Cirrhosis of the liver is a late stage of chronic liver disease. At this stage, a significant amount of your healthy liver tissue has turned to scar tissue. Scarring comes from long-term inflammation in your liver (hepatitis). When you have too much scar tissue, it can prevent your liver from working properly. This leads to liver failure. While cirrhosis can’t be reversed, treatment may slow or stop it from getting worse.
Are There Stages of Cirrhosis?
Cirrhosis worsens as scar tissue builds up in your liver. In the beginning, your body compensates for the damage, and you might not notice any symptoms. This is called compensated cirrhosis. As liver function declines, symptoms develop. This is known as decompensated cirrhosis.
- A smooth, healthy liver, a lumpy, damaged liver, and a deeply scarred liver represent end-stage cirrhosis.
- As liver damage in cirrhosis builds up, your liver function declines.
How Does Cirrhosis Affect My Liver and Body?
Scarring in your liver blocks blood and oxygen from flowing through your liver tissues. This reduces your liver’s ability to:
- Filter toxins
- Process nutrients
- Produce bile and essential proteins
Scar tissue can also compress important blood vessels, including the portal vein, leading to portal hypertension.
How Common is Cirrhosis?
Cirrhosis is relatively common and is a significant cause of hospitalization and death, especially after middle age.
- In the United States, it affects about 0.25% of all adults and about 0.50% of adults between the ages of 45 and 54.
- Each year, about 26,000 deaths in the United States are attributed to cirrhosis, and these rates are rising.
- Cirrhosis is a global health concern.
Symptoms and Causes
Liver Cirrhosis Symptoms
There are many signs and symptoms of cirrhosis, but they may not appear until late in the process. Cirrhosis symptoms become more recognizable as your liver function declines.
Early symptoms may include:
- Nausea or loss of appetite
- Feeling weak and tired
- Feeling generally ill
- Upper abdominal pain
- Visible blood vessels that look like spiders
- Redness on the palms of your hands
Later symptoms may include:
- Jaundice (a yellow tint to your skin and eyes)
- Dark-colored pee and light-colored poop
- Itchy skin (but with no visible rash)
- Small, yellow bumps of fat deposits on your skin or eyelids
- Unexplained weight loss and muscle loss
- Irregular periods
- Swelling in your abdomen (ascites)
- Easy bleeding and bruising
What Causes Cirrhosis of the Liver?
Cirrhosis is a gradual scarring process that’s triggered by chronic inflammation in your liver. Any chronic liver disease that causes inflammation (hepatitis) can lead to cirrhosis.
Common causes include:
- Alcohol-induced hepatitis: Liver damage from long-term, heavy alcohol use.
- Metabolic dysfunction-associated steatohepatitis (MASH): Chronic damage from excess fat storage in your liver.
- Chronic hepatitis C infection: A viral infection that becomes chronic in most people.
- Chronic hepatitis B infection: A viral infection that may become chronic in some cases.
Less common causes include:
- Autoimmune disease: Autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis.
- Genetic disorders: Glycogen storage disease, cystic fibrosis, and Wilson disease.
- Toxic hepatitis: Long-term exposure to toxins or medications, including NSAIDs and acetaminophen.
- Cardiovascular disease: Conditions like congestive heart failure or chronic ischemia that affect blood flow to the liver.
Risk Factors
You might be at a higher risk for cirrhosis of the liver if you:
- Are over 50
- Have a history of heavy alcohol use
- Have a chronic viral hepatitis infection
- Have metabolic syndrome
Early treatment for these conditions can help prevent cirrhosis. Vaccinations can also prevent viral hepatitis.
Complications of Liver Cirrhosis
Side Effects of Cirrhosis of the Liver
- General toxicity: feeling ill, tired, and foggy
- Reduced immunity, healing, and recovery
- Fluid leakage from veins, causing swelling
- Hormonal imbalances and deficiencies
- Digestive difficulties, malabsorption, and malnutrition
- Cognitive impairment and motor dysfunction (hepatic encephalopathy)
Life-Threatening Complications
- Gastrointestinal (GI) varices and gastrointestinal bleeding
- Spontaneous bacterial peritonitis
- Kidney failure (hepatorenal syndrome)
- Respiratory failure (hepatopulmonary syndrome)
- Liver failure
- Liver cancer
Diagnosis and Tests
How Doctors Diagnose Cirrhosis of the Liver
A healthcare provider will begin by:
- Physically examining you for signs of cirrhosis
- Asking about your medical history, medications, and lifestyle
Tests may include:
- Blood tests: To check liver function, clotting, and disease markers.
- Imaging tests: Ultrasound, CT, MRI, or elastography to measure stiffness.
- Liver biopsy: A small tissue sample to confirm cirrhosis and its cause.
Management and Treatment
Can Cirrhosis of the Liver Be Reversed or Cured?
- Cirrhosis means permanent scarring that can’t be reversed.
- However, treatment can slow or stop further damage, depending on the cause.
What Are Cirrhosis Treatments?
Treating the Cause
- Medications: Antivirals for hepatitis C, suppressants for hepatitis B, and immunosuppressants for autoimmune diseases.
- Alcohol dependency treatment: Eliminating alcohol or toxins is crucial.
- Managing metabolic factors: Controlling cholesterol, blood sugar, and weight.
Diet and Lifestyle
- Eliminate alcohol and drugs
- Eat healthy foods and reduce excess weight
- Add dietary supplements for deficiencies
Treating the Complications
- Sclerotherapy to seal a bleeding vein
- Paracentesis to remove fluid
- Blood transfusions
- Kidney dialysis
- Oxygen therapy
- Treatment for liver cancer
- Liver transplantation if other treatments fail
Outlook / Prognosis
What Can I Expect If I Have Cirrhosis of the Liver?
- Cirrhosis means permanent damage, but it doesn’t always worsen rapidly.
- If compensated, you may live long with few symptoms.
- Protecting your liver can help prevent progression to decompensated cirrhosis.
What Is Life Expectancy With Cirrhosis of the Liver?
- Depends on advancement, complications, treatment, and overall health.
- Compensated cirrhosis: Life expectancy may be 15+ years.
- Decompensated cirrhosis: Average life expectancy is 7 years.
- Prognosis measured by CTP and MELD scores.
Prevention
Can Cirrhosis Be Prevented?
Yes, you might prevent progression by:
- Regular health checkups
- Early treatment of liver disease
- Vaccinations against viral hepatitis
- Lifestyle changes to reduce alcohol, toxins, and unhealthy foods
