Liver Cirrhosis Symptoms, Causes & Treatment 

You cannot live without a properly functioning liver. About 26,000 Americans die each year of cirrhosis (liver failure), making it the twelfth leading cause of death in the United States.

The most common cause of cirrhosis is chronic alcoholism, which accounts for approximately 40% of the 26,000 people who die from the disease.

The liver works to keep us healthy, converting food into substances needed for life and growth, and storing glycogen, amino acids, protein, and fat. It also produces the enzymes and bile that help digest food, neutralizes toxins in our blood, and produces immune agents to control infection.

Liver fibrosis is a condition where scar tissue builds up inside your liver over time. This scarring can lead to cirrhosis if you have long-term damage to your liver. 

When cirrhosis sets in, liver scarring begins to replace healthy tissue and the result is a hardened liver. The scar tissue blocks the flow of blood through the liver, preventing the organ from functioning properly.

Liver with Chronic Hepatitis and Cirrhosis

Cirrhosis Causes

Chronic alcoholism and hepatitis C are the most common causes of cirrhosis in the United States, but NASH (non-alcoholic steatohepatitis) is rapidly becoming a leading cause.

Other causes include:

  • Alcoholic liver disease
  • Autoimmune hepatitis
  • Blocked bile ducts
  • Chronic hepatitis B
  • Chronic hepatitis C
  • Exposure to toxins such as alcohol, certain drugs, and infections
  • Inherited illnesses such as alpha-1 antitrypsin deficiency, hemochromatosis, Wilson’s disease, galactosemia, and glycogen storage diseases
  • Nonalcoholic steatohepatitis (NASH)
  • Prolonged exposure to environmental toxins such as arsenic

Men tend to develop cirrhosis of the liver more often than women.

Cirrhosis Symptoms and Complications

During the early stages, many people with cirrhosis experience no symptoms. However, as scar tissue replaces healthy cells, and liver function begins to fail, a person may experience a variety of symptoms and complications:

  • Abnormal accumulation of fluid in the abdominal cavity (ascites)
  • Bleeding from engorged veins (varices) in your esophagus or stomach
  • Dark urine
  • Easy bruising
  • Fatigue
  • Impotence
  • Itching hands and feet
  • Kidney dysfunction
  • Lack of appetite
  • Liver cancer 
  • Liver failure 
  • Loss of interest in sex
  • Muscle wasting or loss
  • Nausea
  • Osteoporosis/osteopenia
  • Portal hypertension (an increase in blood pressure in veins that carry blood from the abdominal organs to the liver)
  • Small, spider-like blood vessels under the skin
  • Swelling of legs and feet from retained fluid (edema)
  • Hepatic encephalopathy (forgetfulness, confusion, trouble concentrating, change in sleeping habits, behavioral, personality, and mood changes)
  • Yellowing of skin and eyes (jaundice and icterus)
Liver Cirrhosis Symptoms, Causes & Treatment

Cirrhosis Screening and Diagnosis

In addition to a personal history and physical examination, various testing methods are used to diagnose cirrhosis:

  • Blood tests – blood count, liver enzymes, renal function, coagulation factors.
  • Computerized tomography (CT scan) – to look for nodularity or a shrunken liver as well as complicates like fluid build up or varices – dilated veins.
  • Magnetic resonance imaging (MRI) – use magnetization and radio waves to produce images of the internal organs to get a picture of the liver.
  • Ultrasound – high-frequency sound waves are bounced off internal tissue, and their echoes converted into images.
  • Liver biopsy – able to look for inflammation, signs of what caused liver disease, and evaluate the degree of fibrosis or scarring.

Cirrhosis Care and Treatment

While liver damage from cirrhosis is permanent and irreversible, treatment can help to delay the progression of the disease, as well as reduce the likelihood of developing complications. Treatment is dependent upon the cause, and is designed to address any complications a patient may be experiencing.

Regardless of the cause, abstaining from alcohol and following a healthy diet are essential. Nutrition plays a key role in therapy because cirrhosis sufferers are often malnourished. A high-calorie, high-protein, nutrient-dense diet can help liver cells to regenerate.

Restricted salt intake is advised as salt causes water retention. The avoidance of raw shellfish and oysters is recommended as they may contain bacteria that can cause severe infection.

Limiting medications is usually advised because a damaged liver is unable to properly detoxify itself of drugs. Avoid aspirin and other non-steroidal anti-inflammatories such as ibuprofen and naproxen.  Tylenol should also be limited to no more than 2 grams in a day.

Because liver damage has an effect on immune functioning, it’s wise to keep up with vaccinations such as those for hepatitis A and B, influenza, and bacterial pneumonia.

When your liver is damaged, it is a good idea to avoid contact with people who are ill since the immune system is not functioning at its optimum.

Ask your health care provider about multivitamins and other supplements. For example, omega 3 fatty acids (found primarily in fish, fish oils, flax, flaxseed oils, and walnuts) are believed to provide protection for the liver. 

Physical activity is important to help prevent deconditioning and loss of muscle mass.

Sometimes complications from cirrhosis cannot be controlled, and/or the liver becomes so damaged from scarring that it ceases to function. In these cases, a liver transplant is necessary and is the only method to overcome cirrhosis of the liver.

Check out these other liver conditions to learn more:

Julie C. Guider MyGoodGut

Medically reviewed by Julie Guider, M.D.

Dr. Julie Guider earned her medical degree from Louisiana State University School of Medicine. She completed residency in internal medicine at the University of Virginia. She completed her general gastroenterology and advanced endoscopy fellowships at University of Texas-Houston. She is a member of several national GI societies including the AGA, ACG, and ASGE as well as state and local medical societies.