"Medical Surgical Nursing" reports that the liver performs more than 400 functions including filtering toxins, storing and metabolizing nutrients, and protecting us from harmful bacteria and cells. Symptoms of advanced liver failure occur when damage becomes so extensive that the liver is no longer able to perform its necessary functions.
Changing Level of Consciousness
In the months or weeks of advanced liver failure, several changes in thinking and consciousness occur. The University of Maryland Medical Center reports that drowsiness and fatigue commonly occur with advanced liver failure. This occurs because the body is often malnourished and anemic due to the liver's inability to metabolize nutrients and rid the body of bad blood cells. Another condition known as hepatic encephalopathy occurs, causing a buildup of toxins in the blood. Hepatic encephalopathy causes confusion, altered thought processes, behavior changes, poor decision-making, coma and eventually death.
Ascites and Abdominal Discomfort
Unfortunately, many abdominal symptoms arise in the advanced stages of liver failure. "Medical Surgical Nursing" lists nausea, vomiting, indigestion, excess, gas, bloating, pain, and constipation alternating with diarrhea as common symptoms of liver failure. Ascites, or fluid buildup in the abdomen, also typically occurs with liver failure. This fluid accumulation causes discomforts such as tightness, pain, shortness of breath, and pressure in the abdomen. Patients with end stage liver failure also often have little or no appetite and are prone to losing significant amounts of weight.
Increased Bleeding
Two conditions cause increased risk for bleeding during advanced stages of liver failure: First, portal hypertension, which is high blood pressure in the portal vein of the liver causes backup of blood into the veins in the esophagus, stomach, and intestines. This causes them to bulge, and makes them extremely prone to rupture. The American Academy of Family Physicians reports that 50 percent of patients with chronic liver failure develop these bulging veins in the esophagus, though only 10 to 30 percent of those rupture. The second cause of increased bleeding is that advanced liver failure causes a deficiency in vitamin K, which is partially responsible for the coagulation of blood. Without vitamin K, the blood thins, putting the liver failure patient at high risk for bleeding.
Various Symptoms
Other symptoms that commonly occur with advanced liver failure include jaundice or yellowing of the skin, spider veins, risk for infections, bruising, slurred speech, muscle rigidity or twitching, itching and insomnia. The American Academy of Family Physicians also reports that kidney failure commonly occurs with advanced liver failure despite having previously healthy kidney function.
References
- "Medical Surgical Nursing" Ignatavicius, D. MSN, Workman, L. Ph.D.; 2002
- University of Maryland Medical Center: Characteristics of Liver Failure
- American Academy of Family Physicians: Cirrhosis and Chronic Liver Failure Part II
