Liver failure (hepatic insufficiency) – causes, complaints & therapy

Causes

Liver failure over a long period of time (weeks, months = subacute liver failure) can have various causes. Often such organ failure is related to another physical disease. These include the following diseases:

• Hepatitis B

• Hepatitis C

• chronic alcohol abuse

• Cirrhosis

• Hemochromatosis (a disorder that causes the body to ingest and store too much iron)

• Malnutrition or malnutrition.

The causes of acute liver failure are also numerous. Common causes include:

• Overdose of paracetamol (many tablets at once, or strong dosage over several days)

• Prescription medications such as antibiotics

• various natural preparations are also associated with acute liver failure (kava, ephedra, skullcap, flea herb)

• Poisoning (for example, with poisonous mushrooms that were mistaken for edible)

• Autoimmune hepatitis (a rare disease that causes the immune system to attack liver cells)

• Vascular diseases (e.g. Budd-Chiari syndrome, here it comes to occlusion of the laxative blood vessels of the liver)

• metabolic diseases (such as fatty liver or Wilson’s disease)

• Liver cancer

Symptoms and course

Typical signs of liver failure:

• Yellowish discoloration of the skin

• Yellowing of the eyes

• Diarrhoea

• Vertigo

• Anorexia

• Vomit

• Confusion

• Fatigue

There are a number of symptoms that may indicate liver failure. These occur sporadically or in combination. Since the symptoms in the early stages can also indicate other causes, liver failure is difficult to diagnose. Early symptoms: dizziness, loss of appetite, swollen abdomen, fatigue, diarrhea, vomiting.

Icterus ( jaundice ) usually occurs during the course of the disease . If left untreated, sufferers fall into a hepatic coma and/or also suffer renal failure due to liver failure . Hypoalbuminemia (a disorder in the blood plasma) can also occur, which often leads to Edema (water retention in the tissue).

Diagnosis

Various methods can be used to diagnose liver failure. A typical method to measure the functionality of the liver is the thromboplastin time. For this purpose, the patient is measured (e.g. with a needle) and then how long it takes for the blood to clot. When the liver is not working properly, the blood clots more slowly than normal. X-rays are also used to diagnose liver failure. The doctor can identify possible damage on the recordings. Another form of diagnosis is the surgical removal of a small piece of the organ ( Biopsy ). The tissue can be subjected to an analysis and the exact reason for the liver failure can be determined.

Complications

As soon as the liver, which forms one of the central metabolic organs, only works to a limited extent, it is referred to as liver failure (liver insufficiency). Sometimes the syndrome appears unexpectedly due to illness, an accident or self-inflicted due to an unhealthy lifestyle. However, it can also have medical reasons, for example due to too much or incorrectly adjusted medication or as part of chemotherapy .

As soon as the organ reduces its service or stops completely, an acute poisoning process of the body begins. Even with the slightest sign of the syndrome, immediate medical attention should be sought and initiated. Medical complications that have led to liver failure can worsen dramatically. Several factors need to be addressed at the same time. The patient must be stabilized and detoxified under medical care and the circumstances of the liver failure must be determined at the same time. This can lead to further problems if the patient is dependent on the medication due to his or her previous illness.

The same applies if the syndrome occurs in the course of emergency surgery in an accident patient. Liver failure at home shows signs of high fever, edema, vomiting blood, severe itching due to excessive bile acid formation, ascites and symptoms of jaundice. In the worst case, there is a risk of circulatory collapse and hepatic coma with severe brain damage.

treatment and therapy

Acute liver failure is treated under constant surveillance in a hospital emergency room. This is where the first treatments are initiated that give the damaged liver the opportunity to heal. If the liver failure was caused by poisoning (overdose of paracetamol, drugs, mushrooms , etc.), the detoxification can be counteracted with appropriate medication.

In severe cases of liver failure, the organ can no longer be saved. The result is an operation in which the damaged liver is replaced with a donor organ.

A number of complications can occur during treatment, which the doctor tries to reduce by taking certain precautions. Liver failure can result in increased pressure in the brain. This condition can be cured with the right medication.

The patient’s urine and blood should be checked regularly to rule out infection, which could complicate treatment. Infection can also be treated with medication.

During treatment for liver failure, the patient may experience internal bleeding in the gastrointestinal tract. If there is increased blood loss, blood transfusions may need to be performed.

prevention

To reduce the risk of liver failure, care should be taken with the liver. This includes prudent self-medication with substances that are harmful to the liver. Careful reading of the leaflet can prevent serious injuries.In the case of drug treatment, the doctor should be informed of all other medications the patient is taking in order to prevent a negative effect on the liver.

Excessive consumption of alcohol and other illegal drugs should be avoided. Any further contact with toxins or infected blood can also damage the liver directly or lead to damaging secondary diseases.

Overall, a healthy and conscious lifestyle (including a healthy diet ) can counteract liver failure.