Severe pain in the epigastrium (upper abdomen) may indicate biliary colic, also known as gallstones. “In liver disease, a gallstone can block the bile duct (which connects the intestine to the liver and transports bile to the digestive tract after each meal) or the gallbladder, causing sudden pain under the ribs, above the navel. This symptom can be misleading because the pain is not necessarily localized to the liver (right side) and can occur intermittently,” warns the specialist. Severe and recurring pain requires an urgent liver ultrasound to detect gallstones in the gallbladder.
6. Unexplained itchy skin
“Itchy skin can indicate liver disease. It typically manifests as diffuse and generalized itching, with no specific localization,” our expert reports. The patient has no visible rashes or skin lesions. “This symptom is often mistaken for an allergic reaction or hives, when in reality, it’s liver dysfunction: the liver is no longer able to metabolize bile properly, leading to an excess of bile acids in the blood, causing microinflammation of the blood vessels and, consequently, persistent itching,” he explains.
7. Sudden weight loss
Rapid and unexplained weight loss associated with sudden anorexia can signal serious liver damage. “Typically, these clinical symptoms appear in the decompensation stage of cirrhosis, rarely earlier,” explains the hepatologist. “Without prompt therapeutic intervention, cirrhosis can progress to hepatocellular carcinoma.” Rapid and significant weight loss accompanied by a decrease in appetite requires consultation with a specialist and further testing (full liver function tests, liver imaging, etc.). It’s important to remember that these symptoms are not specific to liver disease and may be associated with many other conditions.
8. Frequent cognitive impairment
The overloaded liver no longer removes toxins. These substances can enter the brain and cause hepatic encephalopathy, characterized by impaired cognitive function. “This manifests itself in various ways. The patient may experience confusion, temporal disorientation, memory lapses, and episodes of satiety or delirium,” explains Professor Marcellin. In the most severe cases, this condition can lead to hepatic coma. Difficulty concentrating, confusion, or memory loss, especially in young people (under 60-70 years of age), should prompt medical consultation. It’s important to remember that encephalopathy isn’t exclusively related to liver disease and can be associated with other etiologies (brain damage, viral infections, early dementia, etc.).
