Some people with advanced liver disease experience reduced appetite, nausea, or unintended weight loss.
These changes may develop because of altered metabolism, digestive discomfort, or complications of chronic illness.
However, appetite loss and weight loss can also be associated with infections, digestive disorders, thyroid conditions, and other serious illnesses.
If you are losing weight without trying, particularly if the change continues over several weeks, arrange a medical examination.
10. Nausea and Digestive Discomfort
Persistent nausea, reduced appetite, or discomfort in the upper abdomen can occur in people with liver disease.
However, these symptoms are nonspecific and are much more commonly associated with digestive conditions, medication effects, or infections.
The liver is located mainly in the upper-right part of the abdomen, beneath the ribs. Some liver conditions can cause discomfort in this region, but pain location alone cannot establish a diagnosis.
Persistent nausea or abdominal pain should not automatically be attributed to the liver.
11. Red Palms and Small Blood Vessels on the Skin
Certain skin changes can occur in chronic liver disease.
Two examples are:
- Palmar erythema: redness of the palms, particularly around the base of the thumb and little finger.
- Spider angiomas: small, spider-shaped clusters of blood vessels visible beneath the skin.
These findings can occur in people with cirrhosis, but they can also appear in healthy individuals or in other circumstances.
A skin change alone cannot confirm liver damage. A clinician must consider your medical history, physical examination, and appropriate tests.
12. Confusion, Memory Problems, or Unusual Sleepiness
Advanced liver disease can sometimes cause hepatic encephalopathy, a condition in which impaired liver function allows substances to affect brain function.
Possible symptoms include:
- Difficulty concentrating.
- Changes in sleep patterns.
- Confusion or forgetfulness.
- Unusual behavior.
- Increasing drowsiness.
These symptoms can also have other causes, including infections, medication effects, and neurological conditions.
Sudden confusion, marked drowsiness, or difficulty waking someone requires emergency medical attention. Do not wait for additional symptoms to appear.
How Can You Know Whether Your Liver Is Healthy?
Symptoms alone cannot reliably determine whether your liver is functioning normally.
Some people with fatty liver disease, chronic hepatitis, or early cirrhosis have no noticeable symptoms. Others experience fatigue or digestive problems without having liver disease.
If you are concerned about your liver, a healthcare professional may recommend the following tests.
Liver Blood Tests
Blood tests can measure enzymes and other substances that provide information about liver injury and function.
Common tests include:
- ALT and AST: enzymes that can rise when liver cells are damaged.
- Bilirubin: a substance that can accumulate in certain liver or bile duct disorders.
- Albumin: a protein produced by the liver that can be reduced in advanced liver disease.
- Prothrombin time or INR: measurements that help assess blood clotting.
- Alkaline phosphatase: an enzyme that can rise in some conditions affecting bile flow.
No single blood test can reliably confirm or exclude cirrhosis in every case.
Ultrasound and Other Examinations
Depending on your symptoms and test results, your doctor may recommend an abdominal ultrasound, a liver stiffness assessment called elastography, or additional imaging and blood tests.
These examinations can help identify fatty changes, structural abnormalities, signs of advanced scarring, and certain complications.
The appropriate evaluation depends on your individual circumstances.
What Are the Main Causes of Liver Cirrhosis?
Cirrhosis develops after prolonged liver damage. Common causes include:
1. Metabolic dysfunction-associated steatotic liver disease (MASLD)
This condition involves excess fat in the liver and is associated with factors such as obesity, type 2 diabetes, and metabolic abnormalities. Some people develop liver inflammation and progressive scarring over time.
2. Chronic hepatitis B or hepatitis C
These viral infections can cause persistent liver inflammation. Without appropriate treatment, some cases progress to cirrhosis.
3. Long-term excessive alcohol consumption
Alcohol can damage liver cells and contribute to inflammation and scarring.
4. Certain autoimmune and inherited conditions
Autoimmune liver diseases and disorders such as hemochromatosis can also cause progressive liver damage.
Identifying the underlying cause is essential because treatments differ depending on the condition.
Seven Daily Habits That Help Protect Your Liver
Although no food or drink can guarantee protection against cirrhosis, several habits can support liver health.
1. Maintain a healthy weight. If you are overweight, gradual weight loss can help reduce liver fat in people with metabolic fatty liver disease.
2. Eat a balanced diet. Include vegetables, fruit, whole grains, legumes, and appropriate portions of protein. Limit excessive added sugar and highly processed foods.
3. Avoid alcohol if you have liver disease. If you have been diagnosed with cirrhosis, avoiding alcohol is particularly important.
4. Use medications responsibly. Follow dosage instructions and ask a healthcare professional before combining medicines or taking supplements. Excessive acetaminophen, also called paracetamol, can cause severe liver injury.
5. Ask about hepatitis screening and vaccination. Hepatitis B vaccination can prevent infection, and effective treatments are available for hepatitis B and hepatitis C.
6. Exercise regularly. Walking and other appropriate physical activities can support metabolic health and help manage conditions associated with fatty liver disease.
7. Avoid unproven liver cleanses. Herbal mixtures, detox drinks, and supplements advertised as liver cleansers have not been shown to reverse cirrhosis. Some can actually injure the liver or interact with medication.
When Should You See a Doctor?
Arrange a medical appointment if you experience persistent fatigue, unexplained weight loss, ongoing itching, recurrent abdominal discomfort, or other symptoms that concern you.
Seek urgent medical attention for new jaundice, rapidly increasing abdominal swelling, or unexplained dark urine accompanied by pale stools.
Call emergency services if you vomit blood, pass black tarry stools, develop sudden confusion, or experience severe abdominal pain with fever.
Early diagnosis matters because treating the underlying cause can slow or prevent further liver damage, and some complications can be treated effectively.
Final Thoughts
Liver cirrhosis does not develop overnight, and there is no single set of symptoms that proves the liver is failing.
The most important warning signs include jaundice, abdominal swelling, leg swelling, unexplained bleeding, persistent itching, and changes in mental alertness. These symptoms can have several causes, but some require urgent medical evaluation.
Do not wait until you feel seriously ill to seek medical advice if you have risk factors for liver disease. Appropriate blood tests, imaging, and treatment can help identify problems before serious complications develop.
Your liver performs essential functions every day. Protecting it begins with informed health decisions, regular medical care when needed, and avoiding remedies that promise miraculous results.
See more on the next page
