Materiały źródłowe

• #1 Chronic Liver Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554597/

  Chronic liver disease is a progressive deterioration of liver functions. Chronic liver disease (CLD) is a progressive deterioration of liver functions for more than six months, which includes synthesis of clotting factors, other proteins, detoxification of harmful products of metabolism, and excretion of bile. CLD is a continuous process of inflammation, destruction, and regeneration of liver parenchyma, which leads to fibrosis and cirrhosis. Cirrhosis is a final stage of chronic liver disease that results in disruption of liver architecture, the formation of widespread nodules, vascular reorganization, neo-angiogenesis, and deposition of an extracellular matrix. The underlying mechanism of fibrosis and cirrhosis at a cellular level is the recruitment of stellate cells and fibroblasts, resulting in fibrosis, while parenchymal regeneration relies on hepatic stem cells. Signs and symptoms of CLD can be nonspecific, such as fatigue, anorexia, weight loss, or depend upon the complication that the patient has developed. The three significant complications are because of portal hypertension (esophageal varices, ascites), hepatocellular insufficiency (e.g., jaundice, hepatic encephalopathy), and hepatocellular carcinoma. Decompensated chronic liver disease can present with one of the following complications. Portal hypertension is a result of resistance to portal blood flow because of cirrhotic and noncirrhotic etiology. A portal venous pressure above seven mmHg is considered portal hypertension; however, clinical features or complications do not develop until portal pressure is higher than 12 mmHg. Chronic liver disease represents a continuous and progressive process of hepatic fibrosis, liver tissue architectural distortion, and regeneration nodule formation. While fibrosis is usually irreversible, but it can be reversible in the initial stage of development. In chronic liver disease, if not treated, the endpoint is usually irreversible fibrosis, regeneration nodule formation, and development of cirrhosis liver. The development rate of fibrosis is dependent on the underlying etiologies, environmental, and host factors. The evolution of liver fibrosis was studied in 4852 patients with different underlying etiology in one study. The author observed significant differences in the rate of development of fibrosis and its progression. The rate was most rapid in patients with coinfection with HIV- HCV, while primary biliary cirrhosis was the slowest. Fibrosis progression rate was higher with increasing age, and females demonstrated a more gradual progression of liver fibrosis in all but alcoholic liver disease. Chronic liver disease is one of the frequent causes of death, especially in the developing world. The increasing prevalence of chronic liver disease has been noted in recent times. The majority of chronic liver diseases in the developed world include alcoholic liver disease, chronic viral hepatitis, including hepatitis B and C, non-alcoholic fatty liver disease (NAFLD), and hemochromatosis. Compensated chronic liver disease (who has not developed significant complications) usually carries a better prognosis than decompensated liver cirrhosis. Decompensated liver cirrhosis patients (who have developed variceal bleeding, ascites, HCC, SBP, and hepatorenal syndrome) have a poor prognosis. Mean survival of about six months if Child-Pugh score of 12 or greater or MELD score of 21 or higher. The following are the complications of chronic liver disease. Variceal bleeding, Ascites and spontaneous bacterial peritonitis (SBP), Hepatic encephalopathy, Hepatorenal syndrome, Hepatopulmonary syndrome, Hepatocellular carcinoma (HCC).

• #2 The Stages of Liver Disease – American Liver Foundation

  https://liverfoundation.org/about-your-liver/how-liver-diseases-progress/

  In America, liver disease affects millions and is on the rise. Did you know there are more than 100 different types of liver disease? Living with long-term, chronic liver disease can cause damage to your liver. […] Most liver diseases damage your liver in similar ways and for many, the progression of liver disease looks the same regardless of the underlying disease. […] Early diagnosis may prevent damage from occurring in your liver. Your liver is an incredible organ. If you’re diagnosed when some scar tissue has already formed, your liver can repair and even regenerate itself. Because of this, damage from liver disease can often be reversed with a well-managed treatment plan. […] Many people with liver disease do not look or feel sick even though damage is happening to their liver. At a certain point in the progression of liver disease damage can become irreversible and lead to liver failure, liver cancer, or death.

• #3 Symptoms – Liver Foundation

  https://liver.org.au/your-liver/symptoms/

  Most people don’t realise at first that they have a problem with their liver. That’s because liver disease and liver damage rarely cause symptoms in the early stages. […] At first, the signs of liver disease are often vague. If you have early liver disease, you might feel more tired and weak than normal or you might feel a bit nauseous (sick). […] Symptoms of more serious disease depend on the condition and how much damage there is to your liver. […] Signs your liver is struggling include: yellow skin or white of the eyes (jaundice), dark urine, nausea (feeling like you are going to vomit), vomiting (being sick), diarrhoea, bloating (swollen tummy), not feeling hungry, fever, swollen legs, ankles or feet, very itchy skin, hair loss, bruising easily, anaemia (not having enough iron in the blood – you have pale skin; the insides of your eyelids or your fingernails are pale), frequent nosebleeds or bleeding gums, frequent muscle cramps, pain in the right shoulder, dizziness, vomiting blood, black or light coloured poos, being confused or drowsy, memory loss, staggering or falling a lot, finding it harder to write, spidery handwriting, trembling hands, changes in your personality, being moody or cranky, forgetfulness, poor sleep, very rapid heart rate, being more sensitive to alcohol or drugs, erectile dysfunction in men (not being able to get an erection), or losing sexual desire, irregular periods or no periods in women.

• #4 Liver disease

  https://www.nhs.uk/conditions/liver-disease/

  Most types of liver disease do not cause any symptoms in the early stages. […] Once you start to get symptoms of liver disease, your liver is already damaged and scarred. This is known as cirrhosis. […] Symptoms of cirrhosis include: feeling very tired and weak all the time, loss of appetite which may lead to weight loss, loss of sex drive (libido), yellow skin and whites of the eyes (jaundice), itchy skin, feeling or being sick. […] You think you might have liver disease or cirrhosis.

• #5 The Stages of Liver Disease – American Liver Foundation

  https://liverfoundation.org/about-your-liver/how-liver-diseases-progress/

  In America, liver disease affects millions and is on the rise. Did you know there are more than 100 different types of liver disease? Living with long-term, chronic liver disease can cause damage to your liver. […] Most liver diseases damage your liver in similar ways and for many, the progression of liver disease looks the same regardless of the underlying disease. […] Early diagnosis may prevent damage from occurring in your liver. Your liver is an incredible organ. If you’re diagnosed when some scar tissue has already formed, your liver can repair and even regenerate itself. Because of this, damage from liver disease can often be reversed with a well-managed treatment plan. […] Many people with liver disease do not look or feel sick even though damage is happening to their liver. At a certain point in the progression of liver disease damage can become irreversible and lead to liver failure, liver cancer, or death.

• #6 Stages of Liver Disease and Liver Failure | UPMC HealthBeat

  https://share.upmc.com/2022/11/stages-of-liver-disease-and-liver-failure/

  Your liver is a football-sized organ under your ribcage. It is your largest internal organ. Your liver performs many vital tasks, including filtering your blood and helping with digestion. […] Sometimes your liver develops a disease. When doctors consider the stages of liver disease, they focus on how widespread and severe the liver damage is. […] The first stage of liver disease is usually inflammation of the liver, or hepatitis. When the body tries to heal an infection or injury, inflammation (swelling) results. […] When hepatitis continues over time, the result can be scarring in the liver. People with hepatitis often have no symptoms, so they may not seek medical attention. Mild symptoms at this stage can include abdominal pain and swelling. […] The second stage of liver disease typically involves fibrosis, the formation of scar tissue in the liver. As scar tissue crowds out healthy liver tissue, your liver may not work as well over time.

• #7 Liver Failure – End Stage Liver Disease – UChicago Medicine

  https://www.uchicagomedicine.org/conditions-services/liver-diseases-hepatology/liver-failure

  Without proper treatment, liver disease often gets worse over time. The stages of liver disease are: In this early stage of liver disease, your liver is swollen but you may not notice any symptoms. Over time, inflammation turns healthy liver tissue into scar tissue, which is called fibrosis. Fibrosis makes it harder for your liver to work properly, but it is often reversible. When your liver becomes severely and permanently scarred, this is called cirrhosis. Cirrhosis may be caused by heavy alcohol use, viral hepatitis, autoimmune hepatitis, fatty liver disease, bile duct diseases and various hereditary conditions. Over time, cirrhosis can slowly lead to a decline in liver function and, ultimately, end-stage liver disease. This means your liver has shut down and can no longer perform important functions like getting rid of harmful substances, producing proteins that allow for adequate clotting and making bile, which is needed to digest food. When the liver is failing, it can no longer complete its vital tasks. As a result, the body does not work properly. As chronic liver disease progresses, you may experience some or all of the following symptoms: Jaundice, or yellow eyes and skin, Confusion or other thinking difficulties, Swelling in the belly, arms or legs, Severe fatigue, A tendency to bleed easily. Chronic liver failure is a slow decline in liver function that occurs alongside cirrhosis, or severe scarring of the liver. Acute liver failure occurs when the liver fails rapidly, typically over days to a few weeks. A failing liver can develop slowly or rapidly, depending on the cause and the condition of the liver. Early on, liver damage may not cause any symptoms. A failing liver is usually detected with blood tests. When your liver stops working, you need immediate treatment to survive. Get emergency help if you notice these symptoms: Yellow eyes and skin (jaundice), Fluid build-up in the abdomen (ascites), Swelling in the arms or legs (edema), Vomiting blood, Black stools, Mental confusion, Shortness of breath. Liver failure is when the liver has shut down or is shutting down and can no longer work properly. Cirrhosis is a late stage of liver disease where the liver is severely scarred but may still work. Most patients who develop chronic liver failure have underlying cirrhosis.

• #8

  https://www.advocatehealth.com/health-services/digestive-health-center/conditions-we-treat/liver-disease

  Liver disease affects millions of people around the world. It can be caused by excessive alcohol consumption, viral infections, genetics and certain medications. […] If not treated, damage from liver disease can progress through stages from moderate to severe, which may require a liver transplant if your liver disease is further advanced. The stages of liver damage include: Stages of liver disease The four stages of liver disease include fatty liver, fibrosis, cirrhosis and cancer. […] Symptoms may begin to be noticeable in this stage. […] You may not experience any liver disease symptoms in the early stages. As the disease progresses, symptoms may include: Abdominal pain, Dark urine, Fatigue and weakness, Jaundice (yellow discoloration of the skin and eyes), Nausea and vomiting, Pale stool color, Swelling in the legs and abdomen. […] See your doctor if you experience any of these potential symptoms of liver disease.

• #9 What Is Chronic Liver Disease? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/liver-disease/what-is-chronic-liver-disease/

  According to the University of Pittsburgh Medical Center, chronic liver disease can progress via four different stages: Inflammation (hepatitis) In this earlier stage, the liver becomes swollen or inflamed. Fibrosis If inflammation isnt treated, it can lead to scarring of the liver tissue, which is called fibrosis. If caught early, fibrosis is treatable. Cirrhosis In cirrhosis, scarring of the liver becomes permanent and cant be reversed. People with cirrhosis are more likely to develop liver cancer. Liver failure This means the liver stops functioning completely. […] Life expectancy for people with chronic liver disease varies depending on the severity of the disease and what treatments are given. If the disease is caught and treated early, you may be able to avoid severe liver damage or liver failure, according to the Cleveland Clinic.

• #10 Cirrhosis of the Liver: Signs & Symptoms, Causes, Stages

  https://my.clevelandclinic.org/health/diseases/15572-cirrhosis-of-the-liver

  Cirrhosis of the liver is late stage liver disease, in which healthy liver tissue has been gradually replaced with scar tissue. This is a result of long-term, chronic hepatitis. […] Cirrhosis is a progressive condition that worsens as more and more scar tissue develops. In the beginning, your body adjusts to compensate for your reduced liver function, and you might not notice it too much. This is known as compensated cirrhosis. Eventually, though, as your liver function declines further, you will begin to experience noticeable symptoms. This is known as decompensated cirrhosis. […] Signs and symptoms of cirrhosis depend on how advanced it is. You might not have symptoms at all early on, or you might only have vague symptoms that resemble many other conditions. Symptoms of cirrhosis become more recognizable as your liver function declines.

• #11 The stages of long term liver disease – British Liver Trust

  https://britishlivertrust.org.uk/information-and-support/liver-health-2/stages-of-liver-disease/

  Most types of long term (chronic) liver disease develop in stages over many years. […] Many people do not know they have a liver condition until it reaches a late stage (cirrhosis). At this point, they can become very unwell and there may be very few treatment options. […] But if liver disease is found at an earlier stage, the damage can often be stopped or even reversed. […] If the damage is not stopped it may lead to an increase in inflammation in the liver (hepatitis). Then possibly to scarring of the liver (fibrosis). Over time this can cause severe scarring (cirrhosis). […] Even after cirrhosis develops, it is possible to stop it from getting worse. This can help your liver to carry on doing all its important jobs. People can potentially live for many years with cirrhosis. […] But if cirrhosis gets worse it can lead to severe complications or liver cancer. Sadly every day 27 people in the UK die from liver diseases, including cirrhosis.

• #12 Liver Failure: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/digestive/liver-failure

  Liver failure is a life-threatening condition that occurs when the liver stops working. A healthy liver performs many important bodily functions, so immediate emergency care is necessary when it stops working. […] Two types of liver failure occur. The first type is gradual and is the final stage of many liver diseases. The second is quick when liver failure results from a virus or substance overuse. […] Four stages of liver failure define the progression of the disease: […] Patients may not have any symptoms at this stage, but some people may have tenderness on the right side of their abdomen. Elevated liver enzymes can be a sign of liver inflammation. […] Liver scars can form as a result of longstanding inflammation. The scarring can worsen over time if the cause of liver damage is not treated.

• #13 Liver Failure: Causes, Symptoms, Treatments, Tests & More

  https://www.webmd.com/fatty-liver-disease/digestive-diseases-liver-failure

  Liver failure happens when your liver starts to shut down. This is usually because it’s become damaged and can’t be repaired. It’s a life-threatening condition that demands urgent medical care. Most often, liver failure happens gradually, over many years, and is called chronic liver failure. Its the final stage of many liver diseases. But a rarer condition, known as acute liver failure, happens rapidly — in as little as 48 hours. […] When your liver can no longer do these things, then liver failure sets in. […] The early symptoms of liver failure are often similar to those of other conditions. Because of this, liver failure may be tough to diagnose at first. Early symptoms include: Nausea, Loss of appetite, Fatigue, Diarrhea. […] As liver failure progresses, the symptoms become more serious, needing care right away. These symptoms include: Jaundice (yellowing of eyes and skin), Bleeding easily, Swollen belly, Mental confusion (known as hepatic encephalopathy), Sleepiness. […] These symptoms will appear in both chronic and acute liver failure. […] If you have end-stage liver disease, your lifespan will be about 2 years, unless you get a liver transplant. Once your liver starts to shut down (liver failure), you can only live for a day or two.

• #14 The Stages of Liver Disease – American Liver Foundation

  https://liverfoundation.org/about-your-liver/how-liver-diseases-progress/

  Liver cancer is cancer that begins in the cells of your liver. While several types of cancer can form in the liver, the most common type of liver cancer is hepatocellular carcinoma, or HCC, which begins in the main type of liver cells (hepatocytes). […] Liver transplantation is a surgical procedure performed to remove a diseased or injured liver from one person and replace it with a whole or a portion of a healthy liver from another person, called the donor.

• #15 Symptoms of liver disease – British Liver Trust

  https://britishlivertrust.org.uk/information-and-support/liver-health-2/symptoms-of-liver-disease/

  Liver disease usually develops slowly, in stages, over many years. Liver damage can often be repaired if found early. But most people will not have any symptoms until the disease is at a late stage. […] Many people with the early stages of liver disease do not have any symptoms. It is not possible to tell just from symptoms if your liver is healthy or not. […] Early symptoms can include: Feeling generally unwell, Feeling tired all the time, even when you have rested, Feeling or being sick, Pain or a sore feeling under your ribs on your right side, Small spider like veins showing on your skin above waist level (spider angiomas), Blotchy red palms, Trouble sleeping. […] Your liver has around 500 different jobs. In the later stages of liver disease it struggles to do all of these normally. This can cause lots of different symptoms. But most people only get some of these symptoms, so the mix of symptoms is different for everyone. […] If you have any of these symptoms, talk to you doctor and ask for a test to check on your liver. This will usually be a simple blood test to start with. […] Jaundice is usually described as a yellow colour to your eyes and skin.

• #16 Symptoms – Liver Foundation

  https://liver.org.au/your-liver/symptoms/

  Most people don’t realise at first that they have a problem with their liver. That’s because liver disease and liver damage rarely cause symptoms in the early stages. […] At first, the signs of liver disease are often vague. If you have early liver disease, you might feel more tired and weak than normal or you might feel a bit nauseous (sick). […] Symptoms of more serious disease depend on the condition and how much damage there is to your liver. […] Signs your liver is struggling include: yellow skin or white of the eyes (jaundice), dark urine, nausea (feeling like you are going to vomit), vomiting (being sick), diarrhoea, bloating (swollen tummy), not feeling hungry, fever, swollen legs, ankles or feet, very itchy skin, hair loss, bruising easily, anaemia (not having enough iron in the blood – you have pale skin; the insides of your eyelids or your fingernails are pale), frequent nosebleeds or bleeding gums, frequent muscle cramps, pain in the right shoulder, dizziness, vomiting blood, black or light coloured poos, being confused or drowsy, memory loss, staggering or falling a lot, finding it harder to write, spidery handwriting, trembling hands, changes in your personality, being moody or cranky, forgetfulness, poor sleep, very rapid heart rate, being more sensitive to alcohol or drugs, erectile dysfunction in men (not being able to get an erection), or losing sexual desire, irregular periods or no periods in women.

• #17 Liver Disease: Signs & Symptoms, Causes, Stages, Treatment

  https://my.clevelandclinic.org/health/diseases/17179-liver-disease

  Symptoms of late-stage liver disease include jaundice, itching and mild brain impairment. […] Chronic liver disease often won’t cause symptoms in the early stages. But sometimes it begins with an episode of acute hepatitis. […] You might begin to notice more symptoms when your liver function begins to decline. This happens in the later stages of liver disease. One of the first side effects of declining liver function is that bile flow stalls in your biliary tract. […] As liver disease advances, it can affect your blood flow, hormones and nutritional status. This can show up in various ways. […] Liver disease symptoms in women may include irregular periods (menstruation) and female infertility. […] Liver disease symptoms in men may include shrunken testicles and enlarged male breast tissue.

• #18 Symptoms & Causes of Cirrhosis – NIDDK

  https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis/symptoms-causes

  You may have no symptoms in the earliest stage of cirrhosis. Symptoms of cirrhosis may not appear until the liver is badly damaged. […] Early symptoms of cirrhosis may include feeling tired or weak, itching of the skin, poor appetite, losing weight without trying, nausea and vomiting, mild pain or discomfort over the liver in the upper right side of the abdomen, or belly, muscle loss and weakness, muscle cramps, sexual problems. […] As liver function gets worse, people with cirrhosis may have other symptoms, including bruising and bleeding easily, confusion, difficulty thinking, memory loss, personality changes, or sleep disorders, internal bleeding due to the bursting of enlarged veins called varices in the esophagus, stomach, or intestines, swelling in the lower legs, ankles, or feet, called edema, swelling of the abdomen from a buildup of fluid, called ascites, severe itchy skin, darkening of the color of the urine, yellowish tint to the whites of the eyes and skin, called jaundice.

• #19 Cirrhosis of the Liver: Signs & Symptoms, Causes, Stages

  https://my.clevelandclinic.org/health/diseases/15572-cirrhosis-of-the-liver

  Early signs and symptoms of cirrhosis may include: Nausea or loss of appetite. Feeling weak or tired (fatigue). Feeling generally ill (malaise). Upper abdominal pain (especially on the right). Visible blood vessels that look like spiders (spider angiomas). Redness on the palms of your hands (palmar erythema). […] Recognizable symptoms of cirrhosis fall into two categories: symptoms related to declining liver function, and symptoms related to portal hypertension. Symptoms of stalled bile flow, like jaundice, are common indicators of declining liver function. Symptoms of portal hypertension indicate cirrhosis specifically. Its scar tissue in your liver that compresses your portal vein. […] Cirrhosis symptoms related to declining liver function include: Jaundice (yellow tint to your skin and eyes). Pruritus (itchy skin, but with no visible rash). Dark-colored pee and light-colored poop. Digestive difficulties, especially with fats. Small yellow bumps of fat deposits on your skin or eyelids. Unexplained weight loss and muscle loss. Hepatic encephalopathy (confusion, disorientation, mood changes). Motor dysfunction (twitching, tremors or lapses in muscle control). Disruptions to your menstrual cycle. Enlarged male breast tissue and shrunken testes.

• #20 Stages of Liver Disease and Liver Failure | UPMC HealthBeat

  https://share.upmc.com/2022/11/stages-of-liver-disease-and-liver-failure/

  In stage three liver disease, significant damage has occurred. Fibrotic scar tissue has crowded out more of the healthy tissue, making it much harder for the liver to function. […] By this time, people with stage three liver disease may notice more symptoms. These include: Low-grade fever, Nausea, Diarrhea, Itchy skin, Joint pain, Jaundice (yellowed eyes or skin), Loss of appetite. […] In cirrhosis, liver damage happens faster than the healthy cells can regenerate. People with cirrhosis have much more scar tissue in their livers than healthy tissue. At this point, the liver can barely function. […] People with cirrhosis usually have a variety of symptoms, including: Loss of appetite, Fatigue, Nausea, Weight loss, Abdominal pain, Spider-like blood vessels on the skin, Severe itching. […] Liver failure, or end-stage liver disease, occurs when the liver can no longer function. Early symptoms of liver failure can include any or all symptoms from the previous stages. […] As liver failure progresses, symptoms may include: Confusion, Extreme tiredness, Kidney failure, Coma.

• #21 Advanced Liver Disease – Liver Foundation

  https://liver.org.au/your-liver/advanced-liver-disease/

  Anyone with cirrhosis or liver cancer can develop advanced liver disease. If you have advanced liver disease, your liver doesn’t work anymore. You might develop serious health problems. Sometimes liver damage becomes so advanced that the liver doesn’t work anymore. Serious problems that can happen in advanced liver disease include: Portal hypertension: High pressure in the portal vein. Sometimes it can cause internal bleeding […] Ascites: Swollen belly due to build-up of fluid […] Hepatic encephalopathy: A brain disorder when toxins build up in the blood. Often begins subtly with forgetfulness and “clouded thinking” but can progress to people becoming very confused and sleepy […] Jaundice: Yellowing of the eyes or skin. Without treatment, advanced liver disease will get worse. But treatment can prevent this decline. As the liver function deteriorates, you might notice: Belly pain

• #22 Liver Failure: Causes, Symptoms, Treatments, Tests & More

  https://www.webmd.com/fatty-liver-disease/digestive-diseases-liver-failure

  Liver failure happens when your liver starts to shut down. This is usually because it’s become damaged and can’t be repaired. It’s a life-threatening condition that demands urgent medical care. Most often, liver failure happens gradually, over many years, and is called chronic liver failure. Its the final stage of many liver diseases. But a rarer condition, known as acute liver failure, happens rapidly — in as little as 48 hours. […] When your liver can no longer do these things, then liver failure sets in. […] The early symptoms of liver failure are often similar to those of other conditions. Because of this, liver failure may be tough to diagnose at first. Early symptoms include: Nausea, Loss of appetite, Fatigue, Diarrhea. […] As liver failure progresses, the symptoms become more serious, needing care right away. These symptoms include: Jaundice (yellowing of eyes and skin), Bleeding easily, Swollen belly, Mental confusion (known as hepatic encephalopathy), Sleepiness. […] These symptoms will appear in both chronic and acute liver failure. […] If you have end-stage liver disease, your lifespan will be about 2 years, unless you get a liver transplant. Once your liver starts to shut down (liver failure), you can only live for a day or two.

• #23 Liver Failure: Symptoms & Causes | NewYork-Presbyterian

  https://www.nyp.org/digestive/liver-failure

  Liver failure is a life-threatening condition that occurs when the liver stops working. A healthy liver performs many important bodily functions, so immediate emergency care is necessary when it stops working. […] Two types of liver failure occur. The first type is gradual and is the final stage of many liver diseases. The second is quick when liver failure results from a virus or substance overuse. […] Four stages of liver failure define the progression of the disease: […] Patients may not have any symptoms at this stage, but some people may have tenderness on the right side of their abdomen. Elevated liver enzymes can be a sign of liver inflammation. […] Liver scars can form as a result of longstanding inflammation. The scarring can worsen over time if the cause of liver damage is not treated.

• #24 Liver Failure: Causes, Symptoms, Treatments, Tests & More

  https://www.webmd.com/fatty-liver-disease/digestive-diseases-liver-failure

  Liver failure happens when your liver starts to shut down. This is usually because it’s become damaged and can’t be repaired. It’s a life-threatening condition that demands urgent medical care. Most often, liver failure happens gradually, over many years, and is called chronic liver failure. Its the final stage of many liver diseases. But a rarer condition, known as acute liver failure, happens rapidly — in as little as 48 hours. […] When your liver can no longer do these things, then liver failure sets in. […] The early symptoms of liver failure are often similar to those of other conditions. Because of this, liver failure may be tough to diagnose at first. Early symptoms include: Nausea, Loss of appetite, Fatigue, Diarrhea. […] As liver failure progresses, the symptoms become more serious, needing care right away. These symptoms include: Jaundice (yellowing of eyes and skin), Bleeding easily, Swollen belly, Mental confusion (known as hepatic encephalopathy), Sleepiness. […] These symptoms will appear in both chronic and acute liver failure. […] If you have end-stage liver disease, your lifespan will be about 2 years, unless you get a liver transplant. Once your liver starts to shut down (liver failure), you can only live for a day or two.

• #25 Liver Failure: Meaning, Stages, Chronic Treatment

  https://www.verywellhealth.com/liver-failure-8603531

  Liver failure is a potentially life-threatening condition in which the liver is no longer able to service the body’s needs. Liver failure develops in stages, causing early-stage signs like nausea and vomiting before progressing to more serious symptoms like ascites (fluid accumulation in the belly) and jaundice (yellowing of the skin and eyes). […] The speed at which ALF progresses can vary. Hyperacute AFL is when symptoms develop within less than 10 days, fulminant ALF is when symptoms appear within 10 to 30 days, and subacute hepatic failure is the onset of symptoms within five to 24 weeks. […] Chronic liver failure (CLF) is the end stage of chronic liver disease (CLD). It is caused by cirrhosis, the gradual loss of liver function due to progressive scarring of the liver. […] Symptoms of liver failure are initially due to the buildup of waste products like bilirubin in the bloodstream and the depletion of bile and clotting factors from the liver. Over time, other organs (like the kidneys, intestines, and brain) can start to malfunction, leading to progressively worsening symptoms. Notable symptoms include: Dark urine, Clay-colored stool, Vomiting, Pruritus (itching), Severe upper-right abdominal pain, Jaundice (yellowing of the skin and eyes), Peripheral edema (swelling of the feet and ankles due to fluid overload), Ascites (a distended belly due to accumulation of fluid).

• #26 Liver Failure: Signs and Symptoms

  https://www.verywellhealth.com/warning-signs-of-a-dying-liver-5270837

  Jaundice can be the first symptom of liver disease, and in some people, it is the only symptom. […] One of the warning signs of liver failure is bleeding. […] Fluid retention around the midsection, medically known as ascites, is a sign of liver failure. […] Weight loss can be blamed on malnutrition or a lack of appetite. When the liver doesn’t work properly, it can cause people with liver disease to lose weight. […] Sudden weight gain usually is due to fluid retention. […] People with liver disease can experience movement disorders, notably tremors. […] Bleeding in the intestinal tract can manifest as blood in stool or vomit. […] Liver failure can cause the breath to have a musty, garlicky smell. […] Liver failure is often fatal. Most people with acute liver failure will not survive without a liver transplant. Once a person is in the end stages of chronic liver failure, the survival rate is two years without a liver transplant.

• #27 Palliative Care and Liver Disease | Get Palliaitve Care

  https://getpalliativecare.org/whatis/disease-types/liver-disease-palliative-care/

  Liver failure signs and symptoms include fatigue (feeling weak or tired), jaundice (yellowing of the skin and the whites of the eyes), swelling of the legs and abdomen, appetite loss and weight loss, nausea, itchy skin and hiccups. […] Over time, cirrhosis can get worse, and your liver may no longer work properly. This chronic liver failure is called end-stage liver disease, when symptoms may become more severe.

• #28 End Stage Liver Failure: Symptoms, Causes and Care – LifeChoice

  https://mylifechoice.org/2025/02/26/end-stage-liver-failure/

  End-stage liver failure is the last and the most extreme stage of chronic liver disease. By now, the liver is no longer able to operate, which increases fatal hazards. It is critical to recognize the symptoms of end-stage liver failure on time. Severe jaundice, swelling, fluid retention in the abdomen, and mental confusion can all appear if the liver is not able to perform basic functions. […] Patients face the following signs of liver failure in the latter stages: Jaundice: A person suffering from bile and liver issues tends to develop yellow eyes along with the skin. Weakness And Loss Of Energy: A decomposed liver structure destroys glucose metabolism, making one lethargic. Decreased Weight: Along with the decreased strength and lack of appetite, muscle tissues alongside weight are lost. Digestive Issues and Nausea: Progressive digestive issues lead to disturbances in the normal digestive processes, including expanding the stomach, throwing up, and other bowel developments, which can cause nausea.

• #29 Liver Failure: Causes, Symptoms, Treatments, Tests & More

  https://www.webmd.com/fatty-liver-disease/digestive-diseases-liver-failure

  Liver failure happens when your liver starts to shut down. This is usually because it’s become damaged and can’t be repaired. It’s a life-threatening condition that demands urgent medical care. Most often, liver failure happens gradually, over many years, and is called chronic liver failure. Its the final stage of many liver diseases. But a rarer condition, known as acute liver failure, happens rapidly — in as little as 48 hours. […] When your liver can no longer do these things, then liver failure sets in. […] The early symptoms of liver failure are often similar to those of other conditions. Because of this, liver failure may be tough to diagnose at first. Early symptoms include: Nausea, Loss of appetite, Fatigue, Diarrhea. […] As liver failure progresses, the symptoms become more serious, needing care right away. These symptoms include: Jaundice (yellowing of eyes and skin), Bleeding easily, Swollen belly, Mental confusion (known as hepatic encephalopathy), Sleepiness. […] These symptoms will appear in both chronic and acute liver failure. […] If you have end-stage liver disease, your lifespan will be about 2 years, unless you get a liver transplant. Once your liver starts to shut down (liver failure), you can only live for a day or two.

• #30 Liver Failure – Liver and Gallbladder Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/manifestations-of-liver-disease/liver-failure

  In acute liver failure, people may go from being healthy to near death within a few days. […] In chronic liver failure, the deterioration in health may be very gradual until a dramatic event, such as vomiting blood or having bloody stools, occurs. […] Ultimately, liver failure is fatal if it is not treated or if the liver disorder is progressive. Even after treatment, liver failure may be irreversible.

• #31 Chronic Liver Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554597/

  Chronic liver disease is a progressive deterioration of liver functions. Chronic liver disease (CLD) is a progressive deterioration of liver functions for more than six months, which includes synthesis of clotting factors, other proteins, detoxification of harmful products of metabolism, and excretion of bile. CLD is a continuous process of inflammation, destruction, and regeneration of liver parenchyma, which leads to fibrosis and cirrhosis. Cirrhosis is a final stage of chronic liver disease that results in disruption of liver architecture, the formation of widespread nodules, vascular reorganization, neo-angiogenesis, and deposition of an extracellular matrix. The underlying mechanism of fibrosis and cirrhosis at a cellular level is the recruitment of stellate cells and fibroblasts, resulting in fibrosis, while parenchymal regeneration relies on hepatic stem cells. Signs and symptoms of CLD can be nonspecific, such as fatigue, anorexia, weight loss, or depend upon the complication that the patient has developed. The three significant complications are because of portal hypertension (esophageal varices, ascites), hepatocellular insufficiency (e.g., jaundice, hepatic encephalopathy), and hepatocellular carcinoma. Decompensated chronic liver disease can present with one of the following complications. Portal hypertension is a result of resistance to portal blood flow because of cirrhotic and noncirrhotic etiology. A portal venous pressure above seven mmHg is considered portal hypertension; however, clinical features or complications do not develop until portal pressure is higher than 12 mmHg. Chronic liver disease represents a continuous and progressive process of hepatic fibrosis, liver tissue architectural distortion, and regeneration nodule formation. While fibrosis is usually irreversible, but it can be reversible in the initial stage of development. In chronic liver disease, if not treated, the endpoint is usually irreversible fibrosis, regeneration nodule formation, and development of cirrhosis liver. The development rate of fibrosis is dependent on the underlying etiologies, environmental, and host factors. The evolution of liver fibrosis was studied in 4852 patients with different underlying etiology in one study. The author observed significant differences in the rate of development of fibrosis and its progression. The rate was most rapid in patients with coinfection with HIV- HCV, while primary biliary cirrhosis was the slowest. Fibrosis progression rate was higher with increasing age, and females demonstrated a more gradual progression of liver fibrosis in all but alcoholic liver disease. Chronic liver disease is one of the frequent causes of death, especially in the developing world. The increasing prevalence of chronic liver disease has been noted in recent times. The majority of chronic liver diseases in the developed world include alcoholic liver disease, chronic viral hepatitis, including hepatitis B and C, non-alcoholic fatty liver disease (NAFLD), and hemochromatosis. Compensated chronic liver disease (who has not developed significant complications) usually carries a better prognosis than decompensated liver cirrhosis. Decompensated liver cirrhosis patients (who have developed variceal bleeding, ascites, HCC, SBP, and hepatorenal syndrome) have a poor prognosis. Mean survival of about six months if Child-Pugh score of 12 or greater or MELD score of 21 or higher. The following are the complications of chronic liver disease. Variceal bleeding, Ascites and spontaneous bacterial peritonitis (SBP), Hepatic encephalopathy, Hepatorenal syndrome, Hepatopulmonary syndrome, Hepatocellular carcinoma (HCC).

• #32 Cirrhosis of the Liver: Signs & Symptoms, Causes, Stages

  https://my.clevelandclinic.org/health/diseases/15572-cirrhosis-of-the-liver

  Cirrhosis symptoms related to portal hypertension include: Swelling in your abdomen (ascites). Swelling in your hands, feet, legs and/or face (edema). Easy bleeding and bruising (coagulopathy). Blood in your vomit or blood in your poop. Low urine output (from chronic kidney failure). Shortness of breath (from chronic respiratory failure). […] Once you have cirrhosis, your liver won’t get better. But it won’t necessarily get worse. If you still have compensated cirrhosis with little to no symptoms or side effects, you may continue that way for some time. If you can stop or minimize the inflammation causing cirrhosis, it may not progress to the decompensated stage. […] Decompensated cirrhosis has an average life expectancy of seven years. Severe, untreatable diseases and other complications can speed up that timeline. Some people have less than two years.

• #33 Cirrhosis of the Liver – Liver and Gallbladder Disorders – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/liver-and-gallbladder-disorders/fibrosis-and-cirrhosis-of-the-liver/cirrhosis-of-the-liver

  Advanced cirrhosis can cause additional problems. […] Portal hypertension (high blood pressure in the portal vein) is a serious complication. […] Portal hypertension plus impaired liver function may lead to accumulation of fluid within the abdomen (ascites). […] Over time, poor absorption of fats, particularly fat-soluble vitamins, can lead to several problems. […] Cirrhosis causes other problems that can interfere with how blood clots (disordered blood clotting). […] Liver failure can also cause brain function to deteriorate (called hepatic encephalopathy) because the damaged liver can no longer remove toxic substances from the blood. […] Liver cancer (hepatocellular carcinoma, or hepatoma) can develop in people with cirrhosis. […] Stopping all consumption of alcohol prevents further scarring in the liver. If people continue to drink alcohol even small amounts cirrhosis progresses, causing serious complications.

• #34 Loss of brain function – liver disease: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000302.htm

  Loss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy (HE). This problem may occur suddenly or it may develop slowly over time. […] Symptoms of HE are graded on a scale of grades 1 to 4. They may begin slowly and worsen over time. Early symptoms may be mild and include: Breath with a musty or sweet odor, Changes in sleep patterns, Changes in thinking, Mild confusion, Forgetfulness, Personality or mood changes, Poor concentration and judgment, Worsening of handwriting or loss of other small hand movements. […] Severe symptoms may include: Abnormal movements or shaking of hands or arms, Agitation, excitement, or seizures (occur rarely), Disorientation, Drowsiness or confusion, Behavior or personality changes, Slurred speech, Slowed or sluggish movement. People with HE can become unconscious, unresponsive, and possibly enter into a coma. […] The outlook of HE depends on the management of the cause of HE. Chronic forms of the disorder often continue to get worse and come back. The first two stages of the disease have a good prognosis. Stage three and four have a poor prognosis.

• #35 Chronic Liver Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554597/

  Chronic liver disease is a progressive deterioration of liver functions. Chronic liver disease (CLD) is a progressive deterioration of liver functions for more than six months, which includes synthesis of clotting factors, other proteins, detoxification of harmful products of metabolism, and excretion of bile. CLD is a continuous process of inflammation, destruction, and regeneration of liver parenchyma, which leads to fibrosis and cirrhosis. Cirrhosis is a final stage of chronic liver disease that results in disruption of liver architecture, the formation of widespread nodules, vascular reorganization, neo-angiogenesis, and deposition of an extracellular matrix. The underlying mechanism of fibrosis and cirrhosis at a cellular level is the recruitment of stellate cells and fibroblasts, resulting in fibrosis, while parenchymal regeneration relies on hepatic stem cells. Signs and symptoms of CLD can be nonspecific, such as fatigue, anorexia, weight loss, or depend upon the complication that the patient has developed. The three significant complications are because of portal hypertension (esophageal varices, ascites), hepatocellular insufficiency (e.g., jaundice, hepatic encephalopathy), and hepatocellular carcinoma. Decompensated chronic liver disease can present with one of the following complications. Portal hypertension is a result of resistance to portal blood flow because of cirrhotic and noncirrhotic etiology. A portal venous pressure above seven mmHg is considered portal hypertension; however, clinical features or complications do not develop until portal pressure is higher than 12 mmHg. Chronic liver disease represents a continuous and progressive process of hepatic fibrosis, liver tissue architectural distortion, and regeneration nodule formation. While fibrosis is usually irreversible, but it can be reversible in the initial stage of development. In chronic liver disease, if not treated, the endpoint is usually irreversible fibrosis, regeneration nodule formation, and development of cirrhosis liver. The development rate of fibrosis is dependent on the underlying etiologies, environmental, and host factors. The evolution of liver fibrosis was studied in 4852 patients with different underlying etiology in one study. The author observed significant differences in the rate of development of fibrosis and its progression. The rate was most rapid in patients with coinfection with HIV- HCV, while primary biliary cirrhosis was the slowest. Fibrosis progression rate was higher with increasing age, and females demonstrated a more gradual progression of liver fibrosis in all but alcoholic liver disease. Chronic liver disease is one of the frequent causes of death, especially in the developing world. The increasing prevalence of chronic liver disease has been noted in recent times. The majority of chronic liver diseases in the developed world include alcoholic liver disease, chronic viral hepatitis, including hepatitis B and C, non-alcoholic fatty liver disease (NAFLD), and hemochromatosis. Compensated chronic liver disease (who has not developed significant complications) usually carries a better prognosis than decompensated liver cirrhosis. Decompensated liver cirrhosis patients (who have developed variceal bleeding, ascites, HCC, SBP, and hepatorenal syndrome) have a poor prognosis. Mean survival of about six months if Child-Pugh score of 12 or greater or MELD score of 21 or higher. The following are the complications of chronic liver disease. Variceal bleeding, Ascites and spontaneous bacterial peritonitis (SBP), Hepatic encephalopathy, Hepatorenal syndrome, Hepatopulmonary syndrome, Hepatocellular carcinoma (HCC).

• #36 Liver disease – Wikipedia

  https://en.wikipedia.org/wiki/Liver_disease

  Some of the signs and symptoms of a liver disease are the following: […] Jaundice […] Confusion and altered consciousness caused by hepatic encephalopathy. […] Thrombocytopenia and coagulopathy. […] Risk of bleeding symptoms, particularly taking place in the gastrointestinal tract […] Cirrhosis causes chronic liver failure. […] Progression of the disease can lead to liver inflammation from the excess fat in the liver. Scarring in the liver often occurs as the body attempts to heal and extensive scarring can lead to the development of cirrhosis in more advanced stages of the disease. […] Approximately 310% of individuals with cirrhosis develop a form of liver cancer known as hepatocellular carcinoma. […] Liver diseases, including conditions such as non-alcoholic fatty liver disease (NAFLD), alcohol-related liver disease (ALD), and viral hepatitis, are significant public health concerns worldwide.

• #37 Progression of chronic liver disease to hepatocellular carcinoma: implications for surveillance and management | BJC Reports

  https://www.nature.com/articles/s44276-024-00050-0

  Current opinion holds that hepatocellular carcinoma (HCC) arises as a stepwise progression from chronic liver disease (CLD) to cirrhosis and then to HCC. […] Among HCC patients, 28% had no indication of cirrhosis prior to HCC diagnosis. Only 31% of HBV-related HCC cases followed the cirrhotic pathway. HCV patients who achieved sustained virological response (SVR) developed cirrhosis approximately 7 years before HCC diagnosis. […] Our analysis challenges the notion of cirrhosis as an obligatory stage of HCC development in CLD patients. […] In total, HCC developed in 172 patients representing 7% of all cases who were non-cirrhotic at entry into the surveillance programme. […] Of the 172 patients developing HCC, 124 (72%) had Fib-4 values of 3.25 at some time before HCC was diagnosed indicating their eventual progression to liver cirrhosis.

• #38 End-stage liver disease – Organ transplantation – NHS Blood and Transplant

  https://www.nhsbt.nhs.uk/organ-transplantation/liver/is-a-liver-transplant-right-for-you/end-stage-liver-disease/

  End-stage liver disease is when your liver is damaged beyond repair due to chronic liver disease or acute liver failure. […] End-stage liver disease is the final stage of some long-term liver diseases and acute liver failure. […] Patients can have cirrhosis of the liver with or without symptoms. […] Patients with severe symptoms of cirrhosis may benefit from a liver transplant. […] Cirrhosis of the liver happens with long-term liver diseases. […] Patients with end-stage liver disease are usually said to have either compensated cirrhosis or decompensated cirrhosis. […] Patients with decompensated cirrhosis have more severe symptoms and complications. […] Symptoms of decompensated cirrhosis might include: Yellow discolouration of the skin (jaundice), Fluid retention with abdominal distension (ascites), Leg swelling (oedema), Confusion (encephalopathy), Bleeding from abnormal blood vessels (varices) in the oesophagus and stomach (internal bleeding).

• #39 Cirrhosis of the Liver: Signs & Symptoms, Causes, Stages

  https://my.clevelandclinic.org/health/diseases/15572-cirrhosis-of-the-liver

  Cirrhosis of the liver is late stage liver disease, in which healthy liver tissue has been gradually replaced with scar tissue. This is a result of long-term, chronic hepatitis. […] Cirrhosis is a progressive condition that worsens as more and more scar tissue develops. In the beginning, your body adjusts to compensate for your reduced liver function, and you might not notice it too much. This is known as compensated cirrhosis. Eventually, though, as your liver function declines further, you will begin to experience noticeable symptoms. This is known as decompensated cirrhosis. […] Signs and symptoms of cirrhosis depend on how advanced it is. You might not have symptoms at all early on, or you might only have vague symptoms that resemble many other conditions. Symptoms of cirrhosis become more recognizable as your liver function declines.

• #40 End-stage liver disease – Organ transplantation – NHS Blood and Transplant

  https://www.nhsbt.nhs.uk/organ-transplantation/liver/is-a-liver-transplant-right-for-you/end-stage-liver-disease/

  Patients with decompensated cirrhosis are at increased risk of dying from complications of liver disease. […] Their symptoms can severely affect their quality of life. […] The liver of patients with compensated cirrhosis still works relatively well, despite the scarring that comes with end-stage liver disease. […] These patients often have no or few symptoms, but still need to be treated. […] Patients with end-stage liver disease can also develop kidney failure. […] This is often reversible with a liver transplant. […] In these cases, an urgent liver transplant may be their only life-saving treatment.

• #41 Cirrhosis of the Liver: Signs & Symptoms, Causes, Stages

  https://my.clevelandclinic.org/health/diseases/15572-cirrhosis-of-the-liver

  Cirrhosis symptoms related to portal hypertension include: Swelling in your abdomen (ascites). Swelling in your hands, feet, legs and/or face (edema). Easy bleeding and bruising (coagulopathy). Blood in your vomit or blood in your poop. Low urine output (from chronic kidney failure). Shortness of breath (from chronic respiratory failure). […] Once you have cirrhosis, your liver won’t get better. But it won’t necessarily get worse. If you still have compensated cirrhosis with little to no symptoms or side effects, you may continue that way for some time. If you can stop or minimize the inflammation causing cirrhosis, it may not progress to the decompensated stage. […] Decompensated cirrhosis has an average life expectancy of seven years. Severe, untreatable diseases and other complications can speed up that timeline. Some people have less than two years.

• #42 Cirrhosis: Causes, Signs, & Treatment

  https://www.medicinenet.com/what_are_the_4_stages_of_cirrhosis_of_the_liver/article.htm

  The prognosis and life expectancy for cirrhosis of the liver varies and depends on the cause, the severity, any complications, and any underlying diseases. […] In compensated cirrhosis, patients who have not developed any major complications, the average survival rate is more than 12 years. […] The prognosis worsens for patients who have decompensated cirrhosis and have developed complications such as ascites, variceal hemorrhage, spontaneous bacterial peritonitis, hepatocellular carcinoma, hepatorenal syndrome, or hepatopulmonary syndrome. Severity of cirrhosis may be measured using MELD or Child-Pugh scores. […] With a MELD score 18 or child-Pugh score 12, survival from end stage cirrhosis was less than 6 months.

• #43 Chronic Liver Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK554597/

  Chronic liver disease is a progressive deterioration of liver functions. Chronic liver disease (CLD) is a progressive deterioration of liver functions for more than six months, which includes synthesis of clotting factors, other proteins, detoxification of harmful products of metabolism, and excretion of bile. CLD is a continuous process of inflammation, destruction, and regeneration of liver parenchyma, which leads to fibrosis and cirrhosis. Cirrhosis is a final stage of chronic liver disease that results in disruption of liver architecture, the formation of widespread nodules, vascular reorganization, neo-angiogenesis, and deposition of an extracellular matrix. The underlying mechanism of fibrosis and cirrhosis at a cellular level is the recruitment of stellate cells and fibroblasts, resulting in fibrosis, while parenchymal regeneration relies on hepatic stem cells. Signs and symptoms of CLD can be nonspecific, such as fatigue, anorexia, weight loss, or depend upon the complication that the patient has developed. The three significant complications are because of portal hypertension (esophageal varices, ascites), hepatocellular insufficiency (e.g., jaundice, hepatic encephalopathy), and hepatocellular carcinoma. Decompensated chronic liver disease can present with one of the following complications. Portal hypertension is a result of resistance to portal blood flow because of cirrhotic and noncirrhotic etiology. A portal venous pressure above seven mmHg is considered portal hypertension; however, clinical features or complications do not develop until portal pressure is higher than 12 mmHg. Chronic liver disease represents a continuous and progressive process of hepatic fibrosis, liver tissue architectural distortion, and regeneration nodule formation. While fibrosis is usually irreversible, but it can be reversible in the initial stage of development. In chronic liver disease, if not treated, the endpoint is usually irreversible fibrosis, regeneration nodule formation, and development of cirrhosis liver. The development rate of fibrosis is dependent on the underlying etiologies, environmental, and host factors. The evolution of liver fibrosis was studied in 4852 patients with different underlying etiology in one study. The author observed significant differences in the rate of development of fibrosis and its progression. The rate was most rapid in patients with coinfection with HIV- HCV, while primary biliary cirrhosis was the slowest. Fibrosis progression rate was higher with increasing age, and females demonstrated a more gradual progression of liver fibrosis in all but alcoholic liver disease. Chronic liver disease is one of the frequent causes of death, especially in the developing world. The increasing prevalence of chronic liver disease has been noted in recent times. The majority of chronic liver diseases in the developed world include alcoholic liver disease, chronic viral hepatitis, including hepatitis B and C, non-alcoholic fatty liver disease (NAFLD), and hemochromatosis. Compensated chronic liver disease (who has not developed significant complications) usually carries a better prognosis than decompensated liver cirrhosis. Decompensated liver cirrhosis patients (who have developed variceal bleeding, ascites, HCC, SBP, and hepatorenal syndrome) have a poor prognosis. Mean survival of about six months if Child-Pugh score of 12 or greater or MELD score of 21 or higher. The following are the complications of chronic liver disease. Variceal bleeding, Ascites and spontaneous bacterial peritonitis (SBP), Hepatic encephalopathy, Hepatorenal syndrome, Hepatopulmonary syndrome, Hepatocellular carcinoma (HCC).

• #44 Liver Disease Progression | Caring Ambassadors

  https://caringambassadors.org/hepatitis-c/liver-disease-progression/

  There is no accurate way to predict the course of chronic hepatitis C in an individual person. […] The broad range of variability observed between persons living with hepatitis C is especially true of disease progression. […] Checking blood levels of the liver enzymes such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST) is one way to tell if liver cells are dying. […] When liver cells die, ALT and AST are released into the blood. […] If liver cells continue to die in abnormally high numbers over time, ALT and AST levels remain elevated. […] Liver enzymes also provide no information about how well the liver is functioning. […] Your liver can maintain its many functions despite a remarkable amount of damage. […] Like other liver diseases, HCV disease progresses in stages. The usual progression is from inflammation to fibrosis to cirrhosis. Cirrhosis can progress to end-stage liver disease and/or can give rise to liver cancer.

• #45 Symptoms – Liver Foundation

  https://liver.org.au/your-liver/symptoms/

  Most people don’t realise at first that they have a problem with their liver. That’s because liver disease and liver damage rarely cause symptoms in the early stages. […] At first, the signs of liver disease are often vague. If you have early liver disease, you might feel more tired and weak than normal or you might feel a bit nauseous (sick). […] Symptoms of more serious disease depend on the condition and how much damage there is to your liver. […] Signs your liver is struggling include: yellow skin or white of the eyes (jaundice), dark urine, nausea (feeling like you are going to vomit), vomiting (being sick), diarrhoea, bloating (swollen tummy), not feeling hungry, fever, swollen legs, ankles or feet, very itchy skin, hair loss, bruising easily, anaemia (not having enough iron in the blood – you have pale skin; the insides of your eyelids or your fingernails are pale), frequent nosebleeds or bleeding gums, frequent muscle cramps, pain in the right shoulder, dizziness, vomiting blood, black or light coloured poos, being confused or drowsy, memory loss, staggering or falling a lot, finding it harder to write, spidery handwriting, trembling hands, changes in your personality, being moody or cranky, forgetfulness, poor sleep, very rapid heart rate, being more sensitive to alcohol or drugs, erectile dysfunction in men (not being able to get an erection), or losing sexual desire, irregular periods or no periods in women.

• #46 Alcoholic liver disease: MedlinePlus Medical EncyclopediaLock

  https://medlineplus.gov/ency/article/000281.htm

  Alcoholic liver disease is damage to the liver and its function due to alcohol abuse. […] Alcoholic liver disease most often occurs after years of heavy drinking. Over time, scarring and cirrhosis can occur. Cirrhosis is the final phase of alcoholic liver disease. […] There may be no symptoms, or symptoms may come on slowly. This depends on how well the liver is working. Symptoms tend to be worse after a period of heavy drinking. […] Early symptoms include: Loss of energy, Poor appetite and weight loss, Nausea, Belly pain, Small, red spider-like blood vessels on the skin. […] As liver function worsens, symptoms may include: Fluid buildup of the legs (edema) and in the abdomen (ascites), Yellow color in the skin, mucous membranes, or eyes (jaundice), Redness on the palms of the hands, In men, impotence, shrinking of the testicles, and breast swelling, Easy bruising and abnormal bleeding, Confusion or problems thinking, Pale or clay-colored stools, Bleeding in the gastrointestinal tract.

• #47 Alcohol-Related Liver Disease: Symptoms, Treatment and More

  https://www.healthline.com/health/alcoholism/liver-disease

  Liver disease is just one of the consequences of excessive alcohol consumption. This is especially serious because liver failure can be fatal. […] Alcohol-related liver disease (ARLD) is caused by damage to the liver from years of excessive drinking. […] Years of alcohol abuse can cause the liver to become inflamed and swollen. This damage can also cause scarring known as cirrhosis. Cirrhosis is the final stage of liver disease. […] The symptoms of ARLD depend on the stage of the disease. There are three stages: Alcoholic fatty liver disease: This is the first stage of ARLD, where fat starts to accumulate around the liver. It can be cured by not drinking alcohol anymore. Acute alcoholic hepatitis: Alcohol abuse causes inflammation (swelling) of the liver in this stage. The outcome depends on the severity of damage. In some cases, treatment can reverse the damage, while more severe cases of alcoholic hepatitis can lead to liver failure. Alcoholic cirrhosis: This is the most severe form of ARLD. At this point, the liver is scarred from alcohol abuse, and the damage cannot be undone. Cirrhosis can lead to liver failure.

• #48 Nonalcoholic fatty liver disease – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/nonalcoholic-fatty-liver-disease/symptoms-causes/syc-20354567

  NAFLD often has no symptoms. When it does, they may include: Fatigue. Not feeling well, or malaise. Pain or discomfort in the upper right belly area. […] Possible symptoms of NASH and cirrhosis, or severe scarring, include: Itchy skin. Abdominal swelling, also called ascites (uh-SY-teez). Shortness of breath. Swelling of the legs. Spider-like blood vessels just beneath the skin’s surface. Enlarged spleen. Red palms. Yellowing of the skin and eyes, or jaundice. […] Severe liver scarring, or cirrhosis, is the main complication of NAFLD and NASH. Cirrhosis happens because of liver injury, such as the damage caused by inflammation in NASH. As the liver tries to stop inflammation, it creates areas of scarring, also called fibrosis. With ongoing inflammation, fibrosis spreads and takes up more liver tissue.

• #49 Steatotic liver disease – Symptoms, diagnosis and treatment | BMJ Best Practice US

  https://bestpractice.bmj.com/topics/en-us/796

  Metabolic dysfunction-associated steatotic liver disease (MASLD) is one of the most common causes of chronic liver disease in the developed world. […] It is a spectrum of disease, ranging from hepatic fat accumulation without inflammation to steatohepatitis, fibrosis, cirrhosis, and end-stage liver disease. […] The diagnosis of MASLD is based on exclusion of other etiologies of steatotic liver disease, such as alcohol use, and supportive laboratory tests and imaging. […] Lifestyle modification, including weight loss, physical activity, and dietary changes, is the first-line therapy. […] MASLD can be categorized as metabolic dysfunction-associated steatotic liver (MASL), previously known as nonalcoholic fatty liver (NAFL), or metabolic dysfunction-associated steatohepatitis (MASH), previously known as nonalcoholic steatohepatitis (NASH), depending on histologic features.

• #50 Hepatitis – Liver Infection | CureSearch

  https://curesearch.org/Hepatitis/

  Hepatitis is a liver disease spread through blood contact and comes in three types, A, B, and C. Hepatitis A is a liver infection that does not lead to long-term health problems and almost always goes away on its own. However, hepatitis B and C are more serious and require monitoring and care. […] Most people do not experience symptoms of hepatitis B or C when first infected. Some people have symptoms similar to the flu, such as fatigue, loss of appetite, nausea, vomiting, or low-grade fever. Some people may experience symptoms more directly related to the liver, such as jaundice (yellowish eyes and skin), dark urine, severe itching, or pale (clay-colored) stools. In rare cases, people may become very ill and develop liver failure. […] Unfortunately, many people who become infected with hepatitis B or C during childhood become “chronically” infected. People with chronic hepatitis infections may have no symptoms and feel well, but they are at risk for scarring (cirrhosis) of the liver and other complications. In rare cases, liver cancer can develop. People with chronic hepatitis infections are also at risk for spreading the infection to others.

• #51

  https://www.who.int/news-room/fact-sheets/detail/hepatitis-a

  Symptoms of hepatitis A range from mild to severe and can include fever, malaise, loss of appetite, diarrhoea, nausea, abdominal discomfort, dark-coloured urine and jaundice (a yellowing of the eyes and skin). Not everyone who is infected will have all the symptoms. […] The severity of disease and fatal outcomes are higher in older age groups. Infected children under 6 years of age do not usually experience noticeable symptoms, and only 10% develop jaundice. Hepatitis A sometimes relapses, meaning the person who just recovered falls sick again with another acute episode. This is normally followed by recovery. […] Cases of hepatitis A are not clinically distinguishable from other types of acute viral hepatitis. Specific diagnosis is made by the detection of HAV-specific immunoglobulin G (IgM) antibodies in the blood. Additional tests include reverse transcriptase polymerase chain reaction (RT-PCR) to detect the hepatitis A virus RNA and may require specialized laboratory facilities. PCR can detect the presence of HAV infection early in the infection, even before the patient develops antibodies (IgM anti-HAV). This is particularly useful for diagnosing hepatitis A in the early stages. PCR can additionally help to monitor the progression of the infection and the resolution of infection. […] Recovery from symptoms following infection may be slow and can take several weeks or months.

• #52 Skin manifestations of liver diseases | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-skin-manifestations-liver-diseases-S166526811931926X

  Both acute and chronic liver disease can manifest on the skin. The appearances can range from the very subtle, such as early finger clubbing, to the more obvious such as jaundice. Identifying these changes early on can lead to prompt diagnosis and management of the underlying condition. […] Chronic liver disease of any origin can cause typical skin findings. Jaundice, spider nevi, leuconychia and finger clubbing are well known features. Palmar erythema, paper-money skin, rosacea and rhinophyma are common but often overlooked by the busy practitioner. More subtle signs include scratch marks, loss of axillary hair and gynaecomastia. Ascites can lead to striae and an umbilical hernia. […] HCV association with extrahepatic manifestations can occur in one third of patients with chronic infection and is generally seen in the late stages of the disease. Cryoglobulinemia, polyartiritis nodosa, leucocytoclastic vasculitis, urticaria and porphyria cutanea tarda are the classic skin manifestations of chronic HCV and less frequently HBV infection.

• #53 Skin manifestations of liver diseases | Annals of Hepatology

  https://www.elsevier.es/en-revista-annals-hepatology-16-articulo-skin-manifestations-liver-diseases-S166526811931926X

  Both acute and chronic liver disease can manifest on the skin. The appearances can range from the very subtle, such as early finger clubbing, to the more obvious such as jaundice. Identifying these changes early on can lead to prompt diagnosis and management of the underlying condition. […] Chronic liver disease of any origin can cause typical skin findings. Jaundice, spider nevi, leuconychia and finger clubbing are well known features. Palmar erythema, paper-money skin, rosacea and rhinophyma are common but often overlooked by the busy practitioner. More subtle signs include scratch marks, loss of axillary hair and gynaecomastia. Ascites can lead to striae and an umbilical hernia. […] HCV association with extrahepatic manifestations can occur in one third of patients with chronic infection and is generally seen in the late stages of the disease. Cryoglobulinemia, polyartiritis nodosa, leucocytoclastic vasculitis, urticaria and porphyria cutanea tarda are the classic skin manifestations of chronic HCV and less frequently HBV infection.

• #54 Medications & Liver | ACG

  https://gi.org/topics/medications-and-the-liver/

  In most cases substantial liver damage can occur before symptoms appear. Typical symptoms of liver disease may include: nausea, lack of appetite, discomfort on the right upper corner of the abdomen, generalized itching, dark urine and jaundice (yellow discoloration of the eyes and skin). Many people have no symptoms at all. […] Blood tests can usually detect evidence of liver damage before symptoms develop. When a medication known to possibly cause liver damage is used, your physician may recommend that blood tests be checked after starting the medication so that any evidence of liver damage can be detected before symptoms appear. […] People with known liver disease may be at increased risk of liver injury when certain medications are used.

• #55 Liver Disease Progression | Caring Ambassadors

  https://caringambassadors.org/hepatitis-c/liver-disease-progression/

  There is no accurate way to predict the course of chronic hepatitis C in an individual person. […] The broad range of variability observed between persons living with hepatitis C is especially true of disease progression. […] Checking blood levels of the liver enzymes such as alanine aminotransferase (ALT) and aspartate aminotransferase (AST) is one way to tell if liver cells are dying. […] When liver cells die, ALT and AST are released into the blood. […] If liver cells continue to die in abnormally high numbers over time, ALT and AST levels remain elevated. […] Liver enzymes also provide no information about how well the liver is functioning. […] Your liver can maintain its many functions despite a remarkable amount of damage. […] Like other liver diseases, HCV disease progresses in stages. The usual progression is from inflammation to fibrosis to cirrhosis. Cirrhosis can progress to end-stage liver disease and/or can give rise to liver cancer.

• #56 What Is Chronic Liver Disease? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/liver-disease/what-is-chronic-liver-disease/

  According to the University of Pittsburgh Medical Center, chronic liver disease can progress via four different stages: Inflammation (hepatitis) In this earlier stage, the liver becomes swollen or inflamed. Fibrosis If inflammation isnt treated, it can lead to scarring of the liver tissue, which is called fibrosis. If caught early, fibrosis is treatable. Cirrhosis In cirrhosis, scarring of the liver becomes permanent and cant be reversed. People with cirrhosis are more likely to develop liver cancer. Liver failure This means the liver stops functioning completely. […] Life expectancy for people with chronic liver disease varies depending on the severity of the disease and what treatments are given. If the disease is caught and treated early, you may be able to avoid severe liver damage or liver failure, according to the Cleveland Clinic.

• #57 Liver Disease Symptoms & Treatment | GW Hospital

  https://www.gwhospital.com/liver-disease

  Cirrhosis is a condition in which the liver slowly deteriorates and malfunctions due to chronic injury. Scar tissue replaces healthy liver tissue, partially blocking the flow of blood through the liver. Scarring also impairs the livers ability to control infections and remove bacteria and toxins from the blood. […] Primary sclerosing cholangitis, or PSC, is a disease that damages and blocks bile ducts inside and outside the liver. As a result, bile builds up in the liver and damages liver cells. Eventually, scar tissue can spread throughout the liver, causing cirrhosis and liver failure. […] Treatment for liver problems depends on your diagnosis. Some liver problems can be treated with medications. Others may require surgery. Liver transplant may ultimately be required for liver problems that cause liver failure. […] Obesity can cause a condition called nonalcoholic fatty liver disease, which may include fatty liver, hepatitis and cirrhosis.

• #58

  https://healthmatch.io/liver-disease/end-stage-liver-disease

  Changes in consciousness: When enough toxins build up in the bloodstream, this can impair brain function enough to send a person into a coma. […] Mental health problems: Mental health issues such as depression and anxiety are common in people with end-stage liver disease. […] End-stage liver disease can have painful symptoms and negatively affect the patients quality of life. […] One study found that 60% of people hospitalized with liver failure reported that they experienced pain. […] End-stage liver disease is generally the last phase of a progressive illness that develops over many years. […] End-stage liver disease can take anywhere from months to decades to develop. Death from liver failure can be sudden and unpredictable, although the dying process can also be slower. […] The final days of liver failure can vary, depending on the person. Someone may experience symptoms such as yellow skin and eyes, confusion, swelling, and general or localized pain. The symptoms of end-stage liver disease typically worsen as the patient becomes closer to death.

• #59 Cirrhosis: Causes, Signs, & Treatment

  https://www.medicinenet.com/what_are_the_4_stages_of_cirrhosis_of_the_liver/article.htm

  The prognosis and life expectancy for cirrhosis of the liver varies and depends on the cause, the severity, any complications, and any underlying diseases. […] In compensated cirrhosis, patients who have not developed any major complications, the average survival rate is more than 12 years. […] The prognosis worsens for patients who have decompensated cirrhosis and have developed complications such as ascites, variceal hemorrhage, spontaneous bacterial peritonitis, hepatocellular carcinoma, hepatorenal syndrome, or hepatopulmonary syndrome. Severity of cirrhosis may be measured using MELD or Child-Pugh scores. […] With a MELD score 18 or child-Pugh score 12, survival from end stage cirrhosis was less than 6 months.

• #60 The Stages of Liver Disease – American Liver Foundation

  https://liverfoundation.org/about-your-liver/how-liver-diseases-progress/

  In America, liver disease affects millions and is on the rise. Did you know there are more than 100 different types of liver disease? Living with long-term, chronic liver disease can cause damage to your liver. […] Most liver diseases damage your liver in similar ways and for many, the progression of liver disease looks the same regardless of the underlying disease. […] Early diagnosis may prevent damage from occurring in your liver. Your liver is an incredible organ. If you’re diagnosed when some scar tissue has already formed, your liver can repair and even regenerate itself. Because of this, damage from liver disease can often be reversed with a well-managed treatment plan. […] Many people with liver disease do not look or feel sick even though damage is happening to their liver. At a certain point in the progression of liver disease damage can become irreversible and lead to liver failure, liver cancer, or death.

• #61 Cirrhosis

  https://www.nhs.uk/conditions/cirrhosis/

  Many people with cirrhosis can feel well and live for many years. But it can cause complications which can be serious or life-threatening. […] Cirrhosis cannot be cured, but there are treatments that can help slow it down or stop it getting worse. […] It’s also strongly recommended to make healthy lifestyle changes, including to stop drinking alcohol.

• #62 Liver Disease Progression | Caring Ambassadors

  https://caringambassadors.org/hepatitis-c/liver-disease-progression/

  Despite the seriousness of cirrhosis, large numbers of people live many, many years with cirrhosis without symptoms and without progressing to liver failure. […] Once cirrhosis develops, it is very important to avoid further progression of the disease. […] Most people with HCV never develop liver cancer. Nonetheless, people with HCV are at an increased risk for liver cancer. […] The presence of cirrhosis and/or having been infected with HCV for more than 20 years further increases the level of risk. […] The development of liver cancer (hepatocellular carcinoma) is most commonly seen in people who have cirrhosis. […] Progression of chronic hepatitis C in any given person cannot be predicted. […] The majority of people will not progress to cirrhosis. […] However, the seriousness of this disease for people with advanced cirrhosis is beyond question.

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