctor may ask if you have been exposed to any environmental toxins or ingested substances. Some tests that may be ordered are:

Blood tests. These tests help determine how well your liver is functioning. In acute liver failure, your blood will not clot as quickly as in a healthy body. A prothrombin test may be ordered to time how long it takes your blood to clot.

Biopsy. In a liver biopsy, a small piece of your liver tissue is removed and examined by a pathologist to determine why the liver is failing. In some cases, the patient is at high risk for bleeding and a transjugular liver biopsy is performed. This biopsy is done by making a small incision in the right side of the patient’s neck and a small tube (catheter) is inserted into a vein.  The catheter is then passed through the heart and into a vein that extends into the liver. The surgeon then inserts a very small needle into the tube and takes a sample of liver tissue.

Imaging tests. An ultrasound may be ordered by your healthcare provider to examine the liver. Ultrasound imaging can reveal liver damage without invasive surgery. Other imaging tests that may be ordered are CT (computerized tomography) or MRI (magnetic resonance imaging) to closely look at blood vessels and the liver. These imaging tests can identify possible tumors in the liver tissue or other causes of acute liver failure.

Liver failure is a medical emergency that requires immediate admission to an intensive care unit. When in the hospital, a patient with liver failure is treated by a team of specialists that predict, prevent, and treat any complications that arise while supporting the patient’s liver in regeneration and repair. If the reason for your liver damage is an acetaminophen overdose, you will be prescribed an antidote known as N-acetylcysteine (NAC) that can reverse the damaging effects.  You may also be prescribed a medicine for internal bleeding. If the liver is damaged beyond a critical point, transplantation may be needed.

Liver failure is a serious medical condition. In this case, it is best to consult with your medical practitioner about proper treatment methods and avoid taking supplements (herbal and vitamin) and home remedies until the condition is resolved. There are herbal and vitamin supplements that may contain hepatoprotective (prevents damage to the liver) substances. You may consider taking these to help protect your liver from damage. However, the best course of action is to avoid alcohol, toxins, and any substances that may harm your liver. Consult your healthcare provider about any herbal, vitamin, or home remedy supplementation you are planning to take to ensure the supplement is safe.

Milk thistle. In Europe, the milk thistle plant has been used to treat liver disorders for the past 2000 years. In Germany, the German equivalent of the FDA has recommended the use of milk thistle to treat liver damage caused by toxins and cirrhosis. The German Commission E further supports the use of milk thistle to treat chronic diseases of the liver. The active chemical responsible for this activity is known as silymarin. Milk thistle is considered safe with few reported adverse side effects.

Holy basil. Also known as Tulsi, this herb has been used in traditional and folk medicine as a hepatoprotective plant. It is a flavorful herb used in Thai cuisine. Phytochemicals (chemicals in a plant) provide analgesic, anti-inflammatory, antistress, and hepatoprotective properties to the plant. There are no side effects reported with use and is considered non-toxic. Herbal tea with holy basil is a relaxing and enjoyable routine to ingest this herbal medicine.

Natural foods. Fruits, like apples and citrus, are full of antioxidants and have been shown in studies to protect against damage to liver cells. Green leafy vegetables are another excellent source of nutrition and phytochemicals that protect the body against inflammation and liver disease.

 

• Drink alcohol in moderation
• Read labels of medications closely and follow instructions carefully
• Be open with your doctor about all medications you are taking
• Get vaccinated against hepatitis B if you have a history of chronic liver disease
• Never share needles and seek help if you use intravenous drugs
• If you get a tattoo or piercing, find a shop that is safe and sanitary
• Avoid contact with blood or bodily fluids
• Avoid eating wild mushrooms
• Wear proper protective gear when exposed to toxins or chemicals

The liver is a vital organ responsible for several crucial functions in the human body. These include:

• Processing sugars, fats, vitamins, and proteins
• Producing bile acids needed for digestion
• Producing clotting factors that prevent bleeding
• Removing toxic substances

When the liver fails, all of these important functions are hindered and many organs of the body may also fail. Before transplants were available to liver failure patients, the survival rate was very low (10%). Improvements in medicine have increased the survival rate in liver failure patients. Patients with acute liver failure from acetaminophen have a good prognosis if the overdose is caught early. Some complications increase the risk of mortality, including cerebral edema, kidney failure, infection, and sepsis. The liver is an incredible organ with the ability to recover from acute insult. Patients with acute liver failure not associated with any other liver condition (i.e., alcoholic hepatitis) can recover normal liver function. Rapid diagnosis and treatment, including transplant, offers the liver failure patient a good chance at surviving the crisis.

Many cases of acute liver failure may be for an unknown cause. However, you can reduce your chances of harming your liver by choosing a healthy substance-free lifestyle. Avoid drinking alcohol in excess. Choose positive coping mechanisms. Meditation, exercise, and positive social experiences are wonderful outlets for relieving the stresses that may tempt us to turn to alcohol to cope. Practice care when in an environment that may expose you to hazardous toxins.

As the liver becomes more damaged, it undergoes a process called cirrhosis which means the liver has excessive scar tissue. This tissue prevents the liver from doing its job and also disrupts the blood that flows through the organ. In many cases, this chronic process can increase an individual’s likelihood of developing liver cancer. Other complications that may occur are:

• Cerebral edema or fluid collection in the brain
• Kidney failure
• Sepsis or systemic infection
• Bleeding
• Bleeding disorders

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Mayo Clinic Staff. (2020, October 21). Acute liver failure. Retrieved from Mayo Clinic: https://www.mayoclinic.org/diseases-conditions/acute-liver-failure/symptoms-causes/syc-20352863#:~:text=Acute%20liver%20failure%20is%20loss,failure%2C%20which%20develops%20more%20slowly.

Shah, N. J., Mousa, O. Y., Syed, K. & Savio, J. (2020, October 12). Acute on chronic liver failure. Retrieved from StatPearls: https://www.ncbi.nlm.nih.gov/books/NBK499902/

UCSF Department of Surgery. (2021). Acute liver failure (ALF). Retrieved from: https://surgery.ucsf.edu/conditions–procedures/acute-liver-failure-(alf).aspx

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