Cirrhosis is a disease in which the liver becomes permanently damaged and the normal structure of the liver is changed. Healthy liver cells are replaced by scarred tissue. The liver is not able to do its normal functions such as detoxifying harmful substances, purifying blood, and making vital nutrients.
In addition, scarring slows down the normal flow of blood through the liver, causing blood to find alternate pathways. This may result in bleeding blood vessels known as gastric or esophageal varices.
|Cirrhosis of the Liver|
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Causes of cirrhosis include:
- Excessive consumption of alcohol
- Hepatitis C, B, and D
- Autoimmune hepatitis
- Inherited diseases, such as glycogen storage disease, hemochromatosis, or cystic fibrosis
- Genetic conditions such as:
- Nonalcoholic fatty liver disease (NAFLD), is associated with:
Bile duct blockages, associated with:
- Congenital defects
- Scarred ducts—sometimes related to inflammatory bowel disorders
- Gallbladder surgery
- Drugs and toxins:
- Heart failure, causing blood to repeatedly back up into the liver
Factors that may increase your chance of having cirrhosis include:
Cirrhosis often does not cause symptoms early in the disease process. Symptoms start when the liver begins to fail, as scar tissue replaces healthy cells. Symptom severity depends on the extent of liver damage.
Cirrhosis may cause:
- Poor appetite, nausea, or weight loss
- Abdominal swelling, tenderness, and pain
- Appearance of thin, purplish-red, spidery looking blood vessels on the skin
- Menstrual problems
- Erectile dysfunction
- Enlarged breasts in men—gynecomastia
As cirrhosis progresses, it may cause:
- Yellowing of the skin and whites of the eyes—jaundice
- Dark urine
- Swelling in the legs and abdomen
- Loss of body hair
- Bleeding and bruising
- Vomiting blood
- Neurological problems, such as forgetfulness, confusion, agitation, or tremors
Complications of cirrhosis may include:
You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with:
- Blood tests
- Liver biopsy
Images may be taken of your bodily structures. This can be done with:
Other tests may include:
- Removing fluid from the abdomen and examining it
- Inserting a catheter into the liver vein and measuring the pressure within that vein—rarely necessary
- Other tests to determine what caused the cirrhosis and what complications may occur
There is no cure for cirrhosis. The goals of treatment are to keep the condition from getting worse, including:
- Controlling the cause
- Treating underlying medical conditions
- Preventing additional damage
- Treating symptoms and complications
- Having liver cancer screenings
Talk with your doctor about the best treatment plan for you. Options include:
Medication may be advised to:
- Treat hepatitis and complications that arise
- Reduce the absorption of waste products and toxins in the digestive system
- Reduce the risk of a broken blood vessel
- Fight infections
- Shed excess fluids
Liver transplant—may be done if:
- Complications can no longer be controlled using medical therapy
- The liver stops functioning
Endoscopy may be used to tie off bleeding blood vessels or to inject drugs to cause clotting. A thin tool with a lighted tip is inserted down the throat to help the doctor see and access the blood vessels, which are located in the esophagus.
- Stop drinking alcohol completely—If needed, you may be referred to a rehabilitation program.
- Do not take any medicine without your doctor's approval, including over-the-counter drugs.
- Eat a well-balanced diet. Choose a variety of fruits and vegetables, as well as lean proteins, like beans and poultry.
- If your liver disease is more advanced, you may need to limit protein intake. Your weakened liver will not be able to process it properly.
- You may need to limit salt in your diet, because it increases water retention.
- Take any vitamin supplements your doctor recommends.
- Put your feet and legs up to decrease swelling.
- Due to increased risk of infections:
To help reduce your chances of cirrhosis:
- Drink alcohol in moderation. Moderate alcohol intake is no more than 2 drinks per day for men and 1 drink per day for women.
- Get hepatitis vaccines.
- Practice safe sex to lower your chance of getting hepatitis B.
- If you use IV drugs, do not share needles. Needles can spread hepatitis B, C, or D.
- Maintain a healthy weight.
- Follow your doctor's recommendations about blood tests when taking medicine that may damage the liver.
- Manage conditions, such as nonalcoholic fatty liver disease.
- If you were born between 1945 and 1965, you should get screened for hepatitis C infection.
American Gastroenterological Association http://www.gastro.org
American Liver Foundation https://liverfoundation.org
Canadian Liver Foundation https://www.liver.ca
Health Canada https://www.canada.ca
Bondini S, Younossi ZM. Non-alcoholic fatty liver disease and hepatitis C infection. Minerva Gastroenterol Dietol. 2006 Jun 52(2):135-143.
Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis. Updated April 2014. Accessed October 3, 2017.
Cirrhosis of the liver. EBSCO DynaMed website. Available at: https://www.dynamed.com/topics/dmp~AN~T114078/Cirrhosis-of-the-liver . Updated May 31, 2017. Accessed October 3, 2017.
Hepatitis C: screening. US Preventive Services Task Force website. Available at: https://www.uspreventiveservicestaskforce.org/Page/Document/UpdateSummaryFinal/hepatitis-c-screening?ds=1&s=hepatitis%20C. Updated June 2013. Accessed March 14, 2018.
Hirschfield GM, Gershwin ME. Primary biliary cirrhosis: one disease with many faces. Isr Med Assoc J. 2011;13(1):55-59.
Molodecky NA, Kareemi H, et al. Incidence of primary sclerosing cholangitis: a systematic review and meta-analysis. Hepatology. 2011;53(5):1590-1599.
Starr PS, Raines D. Cirrhosis: Diagnosis, management, and prevention. Am Fam Physician. 2011;84(12):1353-1359.
2/12/2010 DynaMed Systematic Literature Surveillance https://www.dynamed.com/topics/dmp~AN~T116915/Nonalcoholic-fatty-liver-disease-NAFLD : Chang Y, Ryu S, et al. Weight gain within the normal weight range predicts ultrasonographically detected fatty liver in healthy Korean men. Gut. 2009;58(10):1419-1425.
- Reviewer: EBSCO Medical Review Board Daus Mahnke, MD
- Review Date: 09/2018
- Update Date: 08/18/2020