Cirrhosis is scarring (fibrosis) of the liver caused by long-term liver damage. The scar tissue prevents the liver working properly. Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. Each time your liver is injured — whether by disease, excessive alcohol consumption or another cause — it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function (decompensated cirrhosis). Advanced cirrhosis is life-threatening.
The liver damage done by cirrhosis generally can’t be undone. But if liver cirrhosis is diagnosed early and the cause is treated, further damage can be limited and, rarely, reversed. Cirrhosis is sometimes called end-stage liver disease because it happens after other stages of damage from conditions that affect the liver, such as hepatitis.
Your liver may keep working even when you have cirrhosis. However, cirrhosis can eventually lead to liver failure, and you can get serious complications, which can be life threatening.
If your doctor tells you that you have cirrhosis, it means you have a condition that causes scar tissue to gradually replace your healthy livercells. It usually happens over a long period of time because of infection or alcohol addiction. Most of the time, you can’t fix the damage to your liver, but if you catch it early, there are treatments that can keep problems in check.
Symptoms for Cirrhosis
You could also bleed or bruise easily and have swelling in your legs or belly. You may also notice changes in your skin, such as:
• Jaundice (when your skin and eyes turn yellow)
• Intense itching
• Spider web-like blood vessels in your skin
• Redness in the palms of your hands or whitening of your nails
You could have some changes to the way you think, such as problems with concentration or memory. If you’re a woman, you may stop having periods. If you’re a man, you could lose your sex drive, start to develop breasts, or see some shrinkage in your testicles.
Cirrhosis often has no signs or symptoms until liver damage is extensive. When signs and symptoms do occur, they may include:
• Easily bleeding or bruising
• Loss of appetite
• Swelling in your legs, feet or ankles (edema)
• Weight loss
• Itchy skin
• Yellow discoloration in the skin and eyes (jaundice)
• Fluid accumulation in your abdomen (ascites)
• Spiderlike blood vessels on your skin
• Redness in the palms of the hands
• For women, absent or loss of periods not related to menopause
Causes of Cirrhosis
A wide range of diseases and conditions can damage the liver and lead to cirrhosis.
Some of the causes include:
• Chronic alcohol abuse
• Chronic viral hepatitis (hepatitis B, C and D)
• Fat accumulating in the liver (nonalcoholic fatty liver disease)
• Iron buildup in the body (hemochromatosis)
• Cystic fibrosis
• Copper accumulated in the liver (Wilson’s disease)
• Poorly formed bile ducts (biliary atresia)
• Alpha-1 antitrypsin deficiency
• Inherited disorders of sugar metabolism (galactosemia or glycogen storage disease)
• Genetic digestive disorder (Alagille syndrome)
• Liver disease caused by your body’s immune system (autoimmune hepatitis)
• Destruction of the bile ducts (primary biliary cirrhosis)
• Hardening and scarring of the bile ducts (primary sclerosing cholangitis
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.
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 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 arehemochromatosis and Wilson’s disease.
• Medication. This includes prescription and over-the-counter drugs like acetaminophen, some antibiotics, and some antidepressants.
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
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.
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.
If cirrhosis has progressed to the point where treatment isn’t enough, one of the last options is a liver transplant.
Malnutrition is common in people with cirrhosis, so it’s important you eat a healthy, balanced diet to help you get all the nutrients you need.
Cutting down on salt can help reduce the chance of swelling in your legs, feet and tummy caused by a build-up of fluid.
The damage to your liver can mean it’s unable to store glycogen, which is a type of fuel the body needs for energy.