Cirrhosis

Cirrhosis symptoms

Signs of cirrhosis will vary depending on how far along it is. As the disease progresses and slows down liver function, symptoms may become more noticeable.

People with compensated cirrhosis may experience no symptoms at this stage, while others may experience:

• Fatigue or loss of energy
• Weight loss or loss of appetite
• Loss of muscle mass
• Nausea
• Abdominal pain
• Spider angiomas (red spots on the skin)

As liver damage increases during decompensated cirrhosis, symptoms may include:

• Jaundice (yellowing of the skin and whites of the eye)
• Fluid buildup causing swelling in the legs or abdomen (ascites)
• Itching, caused by the excessive bile products
• In men, breast tissue growth and shrunken testicles
• Easy bruising and excessive bleeding
• Increased risk of infection
• Mental confusion, irritability (encephalopathy) from a build-up of ammonia

Causes

Chronic scarring develops from ongoing inflammation in the liver. While a healthy liver is very good at regenerating new tissue, it cannot repair itself once permanent scar tissue forms. The most common cirrhosis causes include

• Viral hepatitis (Hepatitis B and Hepatitis C)

• Alcohol abuse (alcoholic cirrhosis)

• Fatty liver disease (MASH)

Although less common, other cirrhosis causes may include autoimmune disorders and blocked or damaged bile ducts due to primary biliary cholangitis (PBC) or sclerosing cholangitis (PSC).

Diagnosis

To confirm a cirrhosis diagnosis, your healthcare provider will use one or more tests to evaluate your liver’s function and damage. These may include:

• Blood tests: A liver panel will assess how well your liver is working by measuring various substances made by the liver
• Imaging tests, such as CT scans, MRIs, or ultrasounds, which show what your liver looks like
• Liver biopsy, or tissue sample, can be useful for determining the underlying
• Non-invasive tests, such as fibroscan

Treatment and preventing complications

Cirrhosis treatments vary based on how far along the disease is and how much of the liver has already been damaged at diagnosis. Most importantly, we try to identify and treat the cause so we can slow down the progression of liver disease.

For example:

• If heavy alcohol use is the cause, it’s critical to stop drinking and potentially seek help for alcohol addiction.
• If the scarring is caused by viral hepatitis, medication can help to stop the infection and prevent further damage.
• If it’s due to metabolic factors, such as fatty liver, changing what and how you eat may help.

Living with chronic scarring requires lifestyle changes to slow the progression and reduce the risk of complications, such as portal hypertension or liver cancer. These recommendations include:

• Quitting any alcohol use, even if alcohol isn’t the cause
• Limiting dietary salt and fat
• Avoiding eating raw oysters and other raw shellfish that can transmit infections
• Vaccinating against hepatitis A and B, flu, and pneumonia
• Getting screened for liver cancer and staying up-to-date on other cancer screenings, such as colonoscopies or mammograms (women)

Screening for liver cancer

One of the most common complications of cirrhosis is primary liver cancer. As a result, healthcare providers generally recommend that patients with cirrhosis get screened for liver cancer every six months using an abdominal ultrasound and/or an alpha-fetoprotein (AFP) blood test. CT scans or MRI may also be used, depending on the findings.

Liver transplant surgery

Once the disease progresses to liver failure, the only course of treatment is a liver transplant. Liver transplantation involves replacing a damaged liver with a healthy donor liver.

Learn more about liver transplant surgery