What Is Cirrhosis of the Liver?

Understanding cirrhosis can help protect your health. If you have risk factors for cirrhosis or symptoms of the condition, early treatment can save your life.

Your liver cleans and detoxifies your blood of harmful substances and damaged blood cells, produces proteins needed for blood clotting, and plays a key role in your body’s metabolic processes — including the breakdown of fats. If your liver is significantly damaged, the consequences to your health can be enormous.

A variety of conditions cause liver swelling and inflammation, resulting in scarring. When your liver is permanently scarred, the result is known as cirrhosis.

If cirrhosis of the liver progresses, scar tissue increases, impairing the ability of your liver to function. Without treatment, cirrhosis can lead to liver failure and death.

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Risks and causes of cirrhosis of the liver

Middle-aged Americans between 45 and 54 have the highest risk of developing cirrhosis, especially men over the age of 50. Type 2 diabetes also increases your risk.

The most common causes of cirrhosis are chronic conditions that damage liver tissue:

• Viral hepatitis. Chronic hepatitis C is one of the top causes of cirrhosis of the liver in the U.S. Hepatitis C causes swelling of the liver and eventual scarring. Approximately one in four people infected with the hepatitis C virus end up developing cirrhosis. Chronic hepatitis B can also cause liver disease.
• Alcoholism. Drinking alcohol excessively is another main cause of cirrhosis. Chronic alcohol abuse causes the liver to swell and scar.
• Nonalcoholic steatohepatitis (NASH). NASH is the most serious type of nonalcoholic fatty liver disease, a condition marked by excess fat stored in the liver. NASH causes liver inflammation that may lead to cirrhosis and liver cancer. NASH occurs primarily in significantly overweight people.

Many different medications can cause drug-induced hepatitis, too, resulting in cirrhosis. Painkillers and fever reducers containing acetaminophen are a common cause of liver damage, especially if you take them in higher than recommended doses. Drinking alcohol to excess while taking acetaminophen also increases your risk. 

Nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen and naproxen, can also injure your liver. Other medications that can cause liver damage include:

• Statins
• Steroids
• Sulfa drugs
• Birth control pills
• Antibiotics

Less common causes of cirrhosis of the liver include:

• Autoimmune hepatitis (in which your immune system attacks your liver)
• Diseases that block your liver’s bile ducts
• Inherited conditions such as hemochromatosis (the most common cause of a toxic accumulation of iron in organs)
• Chronic heart failure with liver congestion, a condition that slows blood flow out of your liver

Cirrhosis of the liver symptoms and complications

There are often no obvious signs of cirrhosis in the early stage of the disease, the American Liver Foundation points out. But, over time, these symptoms will likely occur:

• Extreme fatigue
• Nausea
• Loss of appetite
• Abdominal pain
• Spider-like blood vessels called spider nevi, most commonly seen in alcohol-related cirrhosis
• Severe itching
• Weight loss

As cirrhosis progresses, jaundice (a yellow discoloration of your skin and whites of your eyes) may develop, along with increased bruising and a tendency to bleed easily. Other complications develop as your liver continues to fail and may be the first obvious signs of the disease.

Portal hypertension, caused by scar tissue blocking the normal flow of blood through your liver, is the most common serious cirrhosis complication. The result is high blood pressure in the portal vein (which carries blood to your liver from your spleen, stomach, pancreas, and intestines).

It can cause enlarged veins in your stomach and other organs and lead to internal bleeding. Portal hypertension also causes swelling (edema) in legs, ankles, and feet, as well as ascites — a buildup of fluid in your abdomen.

Hepatic encephalopathy, resulting from a cirrhosis-caused accumulation of toxins in your brain, can trigger confusion and difficulties thinking clearly. Cirrhosis also increases the risk of bacterial infections. Other potential complications of the disease include gallstones, osteoporosis, and malnutrition due to malabsorption of nutrients.

Cirrhosis diagnosis and treatment

Cirrhosis is the 9th leading cause of death in the U.S., according to the Centers for Disease Control and Prevention. Liver cancer is linked to cirrhosis of the liver, too; most people who develop liver cancer already have cirrhosis.

If you have symptoms of liver disease, if you have any conditions that place you at risk for cirrhosis, or if you take medications that can cause liver damage, talk to your doctor.

To check for cirrhosis, your doctor will discuss your medical history (including any drugs you take) and conduct a physical exam, checking to see whether your liver is enlarged and you have pain or tenderness in your abdomen. You may have blood tests, including liver enzyme tests to check for liver damage, tests to see if you have a viral hepatitis infection, and tests for autoimmune conditions.

Imaging tests can show the size, shape, stiffness of your liver (indicating scarring), and how much fat is in your liver. If you have scarring, your doctor may order a liver biopsy, which can also reveal liver cancer.

There’s no specific treatment to cure cirrhosis of the liver, although certain medications can help symptoms. There are treatments (and sometimes cures), however, for some diseases that cause cirrhosis. For example, chronic hepatitis C can be cured in many people.

Treating the underlying cause of cirrhosis can help prevent liver failure. A liver transplant is considered only when cirrhosis leads to liver failure and you have no other treatment options.

Lifestyle changes, such as not drinking alcohol, keeping a healthy body weight, and talking to your doctor before you take any medications, are also important ways to keep your liver as healthy as possible.

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