What Is Cirrhosis of the Liver?

Understanding what is cirrhosis of the liver can help protect your health. If you have cirrhosis risks or symptoms, early treatment can be life-saving.

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 the body’s metabolic processes — including the breakdown of fats. Obviously, if your liver is significantly damaged, the consequences to health can be enormous.

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

If cirrhosis of the liver progresses, scar tissue increases and the ability of the liver to function is impaired. 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 are at highest risk for developing cirrhosis, especially men over the age of 50, the National Institute of Diabetes, Digestive and Kidney Diseases (NIDDK) explains. Having type 2 diabetes also increases the odds of developing cirrhosis.

The most common causes of cirrhosis are these 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 the 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 primarily is found in significantly overweight people.

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

Nonsteroidal anti-inflammatory drugs, orNSAIDs, such as ibuprofen and naproxen, can also injure the liver. Statins, steroids, sulfa drugs, birth control pills, and a variety of antibiotics can lead to liver damage in some people, as well.

Less common causes of cirrhosis of the liver include autoimmune hepatitis (marked by the body’s immune system attacking the liver), diseases that block the liver’s bile ducts, some inherited conditions such as hemochromatosis (the most common cause of a toxic accumulation of iron in organs) and chronic heart failure with liver congestion — a condition that slows blood flow out of the 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 are likely to 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 the skin and whites of the eyes) may develop, along with increased bruising and a tendency to bleed easily. Other complications develop as the 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 the liver, is the most common serious cirrhosis complication. The result is high blood pressure in the portal vein (which carries blood to the liver from the spleen, stomach, pancreas, and intestines). This can cause enlarged veins in the 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 the abdomen.

Hepatic encephalopathy, resulting from a cirrhosis-caused accumulation of toxins in the 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 12th leading cause of death in the U.S., according to the American Academy of Family Physicians. Liver cancer is linked to cirrhosis of the liver, too — most people who develop liver cancer already have cirrhosis.

Bottom line: If you have any symptoms of liver disease, if you have any conditions that place you at increased risk for cirrhosis, or if you are taking 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 if your liver is enlarged and if 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 scarring is found, your doctor may order a liver biopsy, which can also reveal liver cancer.

Unfortunately, there’s no specific treatment to cure cirrhosis of the liver, although certain medications can help symptoms. However, there are treatments (and sometimes cures) for some diseases that cause cirrhosis. For example, chronic hepatitis C can now 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 there are 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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