Liver Cirrhosis: Causes, Symptoms, Diagnosis & Management

Liver cirrhosis is a chronic, progressive condition in which healthy liver tissue is replaced by scar tissue (fibrosis), leading to distortion of liver structure and impaired function. Cirrhosis develops over years due to ongoing liver injury and can result in serious, life-threatening complications if not managed early.

 What Is Liver Cirrhosis?

The liver normally repairs itself after injury.
With repeated or long-standing damage, healing becomes abnormal, causing permanent scarring. As scarring increases:

• Blood flow through the liver is obstructed

• Liver functions decline

• Portal pressure rises (portal hypertension)

Cirrhosis is often irreversible, but early treatment can slow progression and reduce complications.

 Common Causes of Cirrhosis

🔹 Major Causes

• Chronic alcohol consumption

• Chronic viral hepatitis (B & C)

• Non-alcoholic fatty liver disease (NAFLD/NASH)

🔹 Other Causes

Cause

Mechanism

1.Autoimmune hepatitis

Immune-mediated injury

2.Biliary diseases (PBC, PSC)

Chronic bile duct damage

3.Genetic disorders

Hemochromatosis, Wilson’s disease

4.Drugs & toxins

Long-term hepatotoxic exposure

5.Cardiac cirrhosis

Chronic right heart failure

 Symptoms of Liver Cirrhosis

Early (Compensated Cirrhosis)

• Fatigue and weakness

• Loss of appetite

• Mild abdominal discomfort

• Weight loss

Advanced (Decompensated Cirrhosis)

• Jaundice (yellow eyes/skin)

• Ascites (fluid in abdomen)

• Swelling of legs (edema)

• Easy bruising or bleeding

• Itching

• Confusion or altered sleep (hepatic encephalopathy)

• Vomiting blood or black stools (variceal bleeding)

 Emergency symptoms:

• Sudden confusion

• Severe abdominal distension

• Blood in vomit or stools

• High fever with ascites

Diagnosis

Laboratory Tests

• Liver function tests (LFTs) – bilirubin, ALT, AST, ALP

• Low albumin, prolonged INR

• Viral hepatitis markers

Imaging

• Ultrasound abdomen – shrunken, nodular liver

• FibroScan – fibrosis assessment

• CT/MRI – complications

Other Tests

• Upper GI endoscopy (esophageal varices)

• Ascitic fluid analysis

• Liver biopsy (selected cases)

 Stages of Cirrhosis

Stage

Description

Compensated

Liver still performs essential functions

Decompensated

Ascites, variceal bleed, encephalopathy, jaundice

Progression to decompensation markedly worsens prognosis.

 Management & Treatment

There is no cure for established cirrhosis, but treatment aims to halt progression and manage complications.

1️⃣ Treat the Cause

• Stop alcohol completely

• Antiviral therapy for hepatitis B/C

• Weight loss & metabolic control for NASH

• Immunosuppressants for autoimmune hepatitis

2️⃣ Manage Complications

Complication

Management

Ascites

Salt restriction, diuretics

Varices

Endoscopic band ligation, beta blockers

Encephalopathy

Lactulose, rifaximin

Infections

Prompt antibiotics

Coagulopathy

Vitamin K, blood products

3️⃣ Diet & Lifestyle

Recommended

                                                                                                                                                             Avoid

Low-salt diet

                                                                                                                                                                           Alcohol (strictly)

Adequate protein (unless advised)

                                                                                                                                                                            Raw seafood

Small frequent meals

                                                                                                                                                                        Excess fatty foods

                                                                                                                                                                       Unprescribed drugs

 Malnutrition is common—nutritional support is essential.

 Complications of Cirrhosis

• Portal hypertension

• Ascites & spontaneous bacterial peritonitis

• Variceal bleeding

• Hepatic encephalopathy

• Hepatorenal syndrome

• Liver cancer (Hepatocellular carcinoma)

 Prevention

• Avoid alcohol abuse

• Vaccination against hepatitis A & B

• Early treatment of hepatitis

• Healthy diet & weight control

• Avoid unnecessary medications

• Regular screening in high-risk individuals

 Liver Transplantation

For advanced cirrhosis or liver failure, liver transplantation is the definitive treatment. Early referral improves outcomes.

 When to Consult a Doctor

• Persistent jaundice or abdominal swelling
  
  

• Confusion or sleep reversal
  
  

• Gastrointestinal bleeding
  
  

• Known liver disease with worsening symptoms
  
  

Disclaimer:

The information provided on this website is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of a qualified physician or other licensed healthcare provider with any questions you may have regarding a medical condition. Do not ignore or delay seeking medical advice because of information you read on this website. The use of any information provided here is solely at your own risk.