The liver is different from the stomach, intestines, and other body parts. It is a silent organ that does not give problems or uncomfortable symptoms until it is damaged and starts causing all kinds of issues. These problems are not always apparent because they are not always located in the same area of the liver. Thus, you need to know them beforehand to be able to detect them.
That’s why we’re bringing this time a list of the most common signs and symptoms of liver damage.
How do you know you have liver problems?
Liver problems can have a wide range of symptoms, as you will see in this article. Some of them can be difficult to detect. One of the most common signs of a potential liver problem is jaundice, a yellowing of the eyes, skin, or mucous membranes. Other symptoms may include fatigue, nausea, confusion, abdominal pain, or a loss of appetite. Additionally, people with a liver disorder may experience dark urine, pale-colored stools, or itchy skin. In some cases, the liver may be enlarged, tender to the touch, or hard. If you experience any of these symptoms, seek medical attention as soon as possible.
Overall, liver problems can present with a wide range of symptoms and should be evaluated by a physician as soon as possible. Tests can help to confirm a diagnosis and provide further information about the underlying cause of the liver disorder.
Signs and symptoms of liver damage
1. Jaundice
The first symptom to look out for is jaundice, which is characterized by a yellow discoloration of the skin and whites of the eyes. Jaundice is caused by an increased level of bilirubin in the blood and can be either acute or chronic.
In many cases, liver damage is caused by acute or chronic infections with the hepatitis virus. When that happens, jaundice can be acute in hepatitis A and chronic in hepatitis B and C. The symptom is the same, and the only thing that changes is whether you have it for a prolonged period or just a few days or weeks.
2. Abdominal pain
It is located primarily in the upper right quadrant of the abdomen, and it is another common symptom. Abdominal pain happens because your liver is enlarged and full of fatty deposits or fibrotic and inflamed tissue. Thus, the liver can be very painful to touch.
Abdominal pain is not a specific symptom of a specific type of liver disease because it can be caused by many things, like hepatitis, fatty liver disease, or cirrhosis. But abdominal pain can also arise from an ulcer or infection in your stomach or duodenum. The difference is that abdominal pain from liver problems is located in the upper right quadrant, and it is a dull ache that does not improve easily and does not come and go.
3. Nausea and vomiting
The liver is an important organ for the gastrointestinal system, which is why the healthcare professional that specializes in liver diseases is the gastroenterologist. One of many liver functions is to process bile, which is accumulated in the gallbladder and then gets released to the duodenum. The function of the bile in the gastrointestinal tract is to facilitate the absorption of fatty acids.
Thus, if your liver is not working correctly, your fat absorption and metabolism could be altered. That’s why patients with liver disease often complain of nausea and vomiting. These symptoms are common in the early and late stages of the disease.
4. Loss of appetite
Since your liver is not working correctly and not delivering bile to the gastrointestinal tract, fats are not easily absorbed, stay around, and cause an awkward sensation of bloating in your abdomen that does not contribute to increasing your appetite.
It can also happen that the liver becomes enlarged and starts pushing the surrounding organs. One of them is the stomach, which reduces its capacity to store and process food. You could be satisfied with only a tiny portion of food or lose your appetite completely.
Another cause of loss of appetite is liver cancer, which is a late stage causes a syndrome known as cachexia, which features loss of appetite and weight loss.
5. Confusion
There are many different stages of liver disease. Those with more severe damage may also have difficulty concentrating and confusion. The liver’s primary function is to clean the blood of debris and toxins. These toxins should be out of your system as soon as possible and at a continuous rate. Otherwise, they would accumulate and start causing problems in different organs, especially your brain.
The brain is affected by a complication of liver disease called hepatic encephalopathy. This complication features an accumulation of ammonia and other toxins, which trigger a problem in the brain. In the late stage of hepatic encephalopathy, patients become disoriented and confused.
6. Difficulty concentrating
We already described above the late-stage symptoms of hepatic encephalopathy, which include confusion and sometimes coma and death. It can be a very damaging problem with a high mortality rate if not treated promptly. However, the early stage of hepatic encephalopathy is not as severe, and some patients do not recognize it as such.
In an early stage, patients would experience difficulty concentrating, mood changes, and irritation. These symptoms are unspecific and not always easy to detect because they can be confused with other diseases, mental health conditions, or a bad habit of not paying attention. However, paying attention to the combination of mental health symptoms in a patient with liver problems is recommended.
7. Dark urine
This is one of the most critical symptoms of hepatitis and other liver damage ailments. Dark urine looks like coke in severe cases, but it can be simply brownish and not right off black. Dark urine happens when your body cannot get rid of the toxins your liver produces because of cirrhosis or other causes.
More specifically, it is bilirubin that is released into the bloodstream when the liver breaks down red blood cells. A quick way to detect dark urine is by simply checking the color after going to the bathroom, but sometimes you need to store urine in a separate bottle to notice the difference.
8. Light-colored stools
Dark urine in patients with liver damage goes hand in hand with another symptom, which is light-colored stools. This is because the liver processes bilirubin, which has a dark and very strong color that taints other tissues and structures in the body. It is like a very strong dye that gives color to your feces.
Since you’re not releasing any of it to the gastrointestinal tract, it won’t taint your feces to the usual brownish color. Instead, it goes to your bloodstream and gets eliminated by the kidneys, causing dark urine. That’s why light-colored stools are commonly associated with dark urine in these patients.
9. Greasy stools
The stools of a patient with liver damage are not only changing their color but also their appearance and composition. They become greasy stools because, as mentioned above, the liver is one of the main organs behind the absorption and processing of fats in the gastrointestinal tract.
When liver damage affects the production or delivery of bile, you won’t find any of it in the gastrointestinal tube, and fat processing is affected. Instead of being absorbed, it will stay in the intestines for a very long period and lead to significant portions of fat in normal-looking stools or diarrhea of greasy stools because it increases the osmolarity and drags along the water.
10. Excessive fatigue
As liver damage increases, patients will also experience more constitutional symptoms, such as malaise and fatigue. The difference between tiredness and fatigue is that fatigue is a feeling of exhaustion and inability to engage in activities and is generally experienced as a persistent, unpleasant sensation of tiredness that does not go away quickly.
The symptom of fatigue can be experienced as a lack of physical energy or mental energy. The sensation does not go away after resting or sleeping all night. It happens either because the brain has accumulated ammonia and hepatic encephalopathy or because the liver has grown cancerous cells and the tumor consumes too much energy.
11. Itching
The liver has an essential function in processing aging red blood cells. They are replaced by new red blood cells, and there some substances or metabolites are formed in the process. One of them is bilirubin, a waste material that needs to be eliminated as soon as possible through the bile.
Bilirubin is not only a powerful dye. It is also a toxin for other tissues and stimulates nerve terminals in the skin when it is accumulated in the form of jaundice. Thus, jaundice usually comes along with itching because the same bilirubin tainting the skin also stimulates nerve terminals.
12. Swelling of the legs
The liver is also important to produce proteins that keep the liquid inside the blood vessels. One of the most important is called albumin, and it is the most abundant protein in the blood. When the liver is damaged, albumin levels drop, and instead of keeping the liquid inside the arteries and veins, it drains to the outside and accumulates in the soft tissue. This is called edema.
Edema usually starts in the foot and the ankle, then it rises to the lower part of the legs. When the liver damage is severe, the liquid begins to accumulate in the abdomen in something known as ascites.
13. Easy bruising and bleeding
Other vital proteins produced by the liver include clotting factors required for healing and hemostasis (the process of blood clotting to stop bleeding). Thus, clotting factors in patients with liver disease are reduced in the blood, and bleeding episodes are hardly controlled. Patients start experiencing easy bruising and constant bleeding that is difficult to control.
Some diseases also have liver involvement with signs and symptoms of bleeding, and others cause bleeding episodes because platelets are low, as in the case of viral dengue. Thus, easy bruising and bleeding should be seen as an additional symptom you should evaluate with others to reach a conclusion.
14. Fever
In some types of liver damage, patients will also experience fever. It depends on the cause of liver disease. It is more common in hepatitis A, but it can also happen in the case of hepatitis B and C. These are viral diseases that feature a very complex array of reactions in your immune system. Cytokines are released, and when they reach your temperature regulation centers in the brain, they increase your body temperature.
Fever is also a symptom of many other infections, and some can share signs and symptoms of liver damage. That’s why a healthcare professional is essential if you have these signs and symptoms. They are the ones who should tell you if you should worry or not and what to do to confirm if you have liver damage.
What happens if you have these symptoms?
If you have the symptoms listed above, your doctor may order tests to confirm that you have a liver disorder because these symptoms also appear in other people with other diseases. These tests may include blood tests, imaging tests, or liver biopsies. Blood tests can help to detect liver enzymes, bilirubin, albumin, and electrolytes. Imaging tests, such as an ultrasound or CT scan, can be used to visualize the liver and detect any abnormalities. A biopsy involves taking a piece of the liver for analysis to diagnose a specific liver disease. It is an invasive method of diagnosing more severe liver diseases, especially liver cancer.
Keep in mind that liver-related symptoms can also appear in other diseases indirectly affecting the liver. In such cases, the underlying condition should be treated. But the chance of recovery decreases as the severity of the liver damage increases. Thus, it is essential to talk to your doctor about it as soon as possible. Do not delay your appointment and get treated as quickly as you can. Doing so will give you a much better chance of recovery.