The liver is the most essential organ in the body, yet not many pays as close attention to it as they should to ensure overall health. It actually performs over 500 different functions for every other organ and system in the body. Its main job is to remove toxins from other areas and decide how to eliminate them. But the liver is also responsible for helping the body fight off infection, regulate hormones and enzymes and instruct the other organs and systems how to maintain themselves. With all of its responsibilities, and how much the rest of the body depends on the liver, understanding its vulnerability to damage is important.
Although a forgiving organ, and the only one with the capability of repairing itself, damage to the liver can affect a person’s overall health when it isn’t functioning the way that it should. And this can lead to conditions such as liver disease (eg: Fatty Liver Disease), cirrhosis, cancer, and even death.
Because monitoring liver health isn’t a usual inclusion in yearly physical examinations unless a known condition already exists, a person can live with a condition affecting the liver for years without even knowing. And once the liver’s functioning is tremendously impaired, it could take a long time to recover if it does at all.
There are specific symptoms that the liver isn’t functioning properly. Initially, these can be so subtle they are written off as something less worrisome and some of these signs don’t present themselves until the liver is already in distress. Being aware of these symptoms, though, will assist physicians in deciding whether further investigation is required.
1) Yellowing of eyes and skin. This is one of the first telltale signs, and often related to those who consume a lot of alcohol. The truth is alcohol isn’t always the main factor. The yellowing is jaundice which occurs when the liver isn’t able to break down and remove by-products produced by the red blood cells (called ‘bilirubin’). Eyes turning red through the day due to tiredness, debris irritation or other reasons is normal. Yellowing is not.
2) Dark urine. Urine can be a bit on the dark side when dehydration occurs. But urine that is more orange or even brown is a concern and usually a sign that the liver isn’t eliminating toxins effectively. If the discolored urine is coupled with discomfort or pain in the middle back, it could be indicative of a condition called Hepatorenal syndrome (HRS). This condition is found in those suffering from severe liver disease and occurs when the liver isn’t able to remove toxins for the kidneys, which can result in liver failure. Any discoloration of the urine should be checked as soon as possible.
3) Odd colored stool. As with urine that is an off-color, stools that are pale, grey or even yellow are indicative that the liver isn’t producing bile effectively.
4) Swelling in the abdomen. It’s normal to experience a bit of swelling now and again, especially for women on their periods. But when the swelling doesn’t go down or keeps growing in size, it’s usually an indication that fluids are building up around the liver (ascites) that it isn’t able to process. A major concern with excessive fluid build-up is developing Spontaneous bacterial peritonitis (SBP), which is a serious bacterial infection of the ascitic fluid. It’s vital to seek the advice of a medical professional immediately if any swelling doesn’t go down.
5) Abdominal discomfort or pain, specifically in the upper abdomen. There are various reasons to experience occasional discomfort due to foods that irritate the digestive system, not enough fluids, gas, flu, menstrual cycle, to list a few. These issues come and go, but if they are ongoing and more painful, especially after eating, eliminating or exertive exercise, it’s wise to advise a physician. Although abdominal pain can be comorbid with other conditions, it could also be a sign of liver disease.
6) Confusion, forgetfulness or changes in behavior. Everyone gets a touch of each of these from time-to-time, but when it is prolonged or becoming severe, it is a sign that toxins have built up in the body that the liver can no longer filter out. This is a condition called ‘hepatic encephalopathy’, which can actually become quite serious if left undiagnosed.
7) Extremely itchy skin. Although not a more common symptom, it has been listed as a complaint for many liver patients. This is related to the liver’s inability to produce or use bile effectively, releasing bile salts through the skin.
8) Exhaustion. Everyone experiences lack of sleep or feeling run down periodically. But when it becomes difficult to stay awake or to have the energy to do simple tasks, it could be from the liver not processing glucose the way it’s supposed to. The liver’s inability to store or release glucose can tremendously impact energy levels.
9) Unusual bleeding. Any form of bleeding that occurs when an obvious injury isn’t present can be disturbing enough. If any blood is detected in the urine, stools, mouth or even spontaneous nosebleeds can be a sign of bleeding inside of the body. One of the liver’s functions is breaking down old red blood cells and producing proteins that assist with blood clotting. Therefore if wounds aren’t healing as quickly as they should or there is heavier bleeding even for minor cuts, it’s a sign that the liver isn’t able to perform this function. More seriously, it could also be a hint of a condition known as esophageal varices. This occurs when the vessels leading to and from the liver are blocked, causing a backup of blood flow which puts pressure on the main vein that carries blood to the liver. The vessels can burst from the extra pressure and blood will overflow into the abdomen. Any unusual bleeding should be addressed immediately.
Liver disease can take a long time to progress to the point where any of these symptoms may become apparent. Paying close attention to any changes in overall health that aren’t a part of a routine physical examination, as well as to request specific tests to monitor liver health (eg: checking liver enzymes), can be major steps in preventing the development of liver disease and the conditions that stem from it.