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Liver failure or hepatic function impairment is also an elimination issue. People with liver failure usually have jaundice, ascites, hepatic encephalopathy, and generally failing health. Jaundice makes the skin and whites of the eyes look yellow. Ascites may cause the abdomen to swell. Hepatic encephalopathy may cause confusion or drowsiness. Most people also have general symptoms, such as fatigue, weakness, nausea, and loss of appetite. In acute liver failure, people may go from being healthy to near death within a few days. Acute liver failure is a medical emergency and if possible people should be evaluated at a liver transplant center.