11 Symptoms of Liver Disease (You Should Not Ignore)

Medical review: Dr. Clarisse Bezerra
Family Doctor
March 2022

The first symptoms of liver disease are usually right-sided abdominal pain and a ​swollen belly. Symptoms can vary, however, depending on the type of problem occurring. Some common liver conditions include fatty liver, excessive alcohol intake or illnesses like hepatitis, cirrhosis or schistosomiasis.

The most common signs and symptoms that could indicate a liver problem are:

  1. Pain in the upper, right quadrant of the abdomen
  2. Frequent nausea or dizziness
  3. Recurring headache
  4. Easily-occurring fatigue with no apparent reason
  5. Easy bruising
  6. Yellow eyes or skin
  7. Dark urine
  8. Loss of appetite
  9. Yellow, gray or white stool
  10. Swollen belly
  11. Itchiness throughout the body

If any of the symptoms emerge, you should consult your doctor for assessment and treatment as indicated.

Online quiz for liver problems

To assess your risk for a liver problem, report your symptoms in the quiz below:

  1. 1.Pain in the upper right quadrant of the abdomen
  2. 2.Frequent dizziness or light headedness
  3. 3.Frequent headache
  4. 4.Fatigue for no apparent reason
  5. 5.Bruise easily
  6. 6.Yellowing of the eyes or skin
  7. 7.Dark urine
  8. 8.Loss of appetite
  9. 9.Yellowish, gray or off-white feces
  10. 10.Swollen belly
  11. 11.Itching all over the body

The main problems that can affect the liver include:

1. Fatty liver

Fatty liver, which is scientifically known as hepatic steatosis, is caused by an accumulation in fat in the liver. It is generally a result of poor diet, excessive alcohol intake or illnesses like obesity, diabetes or high cholesterol.

Generally, in the initial stages, fatty liver does not cause any symptoms. However, as fat content in the liver increases, symptoms like abdominal pain, weight loss, fatigue, nausea or vomiting and general malaise can occur. Treatment for fatty liver involves changes to diet and lifestyle and management of the disease that could be contributing to it. 

2. Hepatitis

Hepatitis is an inflammation of the liver that can be causes an infection of the hepatitis A, B, C, D, or E viruses. It can also be common in those with a history of drug, alcohol or medication abuse. Some autoimmune disease, like autoimmune hepatitis or primary biliary cholangitis can also increase the likelihood of hepatitis.

The most common symptoms of hepatitis are yellow skin or eyes. Treatment is usually done in accordance with the initial cause.

3. Cirrhosis

Cirrhosis occurs due to permanent destruction of the liver cells that leads to scarring within the liver. This makes liver function much more difficult.

This illness can be caused by toxins, alcohol abuse, fatty liver or hepatitis. Symptoms may not be apparent in its early stages, but as it advances, some people experience abdominal pain, dark urine or white stools.

4. Hepatic insufficiency

Hepatic insufficiency, or liver failure, is the most serious liver illness, as the liver ultimately is no longer able to function problem. This can lead to a series of complications like clotting problems, brain swelling, lung infection or kidney failure.

This illness typically emerges after a few years of repeated liver injury. It can be caused by medication use, hepatitis, cirrhosis, fatty liver, cancer or autoimmune disease. Treatment is almost always done with a liver transplant.

5. Liver cancer

Liver cancer is confirmed with the presence of a malignant tumor within the liver. There may be no symptoms in its early stages, but as the cancer evolves, symptoms like abdominal pain, weight loss, swollen belly and yellow eyes or skin can occur. Treatment usually involves surgery, chemotherapy or a liver transplant.

This type of cancer can be caused by a family history of liver cancer, alcoholism, hepatitis, or exposure to chemicals like vinyl chloride or arsenic. 

Who is at high risk for developing a liver problem

Liver abnormalities are more common in people who are sedentary and who engage in unhealthy diet habits like consuming a high fat diet or drinking alcohol excessively. All of these are factors that can complicate liver function and lead to the emergence of symptoms.

In addition, other factors that may lead to liver problems are:

  • Use of medication without medical guidance: This can overload the liver and compromise its function, as the liver is responsible for the metabolization of may medication
  • Viral infections: like hepatitis, which targets the liver and decreases its activity
  • Parasitic infections: like with the Schistosoma mansoni. This parasite causes schistosomiasis, which is an infectious disease that, in its early stages, can affect portal circulation of the liver, and result in hardening of the liver in the later stages.
  • Portal hypertension:  This occurs when there is increased pressure in the vessels that deliver blood from the abdominal organs to the liver, which can leads to liver function problems
  • Cirrhosis: This is a chronic inflammation of the liver that hardens liver tissue and compromises its function. It typically occurs as a result of autoimmune disease or alcohol abuse.
  • Decompensated diabetes: Which occurs when significantly elevated glucose levels can compromise liver function and lead to the emergence of symptoms

It is important to identify the cause of the liver problem, so that the appropriate treatment can be indicated to avoid further complications.

How to confirm a diagnosis

Diagnosis of liver problems is typically confirmed following medical evaluation of the presenting signs of symptoms. The doctor may then order exams to further assess the liver function, which can include bloodwork.

Blood work that aims to assess the liver is known as liver function tests, or LFTs. They are a group of blood tests that can be done in conjunction with imaging that gives the doctor an idea of whether the liver is functioning within normal limits or not. These exams include total bilirubin (direct and indirect), albumin, lactate dehydrogenase (LDH), gamma-glutamyl transferase (GGT), aspartate aminotransferase (AST), alanine aminotransferase (ALT), and prothrombin time (PTT). Imaging may include ultrasound or CT scan.

How treatment is done

The doctor will indicate treatment based on the underlying cause of the disease. Some, more mild cases will only require simple diet changes, however other cases may require medication to reduce inflammation, cholesterol and glucose (which are all factors that can contribute to further complications).

In addition, you should speak to your doctor about whether you can also introduce home remedies, like those that involve the use of boldo, lettuce or lavender.

Treating the liver through diet

When liver problems are present, you are advised to drink at least 1.5L (or at least 6 cups) of water every day and to eat foods that are easily digestible with low fat content, like fish, white meat, fruits, vegetables, smoothies, white cheeses and skim dairy products.

In addition, you should opt to prepare your food either boiled in a pot, broiled in the oven or grilled. You should avoid fried food, sodas, stuffed cookies, butter, red meat, sausage, bacon, chocolate and sweets in general. You should also avoid consumption of all types of alcohol.

A gastroenterologist is the medical specialist who is most indicated for liver management. You should consult a gastroenterologist if your symptoms persist, even with significant diet changes.

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Atualizado por Tua Saude editing team, em March de 2022. Medical review por Dr. Clarisse Bezerra - Family Doctor, em December de 2021.

References

  • STATPEARLS. Physiology, Liver. 2020. Available on: <https://www.ncbi.nlm.nih.gov/books/NBK535438/>. Access in 19 May 2021
  • REMMER, M.D.H. The role of the liver in drug metabolism. The American Journal of Medicine. 49. 5; 617-629, 1970
Medical review:
Dr. Clarisse Bezerra
Family Doctor
Dr. Bezerra possesses a medical degree and specializes in family medicine. She is licensed to practice under CRM-CE licence #16976.