Definition
Cirrhosis is scarring of the liver that causes permanent damage. The scar tissue causes problems with blood flow and prevents the liver from working as it should. This can disrupt normal functions in the body.
Early treatment can improve outcomes.
Cirrhosis of the Liver |
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Causes
Causes are:
- Alcohol use disorder
- Hepatitis C, B, and D
- Autoimmune hepatitis
- Inherited diseases, such as glycogen storage disease, hemochromatosis, or cystic fibrosis
-
Genetic problems, such as:
- Galactosemia
- Fructose intolerance
- Tyrosinemia
- Wilson disease
- Alpha1-antitrypsin deficiency
- Nonalcoholic fatty liver disease (NAFLD)
- Bile duct blockages
-
Drugs and toxins, such as:
- Arsenic
- Isoniazid
- Methotrexate
- Excess vitamin A
-
Infections, such as:
- Schistosomiasis
- Brucellosis
- Echinococcosis
- Advanced or congenital syphilis
- Heart failure
Risk Factors
Things that may raise the risk of this problem are:
- Alcohol use disorder
- Hepatitis infection
- Liver cancer
- Use of drugs that are toxic to the liver
- Being overweight
- Poorly controlled diabetes
- Ingestion of too much iron
- Nonalcoholic fatty liver disease
Symptoms
Cirrhosis often does not cause symptoms in the early stages. Symptoms start when scar tissue replaces healthy cells and the liver begins to fail. The symptoms a person has depends on the amount of damage.
Problems may be:
- Feeling tired and weak
- Nausea
- Lack of hunger
- Weight loss
- Small, red spider-like blood vessels under the skin
- Breasts that are enlarged and tender in men
- Problems maintaining an erection in men
When the disease worsens, problems may be:
- Loss of body hair
- Bleeding and bruising
- Belly swelling, tenderness, and pain
- Itching
- Yellowing of the skin or eyes
- Vomiting blood
- Changes in mental function
- Dark urine
- Swelling in the legs and belly
Diagnosis
The doctor will ask about your symptoms and health history. A physical exam will be done.
Blood tests will be done to look for signs of liver problems.
A liver biopsy can confirm the diagnosis. A needle is used to take a sample of tissue from the liver. A lab will look for signs of scarring or disease in the tissue.
Other tests may be done to look for the cause or severity.
Treatment
Any underlying causes will need to be treated.
There is no cure. The goal of treatment is to prevent further damage, manage symptoms, and lower the risk of problems. Choices are:
- Dietary changes, such as eating a well-balanced diet and limiting protein and salt
- Lifestyle changes, such as not drinking alcohol
- Medicines to:
- 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
- Getting vaccines for flu, pneumonia, and hepatitis
People who are not helped by these methods may need a liver transplant. Others may need an endoscopy to tie off bleeding blood vessels or to inject drugs to cause clotting.
RESOURCES
American Gastroenterological Association http://www.gastro.org
American Liver Foundation https://liverfoundation.org
CANADIAN RESOURCES
Canadian Liver Foundation https://www.liver.ca
Health Canada https://www.canada.ca
References
Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis. Accessed February 9, 2021.
Cirrhosis of the liver. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/cirrhosis-of-the-liver-31. Accessed February 9, 2021.
Ge PS, Runyon BA. Treatment of Patients with Cirrhosis. N Engl J Med. 2016 Aug 25;375(8):767-777.
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. Accessed February 9, 2021.
Revision Information
- Reviewer: EBSCO Medical Review Board James P. Cornell, MD
- Review Date: 12/2020
- Update Date: 02/09/2021