Your liver is one of the most versatile organs in your body. It is responsible for a number of different processes in the body that are essential for life. The liver is the only organ in the human body that is capable of natural regeneration if a portion of the liver is lost. Even if as much as 25% of the liver tissue is lost, a whole liver will ‘grow’ back naturally. Despite its versatility and regenerative capabilities, the liver is not entirely immune to disease and dysfunction.
Although it can continue to function effectively despite being diseased, there is a point where the liver can no longer contend with its responsibilities. It is often at this stage that the first signs and symptoms of a liver disturbance becomes evident. In other words you may not know that your liver is ‘unhealthy’ until it reaches a serious point. A liver function test (LFT) is one way of checking the health of your liver, as well as imaging techniques such as an ultrasound or MRI even if you have no symptoms. However, routine liver screening is not common.
What does the liver do?
The liver’s functions are vast. When the health of the liver is affected, these functions are usually compromised to some extent or the other which gives rise to the symptoms of liver disease. The liver is responsible for the following:
- Metabolism of carbohydrates, fats and proteins.
- Breaks down byproducts of metabolism, wastes and toxins.
- Produces bile to eliminate wastes and excess nutrients.
- Filters the blood of different substances and also stores large amounts of blood.
- Produces chemicals that are responsible for blood clotting (clotting factors).
These are some of the main functions of the liver. There are many types of liver disease which can affect the health and function of the liver in different ways. Therefore the symptoms may vary slightly although most liver diseases present with the same symptoms. If you are experiencing one or more of the symptoms below then you may have a liver problem.
Yellow Tinge Of The Skin and Eyes
One of the most common signs of an unhealthy liver is jaundice. This is a yellowish discoloration of the skin, ‘whites’ of the eyes and sometimes even the inside of the mouth. Jaundice is a result of bilirubin build up in the body. Normally the liver processes and excretes bilirubin in bile. However, when the liver is malfunctioning, the bilirubin accumulates in the body. Bilirubin is a byproduct of red blood cell destruction, which is constantly occurring in the body. But sometimes there is excessive red blood cell breakdown (hemolysis) and jaundice can occur even though the liver is functioning normally.
Picture sourced from Wikipedia
Pale Stool and/or Dark Urine
Pale stools are another sign of liver dysfunction. Bilirubin that is broken down in the digestive system is responsible for the tan to dark brown color of stool. However, when the liver cannot process bilirubin and expel it with bile int the digestive tract, the brown color of stool may not be as prominent as it normally would. Therefore the stool may appear pale in color. However, the body may compensate and try to increase bilirubin excretion through the kidneys. Here the urine may appear very dark in color. While either of these signs, pale stool or dark urine, can occur on its own, it it is seen together then liver disease should be suspected.
Itchy Skin Throughout The Body
Pruritus is the medical term for itchy skin. It is usually associated with allergies, skin irritation and skin diseases. However, it can occur even thought the skin is otherwise healthy. Itchiness is common in liver dysfunction even without any skin rash. It is not usually isolated to one part of the body but may occur throughout the body. The itchiness is not always immediately associated with a liver problem. Commonly used medication like antihistamines or creams does not usually help. Sometimes itching of the skin can be the only symptom of liver problems for long periods of time until other symptoms arise.
Abdominal Pain With Swelling
Another common symptom is abdominal pain although it usually arises late in liver disease. It is often accompanied by abdominal swelling which may precede the abdominal pain. Enlargement of the liver is known as hepatomegaly. It usually does not cause prominent swelling over the area of the abdomen where the liver lies, unless the liver is grossly enlarged. Even then, hepatomegaly would be detected by a doctor during palpation of the abdomen as part of a physical examination. Swelling of the abdomen (ascites) may therefore be generalized although the pain may be localized to the upper abdomen, particularly on the right side and upper middle portion of the abdomen.
Picture sourced from Wikipedia
Nausea And Weight Loss
Nausea is another symptom on an unhealthy liver and is usually accompanied by a loss of appetite. The severity of nausea can vary, from mild nausea to intense nausea with vomiting especially a short while after eating a meal. Another common digestive symptom that is also seen is diarrhea. The loss of appetite and diarrhea eventually leads to weight loss. It is also a consequence of the liver being unable to metabolize and assimilate nutrients as it normally would. Most of these symptoms are non-specific and is therefore not commonly associated with liver disease. However, when these symptoms occur with jaundice, pale stools and generalized itching, liver disease should be suspected.
There is no single reason for why fatigue occurs with liver problems, but it is a common symptom. The fatigue is usually ongoing and even adequate rest does not completely overcome it. Therefore many people complain of morning fatigue, as they expect to be energetic after a night’s sleep. Generally a person with a liver problem has low energy levels where they are no longer enthusiastic to engage in activities they previously enjoyed. It is in part due to the reduced appetite and inadequate calorie intake. But the liver plays a complex role in the body and may directly or indirectly affect a range of functions in the body that can lead to fatigue.