According to the Centers for Disease Control and Prevention, 4.5 Americans are diagnosed with liver disease, resulting in 44,358 deaths annually.
Per the National Institutes of Health liver disease includes diseases caused by viruses, such as hepatitis A, hepatitis B, and hepatitis C, diseases caused by drugs, poisons, or too much alcohol (fatty liver disease and cirrhosis), liver cancer, and even inherited diseases, such as hemochromatosis and Wilson’s disease.
Unfortunately, many people don’t know when they are suffering from liver damage because they can’t identify the symptoms.
You Notice Swelling in Your Legs
Albert Do, MD, MPH, clinical director of the Yale Medicine Fatty Liver Disease Program, explains that fluid accumulation in the body can occur in cirrhosis (severe scarring of the liver), and can build up and lead to severe symptoms, called peripheral edema, “which fluid accumulates in the legs and soft tissues of the body.
” Various other diseases can cause symptoms of peripheral edema such as heart or kidney disease, but ascites in particular raises more concern for liver disease.
You Notice Swelling in the Abdomen
The same method in which leg swelling can occur, fluid can also accumulate in the abdominal cavity, due to cirrhosis, explains Dr. Do. This is called ascites.
You Start Bruising Easily
If you notice you suddenly start bruising easily, it can be due to liver damage. “The liver is a primary organ making proteins and other factors helping to help with normal blood clotting which helps to stop bleeding from occurring,” explains Dr. Do.
“When the liver does not function well, reduced levels of these essential molecules lead to easy bruising and prolonged time for cuts and minor skin trauma to heal.”
Often after blood testing the site of needle puncture can become bruised and take longer-than-expected to recover.
Similarly, small bumps which would not otherwise cause bruising, can lead to large bruises taking prolonged time to heal.
Your Urine Changes Color
The liver plays an important role in metabolizing (breaking down) and turning over products within the body such as toxic byproducts of normal bodily functions and cells (such as red blood cells), explains Dr. Do.
“When the liver develops impaired function, levels of these toxins and byproducts can increase, and accumulate in various places.” One of them? The urine, and the result can be “cola-colored urine.”
Your Stool Changes Color
Toxins can also increase and accumulate in the stool, resulting in a change of color. Dr. Do explains these are called acholic (“light colored”) stools.
You Experience Jaundice
Jaundice, yellowing of the skin or whites of the eyes, is another example of toxins and byproducts accumulating, in this case in the skin, says Dr. Do.
You Experience No Symptoms
Often with advanced liver disease (severe liver scarring also known as cirrhosis), no symptoms are present, notes Dr. Do. However, “rather nonspecific mild laboratory abnormalities can be present, difficult to identify, even by doctors.”
These include nonspecific findings such as low platelets, mild elevation in bilirubin, particular patterns of liver tests, and subtle physical examination findings.
“For this reason many liver diseases can remain undiagnosed and progress to severe levels,” he points out.
“Generally, identifying and treating chronic liver disease before it ever becomes symptomatic is the most important approach for these diseases.”
You May Have a Decreased Appetite
Darren P. Mareiniss, MD, FACEP, Assistant Professor of Emergency Medicine Sidney Kimmel Medical College – Thomas Jefferson University, points out that a decrease in appetite can occur if you have liver failure. This is generally an early sign.
You May Have Nausea and Vomiting
Nausea and vomiting are another sign of early liver failure, per Dr. Mareiniss.
You May Have Fatigue
Another symptom of early liver failure is feeling tired or fatigued, explains Dr. Mareiness.
You May Have Itchy Skin
If your skin is itchy, it could be from liver damage, says Dr. Mareiniss. The sensation is a result of “elevated bile salts.”
You May Have Confusion
Dr. Maeiniss reveals that patients with very significant liver damage can have confusion. “This is termed hepatic encephalopathy and requires hospitalization.”
What Can Increase Your Risk of Liver Disease?
There are a few things that can up your chances of liver damage. “Factors that may increase your risk of liver disease includes alcohol abuse, obesity, type 2 diabetes, tattoos (increase hepatitis risk), IV drug use (increase hepatitis risk), exposure to bodily fluids, unprotected sex and exposure to certain toxins,” says Dr. Mareiniss.