Cirrhosis is the end result of chronic liver damage caused by chronic (long-term) liver disease. Common causes of chronic liver disease in the United States are:
- Hepatitis B or hepatitis C infection
- Alcohol abuse
Less common causes of cirrhosis include:
- When immune cells mistake the liver's normal cells for harmful invaders and attack them.
- Bile duct disorders.
- Some medicines.
- Liver diseases passed down in families.
- Buildup of fat in the liver that is NOT caused by drinking too much alcohol (called nonalcoholic fatty liver disease [NAFLD] and nonalcoholic steatohepatitis [NASH]). It is closely related to being overweight.
There may be no symptoms, or symptoms may come on slowly, depending on how well the liver is working. Often, it is discovered by chance when an x-ray is done for another reason.
Early symptoms include:
- Fatigue and loss of energy
- Poor appetite and weight loss
- Nausea or belly pain
- Small, red spider-like blood vessels on the skin
As liver function worsens, symptoms may include:
- Fluid buildup of the legs (edema) and in the abdomen (ascites)
- Yellow color in the skin, mucous membranes, or eyes (jaundice)
- Redness on the palms of the hands
- In men, impotence, shrinking of the testicles, and breast swelling
- Easy bruising and abnormal bleeding, most often from swollen veins in the digestive tract
- Confusion or problems thinking
- Pale or clay-colored stools
Your health care provider will do a physical exam to look for:
- An enlarged liver or spleen
- Excess breast tissue
- Swollen abdomen, as a result of too much fluid
- Reddened palms
- Red spider-like blood vessels on the skin
- Small testicles
- Widened veins in the abdomen wall
- Yellow eyes or skin (jaundice)
You may have the following tests to measure liver function:
- Complete blood count
- Prothrombin time
- Liver function tests
- Blood albumin level
Other tests to check for liver damage include:
- Computed tomography (CT) of the abdomen
- Magnetic resonance imaging (MRI) of the abdomen
- Endoscopy to check for abnormal veins in the esophagus or stomach
- Ultrasound of the abdomen
You might need a liver biopsy to confirm the diagnosis.
Some things you can do to help take care of your liver disease are:
- Avoid achohol.
- Eat a healthy diet that is low in salt.
- Get vaccinated for diseases such as influenza, hepatitis A and B, and pneumococcal pneumonia.
- Talk to your provider about all medicines you take, including herbs and supplements and over-the-counter medicines.
- Water pills (diuretics) to get rid of fluid build-up
- Vitamin K or blood products to prevent excess bleeding
- Medicines for mental confusion
- Antibiotics for infections
Other Treatment Options
- Endoscopic treatments for enlarged veins in the throat (bleeding varices)
- Removal of fluid from the abdomen (paracentesis)
- Placement of a transjugular intrahepatic portosystemic shunt (TIPS) to repair blood flow in the liver
When cirrhosis progresses to end-stage liver disease, a liver transplant may be needed.