The early stages of cirrhosis often produce no symptoms. As scar tissue replaces healthy cells, the liver begins to fail, and symptoms may become evident. The severity of symptoms depends on the extent of liver damage.
Because the liver is crucial for so many metabolic activities, cirrhosis impacts a wide range of the body’s functions, including nutrient and hormone metabolism, blood clotting, and processing of ammonia and other toxic wastes. Many of the symptoms of cirrhosis are directly related to disruption of these functions. However, most of these symptoms can also be caused by other conditions, so it is important to consult with your doctor if you experience any of these symptoms, particularly if you have risk factors that increase your likelihood of developing cirrhosis.
Early symptoms of cirrhosis include: Fatigue and weaknessPoor appetiteNauseaWeight lossSmall, red spider-like blood vessels under the skin—caused by increased pressure in the tiny blood vessels due to liver congestionIncreased sensitivity to drugs
Early symptoms in men may include: ImpotenceReduced testicle sizeEnlarged, tender breastsLoss of interest in sex
Symptoms become more pronounced as cirrhosis progresses. In addition, complications may produce other, potentially life-threatening symptoms of the disease.
Later symptoms, some of which are due to complications, include: Reddened or blotchy palmsLoss of body hairSleep disturbancesUlcersFever and other signs of infection—due to altered immune functionPale or clay-colored stools—caused by a reduction in excreted bile pigmentsFrequent nosebleeds, skin bruising, or bleeding gums—resulting from decreased liver synthesis of clotting factorsAscites
—water retention and swelling abdomen caused by obstructed blood flow through the liver and reduced synthesis of the protein albumin
Bacterial peritonitis—infection of ascites causing abdominal pain and feverItching—caused by deposition of bile products in the skinJaundice
—yellowing of the skin or eyes due to build-up bilirubin
Vomiting blood—due to swollen veins in the esophagus that burstEncephalopathy and coma—mental changes, including forgetfulness, trouble concentrating, confusion, and agitation, caused by the build-up of ammonia in the bloodDecreased urine output and dark urine—caused by kidney dysfunction or failure
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American Liver Foundation
website. Available at:
http://www.liverfoundation.org/abouttheliver/info/cirrhosis. Updated December 3, 2012. Accessed April 24, 2013.
EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated December 27, 2012. Accessed April 24, 2013.
Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases
website. Available at:
http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis/index.aspx. Updated February 21, 2012. Accessed April 24, 2013.
Heidelbaugh JJ, Bruderly M. Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation.
Am Fam Physician. 2006;74:756-762.
Last reviewed March 2014 by Daus Mahnke, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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