How Liver Disease Progresses to Liver Failure

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The main goal when you have liver disease is to keep you from developing liver failure. Any type of liver disease can damage the liver, especially if it progresses without treatment. Liver disease usually gets worse in stages. With time, it may become severe enough that your liver loses its effectiveness. It can stop working altogether.

Liver failure means your liver no longer helps process and clear drugs and harmful chemicals from your body. It doesn't help digest food or regulate hormones. Your liver has hundreds of other jobs. When it fails, it can't do any of them. Liver failure is very serious and can be life threatening.

There are several causes of liver failure. Serious scarring of the liver—or cirrhosis—is the most common reason. It's often the result of a long-term untreated liver disease. Sometimes malnutrition is the culprit. Occasionally, liver failure happens suddenly or acutely. The most common cause of acute liver failure is an overdose of medications or another type of poisoning.

Here is a look at how cirrhosis and liver failure tend to develop and liver disease stages.

Early Liver Disease: Inflammation

In the first stages of liver disease, the liver becomes inflamed and larger than normal. It may hurt if you press beneath the right side of your rib cage. That's where your liver is located. Inflammation may not cause any symptoms. Still, it's important to treat it at this stage to keep it from getting worse.

With time, inflammation causes scars—or fibrosis—on the liver. The more scar tissue you have, the less your liver can do its jobs as well as it should. Blood doesn't flow in and out of the liver like it should, which threatens the whole body. When scars affect only part of the liver, the healthy areas of the liver work harder. If liver disease is diagnosed and treated at this stage, your liver may get better over time.

Mid-to-Late Liver Disease: Scarring

Cirrhosis develops if inflammation is not treated and scarring gets worse. With cirrhosis, scarring is serious and you cannot reverse the damage. However, treatment can slow down liver damage and possibly stop it from progressing to liver failure.

Cirrhosis can cause serious symptoms and problems including:

  • Blood vessels visible on your skin

  • Damage to blood vessels connected to the liver

  • Easy bruising and bleeding

  • Fluid buildup in your legs and belly

  • Increased risk of type 2 diabetes or insulin resistance

  • Increased sensitivity to drugs and drug side effects

  • Itchy skin

  • Stomach pain

  • Weight loss

  • Yellowing of your eyes and skin

Also, harmful chemicals may build up in your body, particularly in the brain. This can cause the following:

Cirrhosis is also the most common cause of liver cancer. Liver cancer can occur any time there's severe liver scarring. Hepatitis B, another type of liver disease, can also cause liver cancer.

End-Stage Liver Disease: Liver Failure

Untreated cirrhosis can lead to liver failure. This may happen gradually, over the course of years. As it starts, you may experience diarrhea, fatigue, nausea, and poor appetite. Symptoms of liver failure may include:

  • Feeling confused

  • Severe sleepiness

  • Slipping into a coma

Liver failure is a medical emergency because it can be life threatening. Treatment involves trying to save any working part of the liver. When this is not possible, the only treatment is likely to be a liver transplant.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2021 Jun 17
THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for informational purposes only. It is not a substitute for professional medical advice, diagnosis or treatment. Never ignore professional medical advice in seeking treatment because of something you have read on the site. If you think you may have a medical emergency, immediately call your doctor or dial 911.
  1. Hepatitis C: What Happens in End-Stage Liver Disease? Mayo Clinic. http://www.mayoclinic.org/diseases-conditions/hepatitis-c/expert-answers/hepatitis-c/faq-20058533
  2. Progression of Liver Disease. American Liver Foundation. http://www.liverfoundation.org/downloads/alf_download_940.pdf
  3. The Progression of Liver Failure. American Liver Foundation. http://www.liverfoundation.org/abouttheliver/info/progression/