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The liver plays an essential role in our health, managing key functions such as bile production, cholesterol synthesis, glucose storage, toxin elimination and red blood cell processing.
How to detect liver diseaseLiver pathologies such as cirrhosis, hepatitis, hepatic steatosis and cancer are often asymptomatic and difficult to identify. However, there are telltale signs of liver disease that should prompt you to seek medical attention.
This article presents 7 telltale signs of a liver in distress, from obvious manifestations like yellowing skin and eyes to more subtle clues like persistent fatigue or unexpected weight loss. When faced with these symptoms, a medical consultation is essential to assess and treat your liver.
1. Cutaneous and visual manifestations: jaundice
Jaundice is a clear indicator of liver pathology, manifesting as visible yellowing of the skin and whites of the eyes. This discoloration is caused by bilirubin, a pigment produced when red blood cells break down.
Bilirubin is generally filtered by the liver and eliminated in the bile. In the event of liver dysfunction, the liver has difficulty processing this substance, resulting in increased blood levels and yellow discoloration of body tissues.
Yellow eyes and complexion
Yellowing of the skin and eyes is often the first sign of jaundice. It becomes visible when bilirubin levels exceed 2.5 mg/dl.
Initially visible in the whites of the eyes, yellowing gradually spreads to the face, neck, trunk and extremities, with intensity varying according to the cause and duration of jaundice.
This phenomenon may be accompanied by other symptoms such as itching, fatigue, fever or nausea. Jaundice of the eyes and complexion is often a sign of inflammation or obstruction of the liver or biliary system, linked to hepatitis, cirrhosis, gallstones or liver cancer.
Stool discoloration and dark urine
Discolored stools and darker urine are among the telltale symptoms of jaundice. Under normal circumstances, bilirubin processed by the liver is excreted in the bile, turning stools brown.
When the liver fails, bilirubin is no longer correctly eliminated in the bile, but in the blood, then filtered by the kidneys and expelled in the urine, resulting in light-colored stools and dark urine.
This is worrying because it can also affect the kidneys, especially if it persists, which could amplify pre-existing kidney problems or create new ones. These signs usually suggest an obstruction of the bile ducts, blocking the flow of bile to the intestine. A change in stool or urine color warrants immediate medical attention.
2. Digestive and metabolic disorders
The liver is a central organ of digestion, producing bile which is essential for breaking down and assimilating fats in the intestine.
If the liver is affected, its ability to produce or release bile into the bile ducts is compromised. This leads to digestive and metabolic dysfunction, including difficulty digesting high-fat foods, post-prandial heaviness, bloating and exaggerated gas production.
Intolerance to fatty foods and a feeling of heaviness
Liver problems can lead to intolerance of fatty foods and a persistent feeling of heaviness.
These symptoms result from a lack of bile, which interferes with fat digestion. Fatty foods stagnate in the stomach, causing discomfort and heaviness, before passing into the intestine where they ferment, causing gas and diarrhea.
These signs can be indicative of hepatic steatosis, an accumulation of fat in the liver, potentially due to excess alcohol, overweight, diabetes or dietary imbalances.
Consult a doctor if you experience these difficulties, and it’s advisable to moderate your consumption of high-fat foods such as fried foods, cold meats, cheeses and various pastries.
Bloating and excessive flatulence
Excessive bloating and flatulence are also symptomatic of liver complications. These disorders result from an imbalance in the intestinal flora, i.e. the bacteria that facilitate digestion.
When the liver is defective, it is unable to filter certain bacterial components such as endotoxins, which are normally neutralized, pass into the bloodstream and trigger inflammatory reactions in the intestine.
This process degrades the intestinal barrier and disrupts the flora, leading to an overproduction of gas, and thus to bloating and flatulence. This can be a sign of cirrhosis, an advanced stage of chronic liver disease leading to fibrosis and deformation of the organ.
It is therefore advisable to consult a doctor when faced with these symptoms, and to take care of your intestinal microbiota by consuming probiotics, fiber-rich foods and avoiding irritating substances such as strong spices, coffee or alcohol.
3. Unexpected body changes
The liver plays a particularly important role in the management of carbohydrates, lipids and proteins, and is indispensable to the body’s metabolism.
When it is affected, it no longer performs these functions properly, which can manifest itself in unexpected bodily changes. These may include sudden and unexplained weight loss, lack of appetite or, on the contrary, swelling of the abdomen and accumulation of fluid in the body.
Sudden weight loss and loss of appetite
Rapid weight loss or loss of appetite may be early signs of liver damage.
These symptoms can be explained by a reduction in protein and glucose production by the liver, leading to muscle breakdown and lower blood sugar levels.
They may also result from inflammation of the liver, which can cause nausea, vomiting and an early feeling of fullness. These signs, particularly weight loss and loss of appetite, can be a sign of advanced cirrhosis or liver cancer. In the event of unexplained weight loss and loss of appetite, a medical visit is essential.
Swollen abdomen and water retention
One of the most visible symptoms of liver dysfunction is swelling of the abdomen, accompanied by water retention.
This phenomenon occurs when pressure in the portal vein, which carries blood from the intestine to the liver, increases due to resistance to blood flow from the diseased liver.
The result is an accumulation of fluid in the abdomen (ascites) and legs (edema). The presence of these symptoms is often a sign of advanced cirrhosis or severe liver failure.
If you notice abnormal swelling of your abdomen or edema in your legs, you should consult a doctor.
4. Physical pain and discomfort
Located below the ribs on the right, the liver is vital to our health. If the liver is affected by disease, it can cause noticeable pain and discomfort. These symptoms include pain in the right area under the ribs, called the right hypochondrium, as well as increased sensitivity and a feeling of heaviness in the same area.
Pain in the right hypochondrium
Pain below the right rib cage is a common symptom of liver injury. The pain may be continuous, stabbing or acute, varying in intensity and duration.
It may be triggered or amplified by movement, pressure or even breathing, and may extend to the right shoulder, back or chest.
The causes of this pain are varied: gallstones, hepatitis, gallbladder infection, obstruction of the bile ducts, liver tumors or cirrhosis. The persistence or frequent recurrence of this pain is a warning sign that requires medical consultation.
Increased sensitivity and fullness under the ribs
Increased tenderness and a feeling of fullness under the ribs can also be a sign of a liver disorder. These manifestations are often the result of swelling of the liver (hepatomegaly), which exerts pressure on the surrounding organs and abdominal wall.
Hepatomegaly can result from various chronic liver pathologies such as cirrhosis, hepatic steatosis or liver cancer.
These sensations may be accompanied by other symptoms such as decreased appetite, nausea, fatigue or jaundice. Any change in the consistency or size of your liver should be reported to your doctor.
5. Neurological and psychological disorders
The liver plays a decisive role in detoxifying the blood by eliminating harmful elements such as ammonium, endotoxins and alcohol.
In the case of liver disease, this essential function is compromised, leading to an accumulation of toxins in the blood and brain, causing neurological and psychological disorders.
These include impaired consciousness, confusion, mood swings and drowsiness.
Altered consciousness and confusion
Altered consciousness and marked confusion may be signs of critical liver dysfunction.
These symptoms result from intoxication of the brain by ammonium, a metabolic product normally transformed by the liver into urea and eliminated.
When the liver fails, ammonium accumulates, crosses the brain barrier and disrupts brain function. This disruption manifests itself in difficulties with concentration, memorization and communication, and even behavioral disorders such as aggression, apathy or euphoria.
If left untreated, these symptoms can progress to coma or death. Often associated with hepatic encephalopathy (a neuropsychiatric condition linked to chronic or acute liver disease), they require urgent medical attention.
Treatment consists of reducing protein intake, prescribing laxatives or antibiotics to limit ammonium production, or liver transplantation in the case of end-stage liver failure.
Mood swings and drowsiness
Mood swings and excessive sleepiness are also indicative of liver problems, linked to hormonal and circadian rhythm disturbances, normally regulated by the liver.
The liver is involved in the synthesis and breakdown of hormones such as melatonin and serotonin, essential for maintaining our sleep-wake cycle.
When the liver is affected, hormonal imbalances can lead to depression, anxiety, irritability, apathy or circadian rhythm disorders such as drowsiness during the day and insomnia at night.
These disorders, which can have a major impact on daily life and social relationships, are frequently observed in cases of hepatic steatosis. Steatosis can result from excessive alcohol consumption, overweight, diabetes or an unbalanced diet.
It is strongly recommended to consult a doctor in the event of such symptoms, and to adopt a healthy lifestyle, by limiting alcohol, promoting a balanced diet and regular physical activity.
6. Specific dermatological symptoms
The liver eliminates toxins, regulates hormones and synthesizes vitamins. When the liver is affected by disease, these functions are compromised, resulting in distinct skin symptoms such as stellate angiomas, palmar erythema, nail discoloration and spider veins.
Stellate angiomas
Stellate angiomas are small, star-shaped red spots resulting from dilated blood vessels, often visible on the face, neck, chest or arms. These spots may indicate chronic liver disease such as cirrhosis or hepatitis, due to an increase in estrogen and a reduction in clotting factors by the liver. The presence of these red spots on the skin warrants medical consultation.
Palmar erythema
Palmar erythema manifests itself as a reddening of the palms that seems to indicate a burn. This inflammation, which results from the dilation of blood capillaries, is generally visible on both hands, particularly at the base of the thumb and little finger.
These symptoms may be a sign of chronic liver disease, due to high levels of estrogen and reduced breakdown of prostaglandins. Persistent redness on the hands is an indication to consult a health professional.
White nails
Normally pink nails can turn white, except for the tips which remain pink, in cases of liver pathology. This phenomenon, known as white nails, is linked to reduced blood circulation in the nail matrix and can affect both fingernails and toenails.
Often associated with liver disorders such as cirrhosis or hepatitis, it reflects insufficient production of erythropoietin, proteins and vitamins by this vital organ. Any change in nail color should be examined by a physician.
Varicose veins
Varicosities are visible blue or purple veins that appear under the skin, particularly on the legs. They result from the widening and twisting of superficial veins, testifying to a loss of elasticity and a reduced capacity to circulate blood.
Usually present on the calves, thighs or ankles, they can also indicate liver disease, caused by increased pressure in the portal vein in cases of liver pathology.
7. General signs of health impact
The liver regulates vital processes such as metabolism, hormonal balance, blood coagulation and immune function.
Liver disease can compromise these functions, leading to general symptoms such as prolonged fatigue, increased susceptibility to infection and general body weakness.
Persistent fatigue and general weakness
Persistent fatigue and a feeling of weakness can often reflect liver problems.
These symptoms may be due to an insufficient supply of energy and essential nutrients to the body, leading to profound lassitude, weight loss, anemia or hypoglycemia. The accumulation of toxins in the blood, which disrupts organ and brain function, can also be at the root of these signs.
Recurrent fatigue and weakness impairing daily activities may signal prolonged liver disease, such as cirrhosis or hepatitis, or acute liver disease, such as poisoning or infection. It is essential to consult a physician if these problems persist even after rest.
Immune fragility and frequent infections
Increased susceptibility to infection is another indicator of liver problems. This can result from a failure of the immune response, making the body more vulnerable to attack by pathogenic micro-organisms such as bacteria, viruses or fungi.
The liver is an organ essential to immunity, producing key proteins for the body’s defense, including immunoglobulins and cytokines, and eliminating antigens and exhausted immune cells.
Liver deficiency can weaken these defense mechanisms, increasing the risk of infection. Immune fragility accompanied by repeated or severe infections, such as pneumonia, sinusitis, cystitis or candidiasis, is often a sign of prolonged liver disease, such as cirrhosis or autoimmune hepatitis, or may result from treatments that weaken the immune system, such as chemotherapy or corticosteroids. Medical consultation is essential in the presence of such complications.
The liver plays a decisive role in the body’s well-being, performing a multitude of essential functions. That’s why it’s so important to preserve it and keep it in good health.
Liver disorders are sometimes discreet and early detection is often complicated, but they can have serious repercussions for the whole body.
Fortunately, there are a number of clues that may suggest liver dysfunction, including skin abnormalities, digestive disorders, physical changes, pain, neurological damage, epidermal reactions or general signs affecting health.
If you observe one or more of these symptoms, it is advisable to contact your practitioner. He or she will be able to assess the state of your liver’s health and recommend an appropriate course of treatment, which may range from a change of lifestyle to a liver transplant if necessary.
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