General Practice 2022

Insuficiência hepática: causes, symptoms and treatment

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Insuficiência hepática: causes, symptoms and treatment
Insuficiência hepática: causes, symptoms and treatment

Liver failure is the most serious disease of the liver, in which the organ fails to perform its main functions, such as synthesis of clotting factors, metabolism and elimination of toxins from the body, leading to a series of serious complications such as clotting problems, brain swelling, or kidney failure.

According to the duration and course of symptoms, liver failure can be classified into:

  • Acute: happens suddenly, within days or weeks, usually in he althy people with no previous liver disease. It is usually caused by the hepatitis virus or by the incorrect use of some medicines, such as paracetamol;
  • Chronic: symptoms can take months or even years to appear, and it happens when the liver suffers constant aggression due to situations such as abusive use of alcohol, hepatitis or fat in the liver.

When there is suspicion of liver failure, it is important to consult a hepatologist so that the diagnosis can be made, the cause identified and appropriate treatment initiated, which may include the use of medication or liver transplantation.

Main symptoms

The initial symptoms of acute liver failure can be similar to those of acute hepatitis, and may develop in days or weeks, the main ones being:

  • Yellow skin and mucous membranes;
  • Swelling in the belly;
  • Pain in upper right side of abdomen;
  • Swelling in the legs;
  • Nausea and vomiting;
  • Diarrhea;
  • Loss of appetite;
  • Weight loss;
  • Feeling generally unwell;
  • Feeling full even after a light meal;
  • Excessive sleep;
  • Confusion or disorientation;
  • Sweet smelling breath;
  • Dark urine;
  • Light or whitish stools;
  • Body itch;

In the presence of these symptoms, it is important to see the doctor as soon as possible or seek the nearest emergency room, as the disease can quickly worsen and cause bleeding or serious kidney or brain problems, putting life at risk.

How the diagnosis is made

The diagnosis of liver failure is made based on the clinical history and through blood tests that measure blood clotting time and liver enzymes such as ALT, AST, GGT, alkaline phosphatase and bilirubin.In addition, imaging tests such as a CT scan or MRI may be needed, as well as a biopsy of the liver to see why this organ is not working. See all tests to assess liver function.

In cases where there is no well-established cause, the doctor may also request a blood test for paracetamol levels, a toxicological test and a serology test for viruses.

Online test for liver problems

To know if you may have liver failure, check what you are feeling:

  1. 1.Do you feel pain or discomfort in the upper right part of your belly? Yes No
  2. 2.Are you feeling sick or dizzy frequently? Yes No
  3. 3.Do you have frequent headaches? Yes No
  4. 4.Do you feel tired more easily? Yes No
  5. 5.Do you have multiple purple spots on your skin? Yes No
  6. 6.Are your eyes or skin yellow? Yes No
  7. 7.Is your urine dark? Yes No
  8. 8.Have you been feeling a lack of appetite? Yes No
  9. 9.Is your stool yellow, gray or white? Yes No
  10. 10.Do you feel like your belly is bloated? Yes No
  11. 11.Do you feel itchy all over your body? Yes No


Make an appointment with a specialist

Possible causes

Liver failure is caused by situations that can interfere with the functioning of the liver and alter its functions. Although it can happen in he althy people, liver failure is more common in some cases, such as:

  • Frequent use or higher than recommended doses of paracetamol;
  • Use of medicinal plants such as kava-kava, ephedra, skullcap or pennyroyal;
  • Hepatitis virus type A, B, C or E infection;
  • Use of medications such as antibiotics, anti-inflammatories or anticonvulsants;
  • Excessive consumption of alcoholic beverages;
  • Liver cirrhosis;
  • Epstein-Barr virus, cytomegalovirus or herpes simplex infection;
  • Budd-Chiari syndrome, which can cause blockage in the veins of the liver;
  • Wilson's disease, in which copper accumulates in the liver;
  • Autoimmune diseases such as autoimmune hepatitis;
  • Poisoning by the wild mushroom Amanita phalloides;
  • Liver cancer;
  • Generalized infection.

In some cases, liver failure may not have an apparent cause.In addition, acute liver failure can also occur in the third trimester of pregnancy when a woman has preeclampsia and, therefore, it is important to have a medical follow-up during pregnancy.

How the treatment is done

Treatment for liver failure depends on the causes and stage of the disease and should be done in an intensive care unit so that the person is constantly monitored. So it can be recommended:

1. Use of medication

The drugs that the hepatologist can prescribe to treat liver failure depend on what caused the disease, for example, if it occurred due to paracetamol or wild mushroom (Amanita phalloides) poisoning, drugs should be used to reverse their effects, such as n-acetylcysteine ​​and silibinin, or if the cause was an infection, it should be treated with antibiotics or antifungals.

In addition, the doctor may also indicate other remedies according to the disease and symptoms presented.

2. Making dietary changes

The diet for liver failure should be done under the supervision of a hepatologist and a clinical nutritionist, as the guidelines depend on the person's he alth status and the stage of the disease.

In general, one should control the amount of liquids ingested, restrict the consumption of s alt to less than 2g per day to avoid swelling or accumulation of liquids in the abdomen and do not consume alcoholic beverages, as they can worsen the symptoms symptoms and worsen the disease.

3. Liver transplant

Liver transplantation is surgery that removes the liver that is no longer working properly and replaces it with a he althy liver from a deceased donor or a part of a he althy liver from a living donor.

This treatment, when performed in time, can restore liver function, however it is not indicated in all cases as in liver failure caused by hepatitis, as the virus can install itself in the transplanted liver. Learn about liver transplantation.

Possible complications

Complications of liver failure can arise soon after the first symptoms of the disease or when the disease is in a more advanced stage and include:

  • Brain swelling;
  • Gintestinal bleeding;
  • Infection by bacteria or fungi;
  • Pulmonary edema;
  • Kidney failure.

These complications must be treated immediately, as if not reversed or controlled in time, they can be life-threatening.

How to prevent

Some measures can help prevent or reduce the risk of liver damage that can cause liver failure such as:

  • Avoid taking medications without medical advice;
  • Avoid using medicinal plants without the guidance of a he alth professional;
  • Avoid drinking too much alcohol;
  • Vaccinate against hepatitis;
  • Practice safe sex;
  • Avoid the use of illicit drugs and sharing syringes;
  • Maintain a he althy weight.

Also, when using insecticides and other toxic chemicals, it is important to cover the skin with gloves, long-sleeved overalls, a hat, and a mask, to prevent absorption of the products through the skin that can cause liver failure.

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