liver complications awareness

Overview

The liver is a large, fist-sized organ in the upper right side of your belly. It cleans your blood, makes bile to help digest food, stores energy, and helps fight infections. Liver complications are health problems that happen when the liver is damaged or cannot do its jobs well. They range from mild inflammation (swelling) to serious scarring (cirrhosis) and can affect your whole body.

Yes, liver problems are common. Non-alcohol-related fatty liver disease is the most common cause, affecting about 1 in 3 adults in the UK. Most people with early fatty liver do not know they have it.

Anyone can develop liver complications, but you are at higher risk if you drink large amounts of alcohol, have hepatitis B or C, are overweight, have diabetes, or have a family history of liver disease. It can also affect children.

Symptoms

Common symptoms

• Extreme tiredness (fatigue) that doesn't improve with rest
• Yellowish skin or eyes (jaundice)
• Swelling in your legs, ankles, or feet
• A swollen or bloated belly
• Dark urine or pale (grey) stools
• Itchy skin
• Nausea and loss of appetite
• Bruising or bleeding more easily than usual

Symptoms in children

• Slow weight gain or poor growth
• Yellowness of the skin or eyes that doesn't go away
• Very pale stools and dark urine
• A swollen belly

Symptoms in older adults

• Feeling confused or unusually sleepy
• Dizziness or being unsteady on your feet
• A general feeling of being unwell with no clear cause
• Frequent falls or weakness

Causes

Main causes

• Too much alcohol over time (alcohol-related liver disease)
• Non-alcohol-related fatty liver disease (a build-up of fat in liver cells)
• Viral hepatitis, especially hepatitis B and C
• Autoimmune diseases, where your immune system attacks your liver
• Inherited conditions, such as hemochromatosis (too much iron in the body)
• Damage from certain medications, herbal products, or toxins

Risk factors

• Drinking more than 14 units of alcohol spread across the week
• Being overweight or obese
• Type 2 diabetes or high blood sugar
• High cholesterol and high triglycerides (fats in the blood)
• Sharing needles or having unprotected sex, which can spread hepatitis B or C
• A family history of liver disease

When to see a doctor

See a doctor urgently if:

• See a doctor as soon as possible if you have jaundice, dark urine, pale stools, a swollen belly, unexplained weight loss, or you feel very tired all the time.
• If you have hepatitis B or C, or a family history of liver disease, ask to be tested even if you feel fine.

Book a routine appointment if:

• During routine checkups, ask about liver tests if you drink alcohol regularly, are overweight, or have diabetes.
• If you are starting a new medicine that may affect your liver, discuss any risks with your doctor or pharmacist.

Diagnosis

Your healthcare provider will ask about your health history and lifestyle, and feel your belly. They will likely order blood tests to check liver function. If needed, they may use scans to look at your liver.

Tests that may be done

• Liver function blood tests (these check enzymes and proteins in your blood)
• Ultrasound scan of your belly
• Elastography (a special scan that measures liver stiffness)
• A liver biopsy (a small sample of liver tissue taken with a needle, in some cases)

What to expect at your appointment

Most liver tests happen in a clinic or outpatient department. A blood test takes a few minutes. Imaging scans are painless. A biopsy may cause mild soreness, but you'll be given guidance before and after. You may be asked to fast for several hours before a test or scan.

Treatment

Treatment depends on what is causing the liver disease and how far it has progressed. The main goals are to stop further damage, ease symptoms, and prevent complications. Many people can improve without surgery.

Self-care at home

• Stop drinking alcohol completely if you have any liver condition (ask your doctor for support).
• Follow a balanced diet with plenty of vegetables, fruit, and whole grains, and limit salt, sugar, and ultra-processed foods.
• Stay active in a gentle way, like walking or swimming, if you feel able.
• Do not take any medicine, supplement, or herbal remedy without checking with your doctor or pharmacist first.
• Keep all your medical appointments and talk openly about any concerns.

Medical treatments

Your doctor may prescribe medicines to treat the underlying cause, such as antivirals for hepatitis, or medications to help control diabetes or cholesterol. If you have fluid build-up or other complications, there are procedures to drain it. For advanced liver disease, you may be referred to a liver specialist (hepatologist). Your team will decide what is right for you.

When is surgery considered?

Surgery is uncommon for early liver problems. However, if your liver fails completely, a liver transplant (replacing your liver with a healthy one from a donor) may be the best option. This is a major operation and requires lifelong follow-up, but many people live full lives after a transplant.

Living with this condition

Take things one day at a time. Some days you will have more energy; other days you may feel tired. Rest when you need to and keep a simple routine. Keep a notebook of symptoms to share with your doctor.

Lifestyle tips

• Avoid all alcohol unless your doctor says it is safe.
• Keep a healthy weight and lose weight steadily if you need to.
• Avoid processed foods and sugary drinks.
• Get enough rest and try a relaxing activity like deep breathing or gentle yoga.
• Have a hepatitis A and hepatitis B vaccination if your doctor recommends it.
• Do not share needles, razors, or toothbrushes.

Diet and exercise

Eat a variety of foods, but keep salt low if you have swelling or fluid build-up. Choose lean proteins like fish, chicken, beans, and lentils. If you have diabetes, manage your carbohydrates. For exercise, start with short walks and gradually increase to 20-30 minutes most days. Always check with your doctor before starting something new.

Mental health and emotional wellbeing

It is completely normal to feel anxious, sad, or stressed after a liver diagnosis. Your mental health is important. You can ask your doctor to connect you with a counsellor or a support service. You might also find comfort in talking with people who understand what you're going through.

Prevention

Many liver complications can be prevented or slowed down. The most effective steps are to limit or avoid alcohol, keep a healthy weight, manage diabetes, and protect yourself against hepatitis.

Vaccines

Vaccines are available for hepatitis A and hepatitis B. Ask your doctor or local health service whether you should be vaccinated.

Screening programmes

If you have a family history of liver disease or have risk factors, ask your doctor about regular blood tests. Early screening can find liver changes before symptoms appear, when treatment is more likely to help.

Complications

If left untreated

• Advanced scarring of the liver (cirrhosis)
• Liver failure (the liver stops working properly)
• Bleeding from swollen veins in the food pipe (oesophageal varices)
• Fluid build-up in the belly (ascites)
• Confusion and personality change caused by liver toxins (hepatic encephalopathy)
• An increased risk of liver cancer

Long-term outlook

The outlook is better than many people think. Early liver disease can often be stopped or even reversed by making changes and following medical advice. Even with more advanced stages, treatments can manage symptoms and slow the disease. Your healthcare team will work with you to keep you as well as possible for as long as possible.

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