An overview of liver function

The liver is the largest gland in the human body, located right beneath the diaphragm and the right lung. It has a dual blood supply from the hepatic artery &the portal vein. Liver carries out certain vital functions to the body as follows;

  1. The liver regulates chemical substances in the body and excretes waste products. Simply it helps to detoxify harmful substances from our body and change them to excretable products.
  2. Produce bile for the emulsification of lipid that helps in the digestion of fats containing food. Bile also helps to excrete away waste products through the intestine.
  3. Production of cholesterol. Liver helps produce healthy cholesterol known as high density lipoproteins which is important for balance of cholesterol in the body.
  4. Convert excess glucose to a storage product known as glycogen. This helps to reduce the blood glucose level.
  5. Help synthesize hemoglobin which is essential for the binding of oxygen in red blood cells.
  6. Produce proteins like albumin and clotting factors.
  7. Fight infections in the body by producing immune factors like antibodies.

Liver diseases causing liver failure

  • Hepatitis. Hepatitis simply means inflammation of the liver. It can be caused by generally infective and toxic causes. One of the most important causes are viral hepatitis and bacterial hepatitis. Toxic causes include overdosage of certain drugs and alcohol.
  • Liver cancer. Liver cancer or known as hepatocellular carcinoma is mostly a complication of liver cirrhosis which is the end stage of liver failure. It can spread to other systems such as the liver and back bone.
  • Gallstones. Gallstones obstructing the biliary duct can cause inflammation of the duct leading to acute cholangitis and results in liver failure if left untreated for long.
  • Liver cirrhosis. Cirrhosis is an end stage of liver failure which results in liver scarring leading to inability of the liver to function well.
  • Hemochromatosis. This condition is due to deposition of iron in the liver which damages the liver parenchyma leading to liver failure. The same iron will also deposit to other parts of the body leaving extrahepatic manifestation.
  • Primary sclerosing cholangitis. An unknown etiology causes primary sclerosing cholangitis which causes inflammation and scarring of the bile duct in the liver. Another variant is primary biliary cirrhosis that destroys the bile duct and liver.
  • Congestive cardiac failure(message to the heart). Right sided heart failure can lead to increase in portal pressure leading to portal hypertension and liver failure.
  • Toxicity. Drug and alcohol toxicity can cause permanent damage to the liver.

Type of liver failure and its symptoms

  • Acute liver failure. The liver failure symptoms develop in less than a 6 months period after the insult. This is mainly due to toxic causes like overdosage of drugs like analgesics.
  • Chronic liver failure. This type of liver failure is more common and due to multiple factors as stated above. Usually, symptoms develop after a 6 months period after the insult.

Signs and symptoms of liver failure

  1. Jaundice. Jaundice is the yellow discoloration of skin & eyes. This happens due to mainly 3 reasons caused by extrahepatic issues, hepatic problems and post hepatic diseases. Often, jaundice is accompanied with itching of the skin called pruritus.
  2. Abdominal distension. This is due to an increase in portal pressure leading to extravasation of fluid out. Another cause is probably due to reduction in plasma proteins produced by the liver.
  3. Bleeding. Liver produces clotting factors that prevent bleeding, however in liver failure, this fails to happen and causes bleeding elsewhere in the body.
  4. Confusion and drowsiness. This condition is called hepatic encephalopathy and is caused by the inability of the liver to excrete ammonia which is a main waste product in the body.
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