Signs of Liver Disease

Liver disease often develops silently. In the early stages of liver disease, symptoms are often absent or vague, making early detection challenging. Because the liver can repair itself and compensate for damage for a long time, symptoms may not appear until the condition becomes more advanced. Recognizing the early and late signs of liver disease can help you get treatment sooner and prevent serious complications.

This guide explains the most common warning signs, what causes them, and when to seek medical care.

Why Liver Disease Symptoms Develop

The liver performs hundreds of essential tasks including filtering toxins, producing bile, regulating hormones, storing nutrients, and supporting metabolism. When the liver becomes inflamed, damaged, or scarred, these functions weaken.

Symptoms develop when the liver:

• Can no longer filter toxins effectively

• Loses its ability to produce proteins and enzymes

• Struggles to manage fluid balance

• Develops scar tissue as a result of liver damage, leading to fibrosis or cirrhosis

Early Signs of Liver Disease

Early symptoms may be vague or mild, but noticing them can lead to early diagnosis and better outcomes.

Symptoms of liver disease can be subtle and may resemble other common illnesses, making them easy to overlook. Liver enlargement can sometimes be present in the early stages, even if it causes only mild pain or discomfort.

1. Fatigue and Weakness

One of the earliest and most common signs.

2. Loss of Appetite or Nausea

Changes in appetite can signal liver stress.

3. Upper Right Abdominal Discomfort

A dull ache or pressure under the ribs may indicate liver inflammation. A slightly enlarged liver may also cause mild or vague discomfort in this area.

4. Unexplained Weight Loss

The liver affects digestion and nutrient absorption.

5. Mild Itching

Caused by bile salts build up under the skin, leading to itching.

6. Dark Urine

Indicates rising bilirubin levels.

Visible Skin and Eye Symptoms

Some signs appear on the skin or eyes and are easy to spot. However, yellowing of the skin may be harder to detect on brown skin tones.

1. Jaundice

Yellowing of the skin and eyes is one of the clearest signs of liver dysfunction.

Jaundice occurs when there is a buildup of bile pigment (bilirubin) in the blood, which results from the breakdown of red blood cells and can be caused by problems with the bile ducts.

2. Spider Angiomas

Small, spider-like blood vessels on the face, chest, or arms.

3. Easy Bruising

The liver produces clotting proteins. When damaged, bruising becomes more common.

4. Red Palms (Palmar Erythema)

Often linked to inflammation or cirrhosis.

5. Dry or Itchy Skin

Caused by toxin buildup, bile retention, or accumulation of bile salts, which can lead to itching.

Digestive and Gastrointestinal Symptoms

1. Bloating or Gas

Liver disease can affect digestion and enzyme production.

2. Pale or Clay-Colored Stools

Occurs when bile flow is blocked; pale stool is a sign of bile flow blockage and may indicate cholestasis.

3. Diarrhea or Constipation

Changes in digestion may signal liver stress.

4. Nausea or Vomiting

A common symptom as liver function declines.

Hormonal and Metabolic Symptoms

Liver disease can disrupt hormone regulation.

In Women:

• Irregular periods

• More severe PMS symptoms

In Men:

• Loss of libido

• Erectile dysfunction

• Enlarged breast tissue (gynecomastia)

Advanced Signs of Liver Disease

Symptoms worsen as liver damage progresses to fibrosis or cirrhosis. These advanced signs are often seen in end stage liver disease, which is characterized by decompensated cirrhosis, liver failure, and serious complications such as portal hypertension and primary liver cancer.

1. Ascites (Abdominal Swelling)

Fluid buildup in the abdomen caused by portal hypertension. Ascites can also cause mild pain or soreness in the abdomen. Liver cirrhosis is a leading cause of ascites.

2. Edema (Leg and Ankle Swelling)

Fluid leaks into tissues when the liver cannot maintain protein levels.

3. Hepatic Encephalopathy

Toxin buildup affects brain function. Hepatic encephalopathy, also known as liver encephalopathy or portal systemic encephalopathy (sometimes called portal systemic encephalopathy), is a condition that results from advanced liver dysfunction.

Symptoms include:

• Confusion

• Memory issues

• Difficulty concentrating

• Mood changes

• Sleep reversal (awake at night, sleepy during the day)

This condition is caused by the buildup of toxic substances in the brain due to the liver's inability to properly detoxify the blood. In severe cases, hepatic encephalopathy can progress to hepatic coma.

4. Variceal Bleeding

Variceal bleeding occurs when swollen veins, known as esophageal varices, in the esophagus or stomach rupture due to increased blood pressure (portal hypertension) in the portal vein and portal blood vessels. This high blood pressure causes the formation of new collateral blood vessels that connect blood flow and allow blood to bypass the liver (liver pass). However, these new blood vessels are fragile and prone to rupture, leading to internal bleeding.

Warning signs:

• Vomiting blood

• Black, tarry stools

• Dizziness or fainting

• Belly pain (possible symptom of variceal bleeding or irritation)

This is a medical emergency.

5. Muscle Wasting

The body breaks down muscle when liver function is severely impaired. Muscle cramps and muscle stiffness are also common symptoms in severe liver disease.

6. Severe Jaundice

A sign of significant liver failure.

Nail and Hand Symptoms Linked to Liver Disease

Certain changes in the nails and hands may indicate liver problems.

1. Terry's Nails

Nails appear white with a darker band near the tip.

2. Clubbing

Fingertips become enlarged and nails curve downward.

3. Red Palms

Associated with cirrhosis and hormonal changes.

Also checkout our guide on: Fatty Liver Symptoms on Face: A Comprehensive Guide

Causes of Liver Disease

Liver disease can result from many conditions.

Common causes include:

• Fatty liver disease (MASLD or MASH)

• Alcohol-related liver disease

• Viral hepatitis (such as hepatitis B or C)

• Autoimmune hepatitis

• Liver cancer

• Bile duct cancer

• Other liver disorders

• Genetic disorders (hemochromatosis, Wilson disease)

• Drug or toxin-related injury

• Bile duct disease (PSC, PBC)

A liver disorder is a condition that can lead to liver failure. Various liver disorders can cause significant damage to liver function and result in symptoms such as jaundice, fatigue, and impaired health.

Identifying the cause is essential for proper treatment.

The immune system can contribute to liver disease through autoimmune reactions, and the biliary tract and liver cells are often affected in these conditions.

How Liver Disease Is Diagnosed

Diagnosing liver disease typically involves a combination of blood tests, imaging, and sometimes biopsy.

Diagnosis typically involves:

• Liver function tests (including liver enzyme tests such as ALT, AST, ALP, GGT)

• Bilirubin levels

• Ultrasound or CT scan

• FibroScan (liver stiffness)

• Hepatitis screening

• Autoimmune markers

• Liver biopsy (in complex cases)

When to Seek Medical Care

You should see a doctor if you notice:

• Persistent fatigue

• Abdominal discomfort

• Unexplained itching

• Dark urine or pale stools

• Yellowing of the eyes or skin

Seek emergency care for:

• Vomiting blood

• Severe confusion

• Rapid abdominal swelling

• Difficulty breathing

Treatment Options

Treatment depends on the underlying cause.

Options may include:

• Weight loss for fatty liver

• Alcohol cessation

• Antivirals for hepatitis

• Immunosuppressants for autoimmune disease

• Medications to reduce portal hypertension

• Low-sodium diet for fluid retention

• Paracentesis for ascites

• Liver transplant in severe cases

The Bottom Line

Common liver disease symptoms include both visible changes, such as jaundice, and functional symptoms, such as fatigue and fluid buildup. Signs of liver disease range from subtle early symptoms to serious, life-threatening complications. Recognizing changes such as fatigue, jaundice, swelling, digestive issues, and skin symptoms can help with early diagnosis and treatment.

Liver disease is manageable and in many cases reversible when identified early.

Want to check your liver health from home? You can take an at-home liver enzyme and fibrosis test through Ribbon Checkup and get results in days.

Explore liver health tests →

Related Resources

• Metastatic Liver Cancer: Symptoms, Diagnosis, Treatment, and Prognosis

• Early Symptoms of Kidney Cancer: Top Warning Signs

• What Cancers Cause Elevated Liver Enzymes? Causes, Patterns, and When to Worry

References

References

NIDDK.. (2023). Symptoms & Causes of Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases; NIDDK - National Institute of Diabetes and Digestive and Kidney Diseases. https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis/symptoms-causes 

Common Characteristics of Liver Disease. (2024, May 24). Hopkinsmedicine.org. https://www.hopkinsmedicine.org/health/conditions-and-diseases/common-characteristics-of-liver-disease 

Liver Disease: Signs & Symptoms, Causes, Stages, Treatment. (2017, March 7). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17179-liver-disease 

Liver problems - Symptoms and causes. (2025). Mayo Clinic; https://www.mayoclinic.org/diseases-conditions/liver-problems/symptoms-causes/syc-20374502 

NHS website. (2017, October). Liver disease. Nhs.uk. https://www.nhs.uk/conditions/liver-disease/ 

 

 

Frequently Asked Questions

Q: What are the early signs of liver disease?

A: Early symptoms include fatigue, loss of appetite, nausea, mild right-sided abdominal discomfort, dark urine, and unexplained weight loss. Mild itching and bloating can also appear.

Q: What skin symptoms indicate liver disease?

A: Common skin signs include jaundice, spider angiomas, easy bruising, red palms, and persistent itching or dryness.

Q: What digestive symptoms occur with liver disease?

A: People may experience bloating, pale or clay-colored stools, diarrhea or constipation, increased gas, and nausea or vomiting as liver function declines.

Q: What are advanced signs of liver disease?

A: Advanced symptoms include ascites (fluid in the abdomen), leg swelling, severe jaundice, hepatic encephalopathy (confusion, memory problems), variceal bleeding, and muscle wasting.

Q: What hormonal symptoms can liver disease cause?

A: In women: irregular periods or worsening PMS. In men: low libido, erectile dysfunction, and enlarged breast tissue (gynecomastia).

Q: What nail or hand changes signal liver problems?

A: Terry’s nails (white nails with dark tips), clubbing of the fingertips, and red palms are commonly associated with chronic liver disease and cirrhosis.

Q: What causes liver disease?

A: Major causes include fatty liver disease (MASLD/MASH), alcohol-related liver disease, hepatitis B or C, autoimmune hepatitis, genetic disorders (hemochromatosis, Wilson disease), medication or toxin exposure, and bile duct diseases such as PSC or PBC.

Q: How is liver disease diagnosed?

A: Diagnosis may include liver enzyme tests (ALT, AST, ALP, GGT), bilirubin levels, ultrasound or CT scan, FibroScan, hepatitis tests, autoimmune markers, and sometimes liver biopsy.

Q: When should I see a doctor for possible liver disease?

A: See a doctor for persistent fatigue, abdominal discomfort, itching, dark urine, or pale stools. Seek urgent care for vomiting blood, severe confusion, rapid abdominal swelling, or trouble breathing.

Q: Can liver disease be reversed?

A: Many causes—including early fatty liver, hepatitis, and alcohol-related liver injury—can improve or reverse with treatment. Advanced scarring (cirrhosis) is not reversible but progression can be slowed.