Which of the following describes the best course of action for the management of acute liver failure?

Infections, alcohol abuse, and genetics can all lead to liver disease and damage. Liver failure happens when your liver can’t work well enough to perform its many vital functions, such as producing bile to help you digest food and clearing your blood of toxic substances.

Liver failure can be a life-threatening emergency. It can be either acute or chronic. Acute liver failure comes on quickly, while chronic liver failure occurs gradually over time.

Damage to your liver can accumulate through several stages. Each stage progressively affects your liver’s ability to function properly. Continue reading to learn more about liver failure and its different stages.

It’s important to distinguish between liver disease and liver failure.

Liver disease refers to any condition that causes inflammation or damage to your liver. Liver disease can affect the overall function of your liver.

Liver failure is when your liver has lost some or all of its functionality. It can occur due to the damage that’s caused by liver disease.

Damage from liver disease can accrue in several stages, which increasingly affect your liver’s ability to function.

Inflammation

In this early stage, your liver becomes enlarged or inflamed. Many people with liver inflammation don’t experience symptoms. If the inflammation continues, permanent damage can occur.

Fibrosis

Fibrosis happens when an inflamed liver begins to scar.

The scar tissue that’s generated in this stage takes the place of healthy liver tissue, yet the scarred tissue can’t perform the same functions. This can start to affect your liver’s ability to function optimally.

Fibrosis can be hard to detect because symptoms aren’t often present.

Cirrhosis

In the cirrhosis stage, severe scarring has built up on your liver. Because there’s even less healthy liver tissue, it becomes very difficult for your liver to function properly.

While symptoms may not have been present before, you may now begin to experience symptoms of liver disease.

End-stage liver disease (ESLD)

People with ESLD have cirrhosis in which liver function has deteriorated dramatically.

ESLD is associated with complications such as ascites and hepatic encephalopathy. It can’t be reversed with treatments other than a liver transplant.

Liver cancer

Cancer is the development and multiplication of unhealthy cells. When cancer develops in the liver, it’s called primary liver cancer.

Although it can occur at any stage of liver failure, people with cirrhosis are at an increased risk for developing liver cancer.

Some common symptoms of liver cancer include:

• unexplained weight loss
• abdominal pain or swelling
• loss of appetite or feeling full after eating a small amount of food
• nausea or vomiting
• yellowing of the skin and eyes (jaundice)
• skin itching

The cause of liver failure can depend on the type of liver failure — acute or chronic.

Causes of acute liver failure

Acute liver failure occurs rapidly. It can be caused by a variety of things, although in some cases, the exact cause may be unknown. Some possible causes include:

• viral infections, such as hepatitis A, B, or E
• overdose of acetaminophen (Tylenol)
• reactions to prescription medications such as antibiotics, NSAIDs, or anti-epileptic drugs
• reactions to herbal supplements, such as ma huang and kava kava
• metabolic conditions, such as Wilson’s disease
• autoimmune conditions, such as autoimmune hepatitis
• conditions that affect the veins of the liver, such as Budd-Chiari syndrome
• exposure to toxins, such as those found in industrial chemicals or poisonous wild mushrooms

Causes of chronic liver failure

Chronic liver failure occurs due to liver damage that develops slowly over time. This can lead to cirrhosis, in which the large amount of scar tissue on your liver prevents the organ from functioning properly.

Some examples of possible causes of cirrhosis include:

• chronic hepatitis B or C infection
• alcohol-related liver disease
• nonalcoholic fatty liver disease
• autoimmune hepatitis
• diseases that affect your bile ducts, such as cholangitis

Acute liver failure often occurs in people who don’t have a preexisting liver condition. It’s a medical emergency, and people experiencing symptoms consistent with acute liver failure should seek medical attention immediately.

The symptoms of acute liver failure can include:

• feeling unwell (malaise)
• feeling tired or sleepy
• nausea or vomiting
• abdominal pain or swelling
• yellowing of the skin and eyes (jaundice)
• feeling confused or disoriented

The symptoms of chronic liver failure can be broken down into early symptoms and more advanced symptoms. The early symptoms of chronic liver failure may include:

• feeling tired or fatigued
• loss of appetite
• nausea or vomiting
• mild abdominal discomfort or pain

Some symptoms that can indicate the advanced stages of chronic liver failure include:

• yellowing of the skin and eyes (jaundice)
• easy bruising or bleeding
• feeling confused or disoriented
• buildup of fluid in your abdomen, arms, or legs
• darkening of your urine
• severe skin itching

To diagnose liver failure, your doctor will start by taking your medical history and performing a physical examination. They may then perform a variety of additional tests, including:

• Liver blood tests. Liver blood tests assess the levels of various proteins and enzymes in your blood that can be an indicator of your liver functions.

• Other blood tests. Your doctor may also perform a complete blood count (CBC) or test for viral hepatitis or genetic conditions that can cause liver damage.

• Imaging tests. Imaging technology such as ultrasound, CT scan, or MRI scan can help your doctor to visualize your liver.

• Biopsy. Taking a tissue sample from your liver can help your doctor to see if scar tissue is present and can also aid in diagnosing what may be causing your condition.

Since damage to the liver leads to liver failure, treatment involves addressing what’s causing liver damage to occur.

For example, antiviral medications can be used to treat a viral hepatitis infection, or immune suppressing medication can be given to treat autoimmune hepatitis.

Lifestyle changes may also be recommended as a part of your treatment. These can include things like abstaining from alcohol, losing weight, or avoiding the use of certain medications.

According to the American Liver Foundation, damage from the inflammation and fibrosis stages of liver failure may be reversed and healed over time (if properly identified and treated). The liver damage caused by cirrhosis is often not reversible, although it can be slowed or stopped.

In people with severe cirrhosis or ESLD, a liver transplant may be necessary. This involves removing the diseased liver and replacing it with a liver from a healthy donor.

What about acute liver failure?

Acute liver failure is often treated in the intensive care unit of a hospital. Supportive care is given to help stabilize the condition and control any complications during treatment and recovery.

If a medication overdose or reaction is suspected, drugs may be given to reverse the effects. A liver transplant may also be recommended for some people with acute liver failure.

You can help to prevent liver failure by making lifestyle changes that keep your liver happy and healthy. Here are some tips for improving liver health:

• Drink alcohol in moderation, and never mix medications with alcohol.
• Take medications only when needed, and carefully follow any dosing instructions.
• Don’t mix medications without first consulting your doctor.
• Maintain a healthy weight — there’s a connection between obesity and fatty liver disease.
• Get vaccinated against hepatitis A and B.
• Be sure to have regular physicals with your doctor during which they perform liver blood tests.

Liver failure is when your liver can’t function properly. It can be either acute or chronic. Regardless of the type, liver failure can be a life-threatening emergency that requires prompt medical intervention.

The early stages of liver failure can often heal over time with proper treatment and lifestyle changes. However, the later stages of liver failure aren’t reversible and can sometimes require a liver transplant.

People who are diagnosed with liver disease are often monitored throughout their life to make sure that their condition isn’t worsening or causing further liver damage. If you have concerns about liver health or about liver failure, be sure to talk to your doctor.