Liver Failure: Spot the Warning Signs and Act Fast

Liver failure can show up slowly or suddenly. Sometimes you’ll feel only tired and bloated. Other times, it’s an emergency — confusion, yellow skin, or sudden bleeding. Knowing the common signs, what tests doctors use, and simple steps to protect your liver can make a big difference.

Common signs and how they feel

Watch for jaundice (yellowing of the skin and eyes), dark urine, and pale stools. You may also have swelling in your belly or legs (ascites), easy bruising, and unexplained tiredness. Confusion, sleepiness, or strange behavior can signal hepatic encephalopathy — a serious sign that needs urgent care. Pain or fullness under the ribs on the right side is common, too.

There are two main patterns: acute liver failure comes on fast (hours to days), often from a drug overdose like acetaminophen, severe infection, or a toxin. Chronic liver failure develops over months or years from conditions like hepatitis B or C, alcohol-related liver disease, or fatty liver disease.

What doctors check and treatment basics

Blood tests are the first step: ALT and AST show liver cell injury, bilirubin shows how well the liver clears waste, and INR tells about blood clotting. Imaging like ultrasound or CT looks for obstruction or scarring. Sometimes a doctor recommends a liver biopsy to see the extent of damage.

Treatment depends on the cause. For drug-induced injury, stopping the drug and getting specific antidotes (like N-acetylcysteine for acetaminophen) can save the liver. Viral hepatitis may need antivirals. For advanced chronic disease, doctors manage complications — diuretics for fluid, lactulose for encephalopathy, and procedures to control bleeding from varices. Some people need evaluation for liver transplant.

If you’re on multiple medicines, or take supplements, tell your doctor — many drugs and herbal products can harm the liver when mixed or taken in high doses.

When to get help now

Go to emergency care if you have sudden jaundice, new confusion, heavy vomiting, severe belly pain, or uncontrolled bleeding. Fast treatment can be lifesaving in acute liver failure.

To lower your risk: avoid heavy alcohol, use medicines exactly as labeled, get vaccinated for hepatitis A and B if you’re at risk, practice safe sex and avoid needle sharing, and aim for a healthy weight to prevent fatty liver. Ask your doctor about hepatitis C testing if you have risk factors.

You don’t have to manage this alone. If you notice symptoms or have risk factors, see your primary care doctor or a liver specialist (hepatologist). Early action helps catch problems sooner and gives you more treatment options.