What Is Cirrhosis?

Medically reviewed by Jay N. Yepuri, MD

Cirrhosis is a condition that causes extreme scarring and damage to the liver. Scarring replaces healthy tissue in your liver with hard scar tissue, making it difficult for your liver to function properly.

In most cases, people do not experience symptoms of cirrhosis unless it reaches an advanced stage. If you do develop symptoms, it’s common to experience nausea, fatigue, loss of appetite, and abdominal pain. Unfortunately, cirrhosis has no cure at this time. However, several treatment approaches can help you reduce symptoms and prevent complications.

Approximately 1 in 400 people in the U.S. live with cirrhosis. While the condition can occur in anyone, you are more likely to experience cirrhosis between the ages of 45 and 54. Knowing the symptoms and understanding when to seek medical care can help you improve your condition and overall quality of life.

Symptoms

People usually do not experience any symptoms during the early stages of cirrhosis. However, as scar tissue worsens, you can experience symptoms such as:

• Nausea

• Fatigue

• Loss of appetite

• Weight loss

• Mild pain in the upper right side of the abdomen

As your liver function worsens, you might also experience the following complications:

• Swelling in the legs, feet, or ankles

• Fluid build-up in the stomach

• Easy bruising and bleeding

• Confusion

• Yellowing of the eyes and skin (known as jaundice)

• Darker urine color

• Low sex drive

• Hepatic encephalopathy, or a build-up of toxins in the brain

Causes

Cirrhosis most often occurs as a result of chronic liver injury. Injury to the liver leads to inflammation and the development of scar tissue—a process known as fibrosis. The presence of too much scar tissue can disrupt the normal shape and functioning of the liver, leading to cirrhosis.

Some factors that cause cirrhosis include:

• Alcoholic liver disease: Consumption of too much alcohol is one of the leading causes of cirrhosis in the U.S. Excess alcohol intake over time causes liver inflammation and can ultimately lead to cirrhosis.

• Nonalcoholic steatohepatitis (NASH): This is a type of non-alcoholic fatty liver disease (NAFLD) that causes inflammation and build-up of fat in your liver. Without proper treatment, cirrhosis can occur.

• Viral hepatitis: Having a hepatitis B or C infection can lead to cirrhosis in many people. Approximately 1 in 4 people with chronic hepatitis C develop cirrhosis.

• Bile duct disease: Bile duct disease prevents bile from flowing to your small intestine. This causes bile to flow back into your liver which can result in cirrhosis.

• Genetic conditions: Certain genetic conditions such as Alpha-1 antitrypsin deficiency, hemochromatosis, Wilson disease, and autoimmune hepatitis can increase your risk of developing cirrhosis.

• Certain medications: Medications such as Advil (ibuprofen) and other drugs that help reduce pain and fever can sometimes cause liver damage if you use them too frequently. To prevent cirrhosis, take medication as directed and when medically necessary.

Diagnosis

If you suspect you have symptoms of cirrhosis, it’s best to see your healthcare provider for testing. During your appointment, your provider will ask you about your personal and family medical history, the symptoms you’re experiencing, your lifestyle habits, and whether you’re taking any medications. After learning more about your history, your provider will conduct a physical exam to better understand your symptoms.

Your provider can also conduct a variety of tests that can help them reach a proper diagnosis. These include a liver biopsy, imaging tests, and bloodwork.

Liver Biopsy

A liver biopsy involves taking a sample of your liver tissue and examining the sample under a microscope to understand the extent of scarring. To take a liver biopsy, a healthcare provider (such as a surgeon, radiologist, or gastroenterologist) will insert a thin needle into your liver to remove a small piece of tissue. During the procedure, you will be under local anesthesia to numb the pain.

Imaging Tests

Healthcare providers often conduct imaging tests to check for structural changes and scarring in your liver. They may use any of the following tests during your diagnostic process:

• Computed tomography (CT) scan: Uses special X-ray equipment and a computer to generate multiple images of the liver.

• Magnetic resonance imaging (MRI): Involves the use of powerful magnetic fields and radio waves to create detailed pictures of the liver and check for liver damage.

• Ultrasound: Creates pictures of the liver using sound waves. Your provider can use a Doppler ultrasound to check the blood flow to and from your liver or an ultrasound elastography to determine the stiffness and scarring in your liver.

Blood Tests

In some cases, your provider may also order blood tests during your diagnostic process. These tests include:

• Liver function tests that check for abnormal liver enzyme (protein) levels

• Complete blood count, which can show signs of liver infection and anemia

• Anti-smooth muscle antibody (SMA), antinuclear antibody (ANA), and anti-mitochondrial antibody (AMA) tests that all check for autoimmune liver conditions

• Viral hepatitis tests to check for hepatitis B or C

Treatment

Currently, there are no specific treatments that can cure cirrhosis. However, several treatment options are available for treating the underlying causes of the condition.

Treating the Underlying Cause

Depending on what’s causing your cirrhosis, your healthcare provider will likely recommend certain treatments, such as medication and lifestyle changes, to prevent your condition from worsening.

Lifestyle Changes

In addition to treating the underlying cause of your cirrhosis, your healthcare provider will likely also recommend other lifestyle changes to help improve symptoms and reduce your risk of developing complications. These include:

• Avoiding alcohol completely

• Quitting smoking

• Exercising regularly

• Eating a low-salt diet

Surgery

Advanced stages of cirrhosis can sometimes progress toward liver failure. In such cases, your healthcare provider may consider a liver transplant—especially if you have extreme scarring or very low liver functioning. Generally, a liver transplant is only considered if other treatment options aren’t helping improve symptoms or slowing the progression of the disease.

Keep in mind: before a liver transplant is possible, you will undergo extensive testing to determine if you are suitable for the procedure. If your healthcare provider believes a liver transplant is right for you, they will work with an organ-sharing organization to find a liver match before replacing the damaged liver with a healthy one.

How To Prevent Cirrhosis

The good news: you can take some steps in your daily life that can lower your risk of developing cirrhosis. To prevent the onset of the condition, you may consider trying the following strategies:

• Limiting alcohol intake

• Eating a diet made up of fresh fruits, vegetables, and lean protein

• Exercising 30 minutes a day

• Getting a hepatitis B vaccination

• Avoid eating undercooked fish and meat

Complications

If your cirrhosis worsens or you receive a diagnosis in a late stage, you may be at an increased risk of developing complications, including:

• Portal hypertension: The most common and severe complication of cirrhosis, this condition occurs when your blood flow slows down and gets blocked by scar tissue, resulting in high blood pressure

• Ascites: Occurs due to the build-up of fluids in the abdomen which can cause infections in the intestines and liver

• Varices: Leads to the enlargement of veins in the stomach, intestines, or esophagus, which can lead to internal bleeding if the veins burst

• Infections: People with cirrhosis are more vulnerable to getting severe infections such as pneumonia or urinary tract infections

• Hepatic encephalopathy: Happens when cirrhosis makes it difficult for your body to remove toxins, leading to toxin build-up in your liver which can travel to your brain and cause confusion or difficulty thinking

• Liver cancer: People with cirrhosis are at a higher risk of developing liver cancer

• Malnutrition: Cirrhosis can make absorption and processing of nutrients difficult, making it easier to experience malnutrition, loss of appetite, and unintentional weight loss

• Liver failure: Severe cases of cirrhosis might lead to significant damage to the liver which can result in liver failure and loss of proper liver functioning

Living With Cirrhosis

The life expectancy of living with cirrhosis depends on the stage you were diagnosed with and what treatment options are available for you. Generally, those with asymptomatic cirrhosis (or, people who don’t have symptoms) have a life expectancy of 12 years or more. However, people who have late-stage cirrhosis or cirrhosis-related complications tend to have a shorter life expectancy—as few as two years.

Although cirrhosis can’t be reversed, it is possible to slow its progression by following certain steps such as quitting alcohol, exercising regularly, eating a healthy and balanced diet, and following your treatment plan. Checking in with your healthcare provider frequently can help keep your condition in check and reduce the risk of complications occurring.

A Quick Review

Cirrhosis is a condition that occurs when there is scarring, inflammation, and damage to your liver. The scar tissue replaces healthy liver tissue which in turn affects the functioning of your liver. A variety of factors can lead to cirrhosis, including drinking too much alcohol and having a hepatitis infection, bile duct disease, or certain genetic conditions.

Generally, you don’t experience symptoms of cirrhosis in the early stages. However, as the disease progresses, you might notice you have nausea, fatigue, and loss of appetite. If you have symptoms of cirrhosis or may be at risk of developing the condition, it’s imperative to see your healthcare provider for testing, a proper diagnosis, and treatment options to prevent further complications.

Frequently Asked Questions

Can you live with cirrhosis if you stop drinking?

While avoiding alcohol after you develop cirrhosis will not reverse your condition, quitting drinking can help prevent your cirrhosis from worsening and increase your life expectancy.

Can a liver regenerate after cirrhosis?

Once you develop cirrhosis, you can't undo the damage that it has caused to your liver. Prevention strategies such as limiting your alcohol intake and eating a balanced diet can help reduce your risk of scarring and keep your liver functioning normal.

Is cirrhosis a fatal disease?

If the condition is left untreated or complications start to occur, cirrhosis can cause liver failure and make it difficult for your liver to function properly. As a result, cirrhosis can be fatal—which is why seeking treatment and incorporating lifestyle changes is essential.

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