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
Cirrhosis of the Liver
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Factors that may increase your chance of having cirrhosis include: Alcohol abuseHepatitis infectionLiver cancerUse of drugs that are toxic to the liver
or gaining weight
Diabetes that is poorly controlled
too much iron
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: FatigueWeaknessPoor appetite, nausea, or weight lossItchingAbdominal swelling, tenderness, and painAppearance of thin, purplish-red, spidery looking blood vessels on the skinMenstrual problemsImpotenceEnlarged breasts in men
As cirrhosis progresses, it may cause: Yellowing of the skin and whites of the eyesDark urineSwelling in the legs and abdomenLoss of body hairBleeding and bruisingVomiting bloodNeurological problems, such as forgetfulness, confusion, agitation, or tremors
Complications of cirrhosis may include: Ascites
—build up of fluid in the abdominal cavity
—abnormal heart rhythms
Digestive disorders, such as abdominal infections,
gallstonesLiver cancerInsulin resistanceHypoglycemiaComa
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
Images may be taken of your bodily structures. This can be done with: CT scanUltrasoundLaparoscopy
Other tests may include: Removing fluid from the abdomen and examining itInserting a catheter into the liver vein and measuring the pressure within that vein—rarely necessaryOther 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 causeTreating underlying medical conditionsPreventing additional damageTreating symptoms and complicationsHaving 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 ariseReduce the absorption of waste products and toxins in the digestive systemReduce the risk of a broken blood vesselFight infectionsShed excess fluids
—may be done if:
Complications can no longer be controlled using medical therapyThe liver stops functioning
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.Do not take any medications without your doctor's approval, including over-the-counter drugs.
. 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, take these steps:
Get vaccines for
Avoid raw seafood.Avoid people who are sick with communicable diseases, like the flu or common cold.Wash your hands often.
To help reduce your chance of developing cirrhosis, take these steps: Drink alcohol in moderation. Moderate alcohol intake is no more than two drinks per day for men and one drink per day for women.Get hepatitis vaccines.
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 medications that may damage the liver.
American Academy of Family Physicians.
Information from your family doctor. Cirrhosis and chronic liver failure: what you should know. Am Fam Physician. 2006;75(5):781.
National Institute of Diabetes and Digestive and Kidney Diseases website. Available at:
http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis. Updated April 23, 2014. Accessed September 12, 2014.
Cirrhosis of the liver. EBSCO DynaMed website. Available at:
http://www.ebscohost.com/dynamed. Updated June 13, 2014. Accessed September 12, 2014.
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, Parab R, Barkema HW, Quan H, Myers RP, Kaplan GG.
Incidence of primary sclerosing cholangitis: a systematic review and
Understanding cirrhosis of the liver. American Gastroenterological Association website. Available at:
http://www.gastro.org/patient-center/digestive-conditions/cirrhosis-of-the-liver. Accessed September 12, 2014.
2/12/2010 DynaMed's Systematic Literature Surveillance
http://www.ebscohost.com/dynamed: Chang Y, Ryu S, Sung E, et al. Weight gain within the normal weight range predicts ultrasonographically detected fatty liver in healthy Korean men.
Last reviewed August 2014 by Kim Carmichael, 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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