Early signs of liver problems in children most parents miss

Liver is one of the largest organ in children and is responsible for detoxification metabolism, secrete digestive enzymes and major immune support to children in the body.

But liver diseases still often go unnoticed in their early stages as the symptoms can be non-specific as well as being subtle, this is often overlooked. Hence, when the warning signs are overlooked, it leads to delayed diagnosis.





The question arises that why are liver problems in children often missed?

Unlike adults, children tend not to clearly express discomfort, such as a dragging sensation and fatigue. Additionally, early liver dysfunction does not always present with dramatic symptoms.

Conditions such as rising obesity, sedentary lifestyles, processed diets, along with conditions like biliary atresia and Wilson’s disease often go unnoticed.

Conditions such as hepatitis, fatty liver, glycogen storage disorders or even genetic liver conditions tend to develop over time.

Some of the early signs which parents should not ignore are:

• Pale colored stools and dark colored urine
• Consistent fatigue: children who tend to tire easily and show signs of lethargy may be signs of subtle liver dysfunction.
• The child having a noticeable poor appetite along with failure to gain weight nor height or even failure to gain weight shows an underlying liver issue.
• Abdominal distension, dragging sensation or discomfort in abdomen such as mild pain or feeling of fullness
• Yellowing of skin or eyes should never be ignored
• Child may have frequent bruising, profuse bleeding during injury since the liver produces clotting factors, the dysfunction of it leads to prolonged bleeding
• Itching of skin without allergy reaction signifies defective bilirubin conjugation
• Swelling in the legs should be considered

In newborns, the color of stool is very important. If the stool appears pale or ivory-colored, the child should be taken to the hospital immediately.

Some prevention strategies parents can follow for their children are:

• Ensuring that their child has a balanced diet
• Encouraging physical activity in order to prevent obesity related liver diseases
• Promoting good hygiene in order to avoid infections
• Regular paediatric check-ups with preventable hepatitis vaccine and follow up of childhood obesity , this is an essential when there is a family history of liver disease or family history of viral hepatitis
• Prolonged use of antibiotics and over the counter medicines will lead to liver injury.
• It is important to seek medical attention when there is any degree of yellowing of eye/skin, nausea, consistent vomiting along with the child refusing to eat, fatigue that tends to last for more than a day.

Thus, it is important to understand that children rarely begin liver diseases with dramatic symptoms, hence being attentive is the key for lifesaving. Early detection simplifies treatment and ensures that the child thrives and grows well.
Dr. Kavitha Sampathkumar, Senior Consultant, MGM Malar, Chennai