Cirrhosis: Causes, Symptoms, Diagnosis, and Treatment

Disease Insights: cirrhosis

Select a Disease:

Welcome to the ultimate guide on cirrhosis. Here, you'll find answers to the most common questions to help you or your loved ones understand and manage this condition better.

Description for cirrhosis

A late-stage liver disease characterized by scarring and irreversible damage to liver tissue.

Symptoms of cirrhosis

abdominal pain, fatigue, jaundice, nausea, swelling in legs

Precautions for cirrhosis

Avoid alcohol, Take prescribed medications for li, Monitor liver function regularly, Follow a low-sodium diet

Questions Covered:

what is cirrhosis?
What are the usual symptoms of cirrhosis?
causes of cirrhosis?
How do doctors usually figure out if someone has cirrhosis, diagnosis?
What are the possible complications that could arise from cirrhosis?
How do doctors usually treat cirrhosis?
What are the ways to prevent cirrhosis?

Answers:

Question: what is cirrhosis?

Cirrhosis is the severe scarring or fibrosis of the liver. It happens in the late stage of nonalcoholic fatty liver disease and other conditions that involve liver damage.
The scarring that occurs with cirrhosis is usually irreversible, but treatment can help manage it. Apart from nonalcoholic fatty liver disease (NAFLD) other causes
include hepatitis, long-term alcohol use, and primary sclerosing cholangitis.
According to the National Institutes of Health (NIH), about 1 in 400 adults
are living with cirrhosis in the United States. It's more likely to affect men than women.

Question: What are the usual symptoms of cirrhosis?

Illustrated by Jason Hoffman
Many times, there aren't noticeable symptoms of cirrhosis until the condition has progressed.
Symptoms begin to occur because scarring on the liver has reached the point where the organ is limited in its ability to:
purify the blood
break down toxins
produce clotting proteins
help with the absorption of fats and fat-soluble vitamins
Some of the noticeable symptoms of cirrhosis include
:
decreased appetite
fatigue
unintentional weight loss
mild pain on the upper right side of your abdomen
nausea
vomiting
enlarged or swollen veins (varices or varicose veins)
More serious symptoms include:
yellow discoloration of your skin and eyes (jaundice)
confusion and difficulty thinking clearly
bruising or bleeding easily
very itchy skin
urine that looks darker than usual
abdominal swelling (ascites)
swelling of your legs (edema)
The stages of cirrhosis
Symptoms of cirrhosis fall into two technical stages: compensated cirrhosis and decompensated cirrhosis.
If caught early enough and treated, it's possible to reverse from the decompensated to compensated stage.
Compensated cirrhosis. This is the asymptomatic (showing no symptoms) stage. There may still be scarring on the liver, but it has not progressed enough to cause many, or any, symptoms.
Decompensated cirrhosis. This is the stage where most of the symptoms like jaundice or ascites occur. This is a very serious stage. In some situations, if you're able to manage the reason cirrhosis started in the first place (e.g., heavy drinking), you may be able to reverse your diagnosis back to compensated.

Question: causes of cirrhosis?

There are many different causes of liver cirrhosis. Two of the most common causes of cirrhosis in the United States are chronic hepatitis infections and chronic alcohol misuse.
Alcohol
According to a meta-analysis of studies from 2019
, the risk of liver cirrhosis increases at any level of alcohol consumption for women, which means even a moderate drinker may be at some risk. For men, the risk of cirrhosis increases when an individual has more than one drink a day.
However, every person is different, and enjoying a glass of wine with dinner most nights does not mean you'll get cirrhosis of the liver. Usually, cirrhosis caused by alcohol is the result of regularly drinking in excess over the course of many years.
There are also several other health factors that play into the development of this condition.
Hepatitis
Hepatitis C is a viral infection that can lead to inflammation and damage to the liver. Individuals who are at risk of getting this type of viral hepatitis include those who:
use illegal injected drugs
engage in sex without a condom or other barrier method
are on kidney dialysis
Hepatitis B is another viral form of hepatitis, but it tends to be less common in the United States and more common
in:
Asia
Africa
South America
Eastern Europe
parts of the Middle East
If left untreated, both of these forms of hepatitis can cause cirrhosis of the liver.
Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis
Nonalcoholic fatty liver disease (NAFLD) is a condition that causes fat to build up in the liver, but it's not associated with heavy alcohol use.
Nonalcoholic steatohepatitis (NASH), a more severe form of NAFLD, causes liver damage and inflammation in addition to fat buildup. If NASH is not managed, it can lead to cirrhosis.
Other causes
Other causes of cirrhosis include:
Hepatitis D. Hepatitis D is often seen in people who already have hepatitis B.
Autoimmune hepatitis. Autoimmune hepatitis causes inflammation that can lead to cirrhosis.
Damage to the bile ducts. These ducts function to drain bile. One example of a condition is primary biliary cholangitis.
Disorders that affect the body's ability to handle iron and copper. Two examples are hemochromatosis and Wilson's disease.
Medication. This includes prescription and over-the-counter drugs like acetaminophen, some antibiotics, and some antidepressants.

Question: How do doctors usually figure out if someone has cirrhosis, diagnosis?

A diagnosis of cirrhosis begins with a detailed history and physical exam. Your doctor will take a complete medical history.
It's important to be as honest as possible about long-term alcohol misuse, exposure to hepatitis C, family history of autoimmune diseases, or other risk factors.
The physical exam will look for signs such as:
skin or eyes that appear more yellowed in color
reddened palms
hand tremors
an enlarged liver or spleen
decreased alertness
Tests can reveal how damaged the liver has become. Some of the tests used for evaluation of cirrhosis are:
a complete blood count to look for anemia
coagulation blood tests to see how quickly blood clots
albumin tests to check for a protein produced in the liver
liver function tests
alpha fetoprotein, a liver cancer screening
Additional tests that can evaluate the liver include:
an upper endoscopy to see if esophageal varices are present
an ultrasound scan of the liver
an MRI of the abdomen
a CT scan of the abdomen
a liver biopsy, which is the most conclusive test for cirrhosis

Question: What are the possible complications that could arise from cirrhosis?

If your blood is unable to pass through your liver, it creates a backup through other veins such as those in the esophagus. This backup is called esophageal varices.
These veins are not built to handle high pressure and begin to bulge from the extra blood flow.
Other complications from cirrhosis include:
bacterial infections, like a urinary tract infection (UTI)
bleeding due to decreased clotting proteins
sensitivity to medications (the liver processes medications in the body)
malnutrition
kidney failure
liver cancer
hepatic encephalopathy, which is confusion due to the effects of blood toxins on the brain
gallstones (interference with bile flow can cause bile to harden and form stones)
splenomegaly, which is an enlarged spleen

Question: How do doctors usually treat cirrhosis?

Treatment for cirrhosis varies based on what caused it, what symptoms you are experiencing, and how far the disorder has progressed. Treatments include medications, lifestyle changes, and surgery.
Medications
Depending on the cause of cirrhosis, your doctor may recommend certain medications, such as beta-blockers or nitrates (for portal hypertension). They may also recommend antibiotics or medications to treat hepatitis.
Lifestyle changes
If your cirrhosis is a result of alcohol consumption, your doctor will most likely advise you to stop drinking.
They may also recommend that you lose weight if they consider it medically necessary.
If you are dealing with ascites, a low sodium diet may also be recommended.
Surgery
If cirrhosis has progressed to the point where treatment isn't enough, one of the last options is a liver transplant.

Question: What are the ways to prevent cirrhosis?

Practicing sex with a barrier method can reduce the risk of getting hepatitis B or C.
The Centers for Disease Control and Prevention (CDC)
recommends that all infants and at-risk adults, such as healthcare professionals and rescue personnel, be vaccinated against hepatitis B.
Limiting alcohol intake or avoiding alcohol, eating a balanced diet, and getting adequate exercise can help prevent or slow cirrhosis. Other prevention methods include:
avoiding illegal drugs
talking with your doctor about any medications you take and always taking the appropriate amount
getting screened for heptitis if you believe you may be at risk for it
HEALTHLINE NEWSLETTER
Get our weekly Heart Health email
To help you take good care of your heart, we'll send you guidance on managing high blood pressure, cholesterol, nutrition, and more.
SIGN UP NOW
Your privacy is important to us

Useful Articles on cirrhosis

Additional Information and Resources:

Conclusion & Takeaways

Learning about cirrhosis is the first step toward taking control of your health. By understanding its causes, symptoms, and treatments, you empower yourself to make informed decisions. Remember to consult healthcare professionals for personalized advice and support.