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Seek medical advice if you: Have been told you have abnormal liver blood tests Experience persistent fatigue, particularly if accompanied by other symptoms Notice unexplained weight loss or loss of appetite Develop abdominal discomfort, especially in the right upper quadrant Observe yellowing of skin or eyes (jaundice) Experience easy bruising or prolonged bleeding Notice swelling in legs, ankles, or abdomen Have risk factors including obesity (BMI 30 kg/m), type 2 diabetes, high cholesterol, or metabolic syndrome Urgent medical attention is required for: Jaundice with confusion or drowsiness (potential hepatic encephalopathy) call 999 or attend A&E immediately Vomiting blood or passing black, tarry stools (possible variceal bleeding) call 999 or attend A&E immediately Severe abdominal pain with fever call 999 or attend A&E immediately Sudden abdominal swelling with breathing difficulty call 999 or attend A&E immediately For urgent advice that is not immediately life-threatening, you can contact NHS 111 online or by phone

Heart (2016) 102:3906

or if you are taking medications for diabetes, high blood pressure, or seizures