End stage liver disease results from several different causes. Liver failure is often a result of long term damage from, genetic/auto-immune disorders, hepatitis C, liver cancer, or cirrhosis often caused by alcoholism. Damage also occurs in the liver with the long term use of certain medications for other disorders and chronic obesity. Symptoms of end stage liver disease result from extensive damage to the liver.
Hepatic Encephalopathy
The liver is an important filter for toxins in the body. When the liver malfunctions due to failure it is often unable to filter substances in the blood. The build up of ammonia and other toxins causes hepatic encephalopathy. The National Institute of Health lists several symptoms that accompany hepatic encephalopathy including change in sleeping patterns, sweet smelling breath, problems with memory and cognition/thought processes, confusion, slurred speech, and trouble with hand coordination.
Ascites
Ascites is build up of fluid in the stomach that leaks from the liver due liver failure. Ascites can continue to build in the abdomen and become very uncomfortable. Symptoms that accompany fluid build-up include abdominal pain, shortness of breath, a full feeling in the abdomen, and tightness of the skin.
Bleeding and Portal Hypertension
Portal hypertension is a condition of high blood pressure in the portal vein that leads to the liver. Portal hypertension increases the risk for bleeding in the esophagus. Dr. Michael Picco of the Mayo Clinic refers to this condition as esophageal varices. In addition, the liver also contributes to the clotting of blood. In liver failure the damaged liver is unable to clot blood and this also increases the risk for internal bleeding.
Jaundice
The University of Maryland Medical Center describes jaundice as a build up of billirubin in the blood stream. This build up causes skin to appear yellow or orange in color. Build up billirubin occurs when the liver is inflammed or special ducts within the liver are blocked. This may be an early sign of liver damage but can also accompany end stage liver disease.
Cholestatis
Blockage of the flow of bile into or out of the liver is referred to as cholestatis. This is often a symptom of end stage liver failure. The University of Maryland Medical Center list several symptoms that accompany this disorder including jaundice, bleeding/bruising, itching, spider veins on skin, pain, enlarged spleen/pancreas, and pale stools.
Other Liver Failure Symptoms
Dr. Picco of the Mayo Clinic states that fatigue, nausea, and loss of appetite also occur with liver failure. Other symptoms include neurological damage,brain damage, and weakness. Coma and death are possibilities at the end stages of liver failure as a result of the many other complications (ascites, encephalopathy, bleeding, etc.).
