‘Frequent’ epistaxis is a sign of severe fatty liver disease

Liver disease: Doctor discusses causes and symptoms

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Fatty liver disease – also known as non-alcoholic fatty liver disease – is the name for a range of liver conditions not caused by alcohol. The liver is responsible for more than 500 functions, meaning complications from the disease can affect areas around the body. To prevent the disease progressing you should seek medical help if you think you have symptoms.

In its early stages fatty liver disease often doesn’t cause any side effects.

However, if fat continues to build up in the organ it can become inflamed – a stage known as non-alcoholic steatohepatitis.

Persistent inflammation then results in scarring, and this stage is called fibrosis.

If this is left untreated it can progress to cirrhosis, the most severe stage of fatty liver disease.

At this stage the liver becomes scarred and lumpy, and it shrinks.

Cirrhosis requires immediate medical attention as it can lead to liver failure and cancer.

One symptom of cirrhosis is epistaxis – or nosebleeds.

According to NHS Inform, “frequent” nosebleeds can happen due to the body being more susceptible to bleeding.

This can also cause bruising and bleeding gums, it warns.

The service lists other symptoms of cirrhosis as:

  • Tiredness and weakness
  • Loss of appetite
  • Weight loss and muscle wasting
  • Feeling sick (nausea) and vomiting
  • Tenderness or pain around the liver area
  • Tiny red lines (blood capillaries) on the skin above waist level
  • Yellowing of the skin and the whites of the eyes (jaundice)
  • Hair loss
  • Fever and shivering attacks
  • Swelling in the legs, ankles and feet due to a build-up of fluid (oedema)
  • Swelling in your abdomen (tummy), due to a build-up of fluid known as ascites.

“You may also notice changes in your personality, problems sleeping (insomnia), memory loss, confusion and difficulty concentrating,” NHS Inform says.

“This is known as encephalopathy and occurs when toxins affect your brain because your liver is unable to remove them from your body.”

Later stage cirrhosis can also cause other symptoms.

It explains: “In the later stages of cirrhosis, you may vomit blood or have tarry, black stools.

“This is because blood can’t flow through the liver properly, which causes an increase in blood pressure in the vein that carries blood from the gut to the liver (portal vein).

“The increase in blood pressure forces blood through smaller, fragile vessels that line your stomach and gullet (varices).

“These can burst under high blood pressure, leading to internal bleeding, which is visible in vomit and/or stools.

“Over time, the toxins that would normally be removed from the body by a healthy liver can cause multiple organ failure, followed by death.”

There are a number of factors that can increase the risk of fatty liver disease, including if you:

  • Are obese or overweight
  • Have type 2 diabetes
  • Have a condition that affects how your body uses insulin
  • Are insulin resistance, such as polycystic ovary syndrome
  • Have an underactive thyroid
  • Have high blood pressure
  • Have high cholesterol
  • Have metabolic syndrome (a combination of diabetes, high blood pressure and obesity)
  • Are over the age of 50
  • Smoke.

If you think you could have fatty liver disease you should see your GP as soon as possible.

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