Signs and Symptoms of Liver Disease

Last updated: 3 Nov 2026

The liver is a large organ in the upper right part of the tummy. It makes proteins that help your blood clot, produces bile to help digest fat, clears waste products and toxins from the blood, breaks down many medicines and processes bilirubin, a yellow substance made when old red blood cells are broken down.[1][2]

Because the liver has so many jobs, it can keep working for a long time even when it is being damaged. That is why most types of liver disease cause no symptoms in the early stages.[3] This guide explains the liver disease symptoms to watch for, what liver blood tests can show and when to see a doctor.

Why liver disease often has no symptoms

Many people only find out that something is wrong with their liver after a routine blood test or a scan done for another reason. By the time liver problem symptoms appear, the liver may already be scarred, a stage called cirrhosis.[3][4] This is why abnormal liver blood tests are worth following up, even if you feel well.

The symptoms below are not specific to the liver. Each can have other causes, so they are a reason to get checked rather than a diagnosis in themselves.[4]

Early liver problem symptoms

Early symptoms tend to be vague and easy to put down to stress or a busy life. They can include:[3][4]

• feeling very tired and weak much of the time
• loss of appetite, or losing weight without trying
• feeling sick (nausea) or being sick
• discomfort or pain in the tummy
• small, spider-like blood vessels on the skin
• blotchy red palms.

Jaundice: yellow skin and eyes

Jaundice is the most familiar sign of liver disease. The skin and the whites of the eyes turn yellow because bilirubin builds up in the body.[5][6] On darker skin, yellowing may be easier to see in the whites of the eyes than on the skin.[5] Jaundice often comes with:[5][6]

• itchy skin
• dark, tea-coloured urine
• pale or clay-coloured stools.

Jaundice can happen when the liver is damaged and can't clear bilirubin, when too many red blood cells are being broken down, or when bile can't drain from the liver because a duct is blocked.[6] Causes include viral hepatitis, alcohol-related liver disease, some medicines, blood disorders, pancreatitis and gallstones that block the bile duct.[5][6]

Jaundice may be short-lived, for example with hepatitis A, where the liver usually recovers and the yellowing fades. In long-term (chronic) liver disease with ongoing damage, jaundice may persist.[7] If gallstones are a possible cause, our article on gallstone symptoms, diagnosis and management explains how they can block the bile duct.

Yellow skin or eyes always needs prompt medical attention, because the cause can be serious.[5]

Swelling of the tummy and legs

When the liver isn't working well, fluid can build up in the body. Swelling often starts in the feet and ankles and can spread up the legs as liver function gets worse.[4] Fluid can also collect in the tummy, a condition called ascites. It may not be noticeable at first, but as more fluid gathers the tummy becomes larger and the belly button may push outwards.[4][8][11]

Confusion and drowsiness

One of the liver's jobs is to remove toxins, such as ammonia, from the blood. Some of these are made by bacteria in the gut, and others when the body breaks down protein. If the liver can't clear them, they can build up and affect the brain.[8] This is called hepatic encephalopathy. It can cause drowsiness, confusion, difficulty concentrating, slurred speech and trembling hands.[4][8]

Easy bruising and bleeding

The liver makes several of the proteins your blood needs to clot. When liver function falls, fewer of these proteins are made, so you may bruise after only a minor knock or bleed more easily.[2][4] In advanced liver disease, swollen veins in the food pipe or stomach can bleed, which may show as vomiting blood or very dark, black stools. This is an emergency.[4] Bright red blood on the toilet paper is commonly caused by piles (haemorrhoids), but any rectal bleeding should be checked by a doctor.

Tummy discomfort

Pain is not a common symptom of liver disease. The liver tissue itself has no pain-sensing nerves, but the thin capsule around it does. If the liver swells quickly, for example with acute hepatitis A, stretching of this capsule can cause discomfort or pain in the upper right side of the tummy. Many people with long-term liver disease have no pain at all.

What liver blood tests can show

Liver function tests (LFTs) are a group of common blood tests used to see how well the liver is working.[2] An abnormal result usually means something is affecting the liver, but none of these tests is specific to the liver, and conditions elsewhere in the body can change them too.

Sources: [2], live page.

Blood tests are only one part of the picture. Depending on the results and your symptoms, a doctor may also suggest tests for viral hepatitis, an ultrasound or other scans, or a test of liver stiffness.[6][9]

Common causes of liver disease

There are many types of liver disease. Some of the more common causes are:[1][3]

• Fat building up in the liver, often linked to being overweight, type 2 diabetes or high cholesterol. It usually causes no symptoms. Our article on fatty liver explains the symptoms, diet and tests.
• Viral hepatitis, such as hepatitis B or C, which can cause long-term liver damage. Our article on hepatitis B screening in Singapore explains the blood tests and what a carrier result means.
• Alcohol, when drinking regularly goes above recommended limits.[3][10]
• Autoimmune and inherited conditions, such as autoimmune hepatitis, primary biliary cholangitis and haemochromatosis.[1][4]
• Some medicines and supplements, which can affect the liver in some people.[6]

Keeping to a healthy weight, staying within alcohol limits and being vaccinated against hepatitis A and B if you are at risk can lower the chance of several types of liver disease.[3]

When to seek urgent help

Call 995 or go to the nearest Emergency Department if you:[4]

• vomit blood, or your vomit looks like coffee grounds
• have very dark or black, tarry stools
• suddenly become confused, very drowsy or have slurred speech.

Get medical help promptly if your skin or the whites of your eyes turn yellow, or if you have known liver disease and your tummy, legs or ankles become swollen or you get short of breath.[4][5]

When to see a doctor

See your family doctor if you have any of the symptoms above, if a blood test has shown abnormal liver results, or if you have risk factors such as hepatitis B or C, heavy drinking or a family history of liver disease.[3][4] Your doctor can arrange the right tests and, if needed, a referral.

The evaluation of abnormal liver function tests, hepatitis, fatty liver disease and liver cirrhosis is among the gastroenterology and liver clinic services of Dr Ling Khoon Lin, a gastroenterologist at Mount Elizabeth Medical Centre. Questions about which tests you may need and what to expect are covered at the consultation; you can send them through our contact form or request a consultation with the appointment form.

Frequently asked questions

What are the first symptoms of liver disease?

Many people have no symptoms at first. When early liver disease symptoms do appear, they are often vague: tiredness, weakness, loss of appetite, weight loss, nausea or tummy discomfort.[3][4]

What does jaundice look like?

The skin and the whites of the eyes turn yellow. You may also notice itchy skin, dark urine and pale stools. On darker skin, the yellow colour is often easier to see in the eyes.[5][6]

Does jaundice always mean liver disease?

No. Jaundice can also be caused by gallstones blocking the bile duct, problems with the pancreas or blood disorders that break down red blood cells faster. It always needs to be checked by a doctor.[5][6]

Can you have liver disease without symptoms?

Yes. Most types of liver disease cause no symptoms in the early stages, which is why many people find out through a routine blood test or scan.[3]

What blood tests check the liver?

Liver function tests usually include albumin, bilirubin, ALT, AST, alkaline phosphatase and GGT, and sometimes a clotting test (INR). Abnormal results need to be interpreted alongside your symptoms and other tests.[2]

Is liver pain a common symptom?

Not usually. The liver itself has no pain nerves, so many people with liver disease have no pain. Discomfort in the upper right tummy can occur if the liver swells quickly, as in acute hepatitis.

When should I see a doctor about liver problem symptoms?

See a doctor if you have yellow skin or eyes, swelling of the tummy or legs, easy bruising, ongoing tiredness with weight loss, or an abnormal liver blood test. Vomiting blood, black stools or sudden confusion need emergency care.[4][5]

Sources

1. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Liver Disease. https://www.niddk.nih.gov/health-information/liver-disease
2. MedlinePlus Medical Encyclopedia (US National Library of Medicine). Liver function tests. https://medlineplus.gov/ency/article/003436.htm
3. NHS. Liver disease. https://www.nhs.uk/conditions/liver-disease/
4. NHS. Cirrhosis – Symptoms. https://www.nhs.uk/conditions/cirrhosis/symptoms/
5. NHS. Jaundice. https://www.nhs.uk/conditions/jaundice/
6. MedlinePlus Medical Encyclopedia. Jaundice. https://medlineplus.gov/ency/article/000210.htm
7. NIDDK. Hepatitis A. https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-a
8. NIDDK. Symptoms & Causes of Cirrhosis. https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis/symptoms-causes
9. NIDDK. Diagnosis of Cirrhosis. https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis/diagnosis
10. NHS. Alcohol-related liver disease (ARLD). https://www.nhs.uk/conditions/alcohol-related-liver-disease-arld/
11. MedlinePlus Medical Encyclopedia. Cirrhosis. https://medlineplus.gov/ency/article/000255.htm