What Are the Signs and Symptoms of Liver Failure?

Signs of liver failure are clinical in nature. They’re key red flags that only a doctor may be able to detect through a physical exam, blood testing, and imaging tests.

Possible signs of liver failure may include:

• ascites, a type of abdominal swelling caused by fluid buildup
• atypical liver function tests, including albumin, bilirubin, and alanine or aspartate transaminase
• enlarged veins in your stomach, intestines, or esophagus, which may also cause internal bleeding
• dark urine samples
• jaundice
• enlarged or shrunken liver, as shown on a liver imaging test
• weight loss

In addition to the signs of liver failure, you may also be able to see and feel possible symptoms of this condition. Many of these also occur during the later stages of liver disease.

Common symptoms of severe liver disease and failure include:

• abdominal swelling
• abdominal pain, especially in the upper right side
• easy bruising and bleeding
• muscle cramps and weakness
• swelling in your ankles and feet (edema)
• dehydration
• yellowing of your skin and whites of your eyes (jaundice)
• darker urine than normal
• nausea or vomiting
• appetite loss and unintentional weight loss
• unexplained weakness and fatigue (malaise)
• problems with memory, thinking, and sleep
• itchy skin, which may become severe
• loss of libido

Chronic liver failure develops gradually, usually over the course of several years. It also occurs when you already have underlying liver disease.

Acute liver failure, on the other hand, is damage from a short-term or rapid onset. In such cases, you may not have a history of liver disease.

It’s important to get medical help right away if you’re having possible symptoms of liver failure, such as abdominal pain and swelling, yellowing skin and eyes, and vomiting.

Although these may point to liver failure if you have a history of liver disease, they may also indicate possible acute liver failure.

A doctor may diagnose liver failure with a combination of the following:

• symptoms you may be experiencing
• your personal health history, including any prior cases of jaundice and your typical alcohol consumption
• your family history
• blood tests, which will look for liver function, autoimmune markers, and a complete blood count, and which doctors also perform to rule out infection or viruses
• imaging tests to confirm liver damage, such as an ultrasound scan, CT scan, or MRI scan
• biopsy of the liver (less common in acute cases of liver failure)

With late-stage liver failure, you’ll likely require hospitalization along with a liver transplant.

Further treatment for liver failure also depends on the underlying cause and whether it’s a chronic or acute case. For example, you may need antiviral medications to treat hepatic-injuring viruses in acute liver failure.

You may need additional treatments to help with complications that may arise from acute liver failure, such as renal failure, cerebral edema, and sepsis.

Chronic cases of liver failure are often due to long-term tissue damage in the liver. This is also called cirrhosis. Most commonly, you may develop cirrhosis from:

• alcohol overuse
• non-alcohol-related fatty liver disease
• long-term hepatitis infection

Less common causes include:

• autoimmune disease
• hemochromatosis (iron overload)
• Wilson’s disease (copper overload)

The most common causes of acute liver failure in Western nations are overuse of medications like acetaminophen (Tylenol) and hepatitis infections. Less commonly, acute liver failure may develop from liver injury related to Epstein-Barr, herpes simplex, and other viruses.

Learn more about liver failure.

Liver failure is a medical emergency. If you have concerns about liver disease and possible liver failure, consider the following frequently asked questions.

What is the first sign of liver failure?

Jaundice is one of the first signs of liver failure. It develops from a buildup of bilirubin in your body, and it can cause symptoms like yellowing of your skin or eyes. Not all cases of jaundice are due to liver failure, however, which is why it’s important for a doctor to rule this out.

Can liver disease be cured?

The early stages of liver disease may be reversible before it progresses to cirrhosis. This is especially the case with liver fibrosis, where scarring has started to occur but isn’t yet permanent.

Cirrhosis isn’t curable, but you may be able to manage it with lifestyle changes. These include avoiding alcohol and maintaining a healthy weight. Keeping up to date on vaccines for hepatitis A and B can also reduce your risk of developing liver disease from these viruses.

What is the best medicine for liver disease or liver failure?

Medications for liver disease or liver failure depend on the underlying cause. Certain antivirals, for example, may treat acute liver failure.

In 2024, the Food and Drug Administration (FDA) approved resmetirom (Rezdiffra), the first medication to treat liver fibrosis due to non-alcohol-related fatty liver disease. There’s currently no medication available to treat cirrhosis directly.

Most symptoms of liver disease don’t develop until there’s significant damage to your liver. This underscores the importance of contacting a doctor for an annual physical, as they may catch early signs of liver disease before it evolves into liver failure.