Cirrhosis of the Liver: Causes, Symptoms, and Treatment Options

Cirrhosis of the liver is a severe condition characterized by permanent scarring and extensive liver damage. As cirrhosis worsens, the liver becomes more compromised, which can eventually lead to liver failure.^1,2

What is cirrhosis of the liver?

Cirrhosis occurs when healthy liver tissue is gradually replaced by scar tissue. This gradual scarring is known as fibrosis. When fibrosis reaches an advanced stage that cannot be reversed, it is known as cirrhosis. ^1,2

How common is cirrhosis?

About 1 in 400 people in the United States is reported to have cirrhosis. However, experts believe this number is likely higher. Many people in the early stages of liver damage are not yet diagnosed.²

What are the causes and risk factors for cirrhosis?

Cirrhosis has various causes, including:^1-4

• Alcohol-associated liver disease
• Hepatitis C and Hepatitis B
• Nonalcoholic fatty liver disease (NAFLD), which is a buildup of fat in the liver
• Nonalcoholic steatohepatitis (NASH), an advanced form of NAFLD that causes liver inflammation

Other potential risk factors for cirrhosis include:²

• Obesity or being overweight
• Living with type 2 diabetes
• Being over 40 years old
• Being male

How does scar tissue affect the liver?

In cirrhosis, the buildup of scar tissue prevents crucial blood flow through the liver. Consistent blood flow enables the liver to perform its many functions.¹

The liver is a vital organ that removes harmful substances, produces bile for digestion, and stores essential nutrients. As liver damage progresses, the organ struggles to complete these jobs, leading to a range of health issues.¹

When a person has cirrhosis, the liver cannot filter toxins. This leads to a buildup in the bloodstream, causing confusion and fatigue.^1,3

Additionally, bile production decreases. This affects digestion and the body’s ability to absorb key nutrients.^1,3

Blood flow is also obstructed. Increased pressure in the portal vein can enlarge the veins and lead to severe bleeding.^1,3

Over time, reduced liver function can result in:^1,3

• Portal hypertension: Increased blood pressure in the portal vein.
• Liver failure: The liver is unable to function properly.
• Liver cancer: The growth of malignant cells in the liver.

What are the symptoms of cirrhosis?

In the earliest stages, there may be no noticeable symptoms. This is called compensated cirrhosis. Because the liver is resilient, symptoms may not appear until scar tissue becomes more advanced.^1,4

Early symptoms may include:⁴

• Fatigue
• Itchy skin
• Muscle cramping
• Weakness
• Loss of appetite
• Unexplained weight loss

As the disease progresses to decompensated cirrhosis, more severe symptoms can develop:^1,4

• Easy bruising and bleeding
• Confusion, difficulty thinking clearly, memory loss, or mood changes (hepatic encephalopathy)
• Dark urine
• Yellowing of the skin and eyes (jaundice)
• Swelling in the legs, ankles, and feet (edema)
• Swelling of the abdomen, due to fluid buildup (ascites)
• Enlarged veins in the esophagus or stomach (varices)

What is the prognosis for people with cirrhosis?

Outcomes vary based on the cause and severity of the liver damage. About 20 percent of people with NASH will develop cirrhosis of the liver over time.^1,3

How is cirrhosis diagnosed?

Doctors diagnose cirrhosis through a combination of the following:⁵

• Clinical review: Medical history and physical exams (to check for signs of jaundice or an enlarged liver).
• Laboratory tests: Liver enzyme tests and complete blood counts to assess liver function and detect markers of liver damage.
• Imaging: Ultrasound, computed tomography (CT) scans, and magnetic resonance imaging (MRI) to provide detailed views of the liver's structure.
• Biopsy: Examining a small tissue sample under a microscope to confirm diagnosis and determine the extent of cirrhosis.

How is cirrhosis treated?

There is no cure for cirrhosis, but treatments can manage symptoms, slow down liver damage, and address underlying causes. Key approaches include:^1,6

Lifestyle changes

Avoiding alcohol, eating a healthy diet, and maintaining a healthy weight are crucial. If you have NAFLD or NASH, losing weight is the primary approach to improving liver health.⁶

Medicines

Medicines can help manage symptoms like hepatitis or high blood pressure.

However, certain medications can actually harm the liver. Always talk with your doctor about whether your current prescriptions are safe.⁶

Monitoring and screening

Regular check-ups are essential. This includes blood tests, imaging studies, and periodic liver biopsies to track the progression of cirrhosis.⁶

Managing complications

There are many complications tied to cirrhosis. For example:⁶

• If you have portal hypertension or varices, doctors may prescribe medicines to lower high blood pressure.
• For edema, doctors may prescribe medicines to reduce swelling.
• For hepatic encephalopathy, you may be prescribed medicines that reduce the amount of toxins in the brain and help improve brain function.

Liver transplant

If liver damage leads to total failure, a liver transplant is the only option. This involves replacing the damaged liver with a healthy donor organ, which can greatly improve survival rates.⁶

Don’t delay treatment

Cirrhosis of the liver is serious. It is a chronic condition that requires consistent treatment. While there is no cure, proactive management can significantly improve your quality of life.^1,6