Cirrhosis is a condition in which the liver is heavily scarred and permanently damaged. Scar tissue replaces healthy liver tissue and prevents the liver from working normally. Scar tissue also partly blocks the flow of blood through the liver. As cirrhosis gets worse, the liver begins to fail.
A healthy liver (left) and a liver with cirrhosis (right).
Researchers estimate that about 1 in 400 adults in the United States have cirrhosis. Researchers believe the actual numbers may be even higher than that because many people with cirrhosis are undiagnosed. Many people with early stages of cirrhosis may not be diagnosed because they may be asymptomatic, or have only mild or vague symptoms.
Who is more likely to develop cirrhosis?
Cirrhosis can develop in those with chronic viral hepatitis, autoimmune hepatitis, drug-induced liver injury, some genetic disorders, certain infections, and more.
Cirrhosis is also more common in people who
· have a history of heavy alcohol use
· are overweight or obese
· have type 2 diabetes
· are men
· are age 40 or older
What are the complications of cirrhosis?
As the liver fails, complications may develop. In some people, complications may be the first sign they have cirrhosis.
Some complications include:
Portal hypertension
Portal hypertension is a serious problem caused by cirrhosis and can lead to some of the most common complications of cirrhosis. Portal hypertension occurs when scar tissue in the liver slows the normal flow of blood, which causes high blood pressure in the portal vein. The portal vein is the large blood vessel that carries blood from the stomach, intestines, spleen, gallbladder, and pancreas to the liver.
When portal hypertension reaches a certain level, it can cause complications, such as:
· buildup of fluid in the abdomen or belly, called ascites. Ascites can lead to a serious infection—called peritonitis —in the space that surrounds the liver and intestines.
· swelling in the legs, ankles, or feet, called edema.
· enlarged veins—called varices—in the esophagus, stomach, or intestines. These varices can lead to internal bleeding if the veins burst.
· confusion or difficulty thinking caused by a buildup of toxins in the brain, called hepatic encephalopathy.
Infections
Cirrhosis increases your chance of getting bacterial infections such as urinary tract infections and pneumonia
Liver cancer
Cirrhosis increases the chance of getting liver cancer. Most people who develop liver cancer already have cirrhosis.
Liver failure
Cirrhosis may eventually lead to liver failure, also called end-stage liver disease. With liver failure, the liver is badly damaged and stops working. People with liver failure may require a liver transplant.
Other complications
Other complications of cirrhosis may include
· bone diseases, such as osteoporosis
· problems with the bile ducts—the tubes that carry bile out of the liver
· malabsorption and malnutrition
· bruising and bleeding easily
· falls
· sensitivity to medicines
· insulin resistance and type 2 diabetes
As the liver fails, complications may develop. In some people, complications may be the first sign they have cirrhosis.
Some complications include:
Portal hypertension
Portal hypertension is a serious problem caused by cirrhosis and can lead to some of the most common complications of cirrhosis. Portal hypertension occurs when scar tissue in the liver slows the normal flow of blood, which causes high blood pressure in the portal vein. The portal vein is the large blood vessel that carries blood from the stomach, intestines, spleen, gallbladder, and pancreas to the liver.
When portal hypertension reaches a certain level, it can cause complications, such as:
· buildup of fluid in the abdomen or belly, called ascites. Ascites can lead to a serious infection—called peritonitis —in the space that surrounds the liver and intestines.
· swelling in the legs, ankles, or feet, called edema.
· enlarged veins—called varices—in the esophagus, stomach, or intestines. These varices can lead to internal bleeding if the veins burst.
· confusion or difficulty thinking caused by a buildup of toxins in the brain, called hepatic encephalopathy.
Infections
Cirrhosis increases your chance of getting bacterial infections such as urinary tract infections and pneumonia
Liver cancer
Cirrhosis increases the chance of getting liver cancer. Most people who develop liver cancer already have cirrhosis.
Liver failure
Cirrhosis may eventually lead to liver failure, also called end-stage liver disease. With liver failure, the liver is badly damaged and stops working. People with liver failure may require a liver transplant.
Other complications
Other complications of cirrhosis may include
· bone diseases, such as osteoporosis
· problems with the bile ducts—the tubes that carry bile out of the liver
· malabsorption and malnutrition
· bruising and bleeding easily
· falls
· sensitivity to medicines
· insulin resistance and type 2 diabetes
Cirrhosis of the liver often has no symptoms in its early stages. When symptoms do appear, they can include:
· Fatigue: Feeling tired or weak
· Weight loss: Losing weight and muscle mass
· Nausea and vomiting: Feeling sick to your stomach or throwing up
· Itchy skin: Feeling an intense itchiness on your skin
· Jaundice: Yellowing of your skin or the whites of your eyes
· Swelling: Swelling in your legs, feet, ankles, or abdomen
· Bruising and bleeding: Bruising or bleeding easily
· Spider angiomas: Tiny red blood vessels that look like spiders on your skin, usually above the waist
· Red palms: Redness on the palms of your hands
· Dark urine: Urine that is dark orange, amber, cola-colored, or brown
· Gastrointestinal bleeding: Vomiting blood or passing very dark or black stools
· Confusion or drowsiness: Feeling confused or drowsy
Cirrhosis is a chronic condition that can lead to liver failure if left untreated. Treatments include medications, lifestyle changes, and in advanced cases, a liver transplant.
Cirrhotic scarring in the liver cannot be reversed but identification of the underlying cause, managing lifestyle modifications, medications and comorbid diseases can prevent increasing liver damage and slow the progression of the disease.
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