OverviewCirrhosis causes scaring and nodules to form throughout the liver.What is cirrhosis of the liver?Cirrhosis is a late-stage liver disease in which healthy liver tissue is replaced with scar tissue and the liver is permanently damaged. Scar tissue keeps your liver from working properly. Show
Many types of liver diseases and conditions injure healthy liver cells, causing cell death and inflammation. This is followed by cell repair and finally tissue scarring as a result of the repair process. The scar tissue blocks the flow of blood through the liver and slows the liver’s ability to process nutrients, hormones, drugs and natural toxins (poisons). It also reduces the production of proteins and other substances made by the liver. Cirrhosis eventually keeps the liver from working properly. Late-stage cirrhosis is life-threatening.
How common is cirrhosis?Scientists estimate that cirrhosis of the liver affects about one in 400 adults in the U.S. It affects about 1 in 200 adults age 45 to 54, the age group most commonly affected by cirrhosis. Cirrhosis causes about 26,000 deaths each year in the U.S. and is the seventh leading cause of death in the U.S. among adults 25 to 64 years of age. Who gets cirrhosis, who is most at risk?You are more likely to get cirrhosis of the liver if you:
Is cirrhosis cancer?No, cirrhosis of the liver isn’t cancer. However, most people who have liver cancer have cirrhosis. If you have cirrhosis, you have an increased risk of liver cancer. If you have hepatitis B or hepatitis C, you have an increased risk of liver cancer because these diseases often lead to cirrhosis. Any cause of liver disease can lead to cirrhosis, which increases your chance of liver cancer. (Even if you have hepatitis B or fatty liver disease without cirrhosis, you are at increased risk of liver cancer.) Is cirrhosis a hereditary disease?Cirrhosis itself is not an inherited (passed from parent to child) disease. However, some of the diseases that can cause liver damage that lead to cirrhosis are inherited diseases. Can cirrhosis be reversed?Generally no. If you have been told you have cirrhosis, you have a late-stage liver disease and the damage that is already done is permanent. There are many liver diseases and complications of liver diseases that can lead to cirrhosis. If your liver disease or complication is caught early and successfully managed, it may be possible to slow or stop the progression of disease. Is cirrhosis fatal?Having a diagnosis of cirrhosis of the liver doesn’t mean you have an immediately fatal condition. However, as cirrhosis continues, more scarring occurs and liver function continues to decline. Eventually, your failing liver may become a life-threatening condition. Yet there’s still hope. You and your medical team will discuss if you are a candidate for a liver transplant. If so, you will begin the process of being placed on a national liver transplant recipient list. Symptoms and CausesWhat are the symptoms of cirrhosis?The symptoms of cirrhosis depend on the stage of your disease. In the beginning stages, you may not have any symptoms. If you do have symptoms, some are general and could easily be mistaken for symptoms of many other diseases and illnesses. Early symptoms and signs of cirrhosis include:
As liver function gets worse, other more commonly recognized symptoms of cirrhosis appear including:
Is cirrhosis painful?Yes, cirrhosis can be painful, especially as the disease worsens. Pain is reported by up to 82% of people who have cirrhosis and more than half of these individuals say their pain is long-lasting (chronic). Most people with liver disease report abdominal pain. Pain in your liver itself can feel like a dull throbbing pain or a stabbing sensation in your right upper abdomen just under your ribs. General abdominal pain and discomfort can also be related to swelling from fluid retention and enlargement of your spleen and liver caused by cirrhosis. Pain can come both from the diseases that lead to cirrhosis and/or cirrhosis can make the pain from existing diseases worse. For instance, if you have non-alcohol related fatty liver disease and have obesity, you may also have osteoarthritis and cirrhosis makes your bone and joint pain worse. Cirrhosis also causes an inflammatory state in your entire body. Inflammation and your body’s reaction to inflammation can cause general pain. What causes cirrhosis?The most common causes of cirrhosis of the liver are:
Anything that damages the liver can lead to cirrhosis. Other causes include:
Changes from liver diseases that lead to cirrhosis are gradual. Liver cells are injured and if injury – from whatever cause – continues, liver cells start to die. Over time, scar tissue replaces the damaged liver cells and the liver can’t function properly. What are the complications of cirrhosis?There are many complications of cirrhosis of the liver. Because cirrhosis develops over many years, some of these complications may be your first noticeable signs and symptoms of the disease. Portal hypertension: This is the most common serious complication. Portal hypertension is an increase in the pressure in your portal vein (the large blood vessel that carries blood from the digestive organs to the liver). This increase in pressure is caused by a blockage of blood flow through your liver as a result of cirrhosis. When blood flow through veins is partially blocked, veins in your esophagus, stomach or intestines can become enlarged (a condition called varices). As the pressure in these veins builds, the veins can bleed or even burst, causing severe internal bleeding. Additional complications of portal hypertension include:
Hypersplenism: Hypersplenism is an overactive spleen. This condition causes quick and premature destruction of blood cells. Infections: Cirrhosis increases your risk of getting and fighting serious infections, such as bacterial peritonitis (infection of the tissue that lines the inner wall of your abdomen). Malnutrition: Your liver processes nutrients. A damaged liver makes this more difficult and leads to weight loss and general weakness. Liver cancer: Most people who develop liver cancer have cirrhosis of the liver. Liver failure: Many diseases and conditions cause liver failure including cirrhosis of the liver. As its name implies, liver failure occurs when your liver isn’t working well enough to perform its many functions. Diagnosis and TestsHow is cirrhosis of the liver diagnosed?Your healthcare provider will first ask about your medical history and over-the-counter and prescription drug use. They will also ask about any supplements or herbal products you may take. Your provider may suspect you have cirrhosis if you have a long history of alcohol use, injectable drug use or have had hepatitis B or C and have the symptoms listed in this article. To diagnosis cirrhosis, your provider will perform a physical exam and may order one or more of the following tests:
In addition, other blood work will include a complete blood count to look for signs of infection and anemia caused by internal bleeding and a viral hepatitis test to check for hepatitis B or C.
Are there stages of cirrhosis?If you have been diagnosed with cirrhosis of the liver, you are already beyond the early stages of liver disease. Having cirrhosis means your liver has scar tissue in it because it has been damaged. Liver specialists and researchers have developed many different scoring systems to predict outcome and to guide treatment for chronic liver disease. Some specific liver diseases also have their own scoring systems. However, not every liver disease has a scoring system and there’s no scoring system if you happen to have more than one liver disease at the same time. For these reasons, perhaps it’s easier to talk about cirrhosis according to a classification system you are more likely to hear from your healthcare provider. He or she may refer to you having either compensated cirrhosis or decompensated cirrhosis. Compensated cirrhosis means you have cirrhosis but you don’t yet have noticeable symptoms (you are asymptomatic). Your lab work and imaging findings may not be abnormal. A liver biopsy may be the only way to confirm a diagnosis of cirrhosis. Median survival in patients with compensated cirrhosis is approximately nine to 12 years. (Median is the middle point in set of numbers, so an equal number of individuals survived less than 9 to 12 years as the number of individuals who survived over this time range.) Decompensated cirrhosis means your cirrhosis has worsened to the point that you have noticeable symptoms. Your healthcare provider recognizes your condition based on your history, physical and lab findings. You have at least one complication, which includes jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome, variceal bleeding or liver cancer. You are usually admitted to the hospital for care. Median survival in patients with decompensated cirrhosis is approximately two years. Management and TreatmentIs there a cure for cirrhosis of the liver?No, there is no cure for cirrhosis. The damage already done to your liver is permanent. However, depending on the underlying cause of your cirrhosis, there may be actions you can take to keep your cirrhosis from getting worse. These actions include:
Follow other tips listed under the Prevention section in this article. What are the goals of cirrhosis treatment?The goals of treatment for cirrhosis of the liver are to:
How is cirrhosis of the liver treated?Treatment depends on what’s causing your cirrhosis and how much damage exists. Although there is no cure for cirrhosis, treatments can delay or stop its progress and reduce complications. Treatments for the causes of cirrhosis are as follows:
How are the complications of cirrhosis treated?Portal hypertension: Portal hypertension is mainly the result of chronic end-stage liver disease. Treatment consists of treating its many complications. Treatments of portal hypertension include:
Bacterial peritonitis: Antibiotics and infusion of a protein (albumin) will be prescribed. Typically patients are admitted to the hospital for treatment and monitoring. Following a diagnosis of bacterial peritonitis, an oral antibiotic will be prescribed for daily use to prevent recurrence of infection. Liver cancer: Treatment depends on the stage of your cancer and other factors. One or more treatments may be tried. Options include surgery to remove part of your liver or your whole liver (to be replaced with a new liver as part of a liver transplantation) and nonsurgical tumor-destroying methods including ablation, chemotherapy, targeted therapy (drugs zero in on cancer genes or tissue), immunotherapy and radiation bead therapy (inject bead that give off radiation into the blood vessels that feed the tumor). Kidney failure: Treatment may include medication, dialysis and kidney transplant, depending on the cause and extent of failure. Liver failure: Treatment depends on if you have acute or chronic failure. For chronic liver failure, diet and lifestyle changes include stopping alcohol and medications that harm the liver; eating less red meat, cheese and eggs; losing weight; controlling high blood pressure and diabetes and cutting down on salt. Acute treatments for liver failure include intravenous fluids to maintain blood pressure, laxatives to help flush toxins from the body and blood glucose monitoring. If you have either acute or chronic liver failure, your liver specialist may recommend a liver transplant. Liver transplants can come from a living or deceased donor. Only a portion of the donor liver needs to be transplanted. The liver is the only human organ capable of growing back. Many tests are required of both you (the liver transplant recipient) and the person donating a portion of their liver or the cadaver liver (liver from a deceased person). If your doctors determine that you need a liver transplant, you will be placed on a national liver transplant waiting list, which lists patients by blood type, body size and severity of end-stage liver disease. PreventionHow can I prevent cirrhosis of the liver?Food and drink issues:
Healthy body habits:
Healthy liver practices:
Outlook / PrognosisWhat can I expect if I have cirrhosis?Damage already done to your liver is permanent. But your liver is a large organ. If part of your liver is still working, you might be able to slow the progression of disease, depending on its cause. For instance, if your cirrhosis is caused by alcohol use, talk to your provider about how to stop drinking. If you have obesity or diabetes, you will need to lose weight and manage your blood sugar so you can lower the damage caused by fatty liver disease. You and your healthcare provider or team will work together to determine what’s causing your cirrhosis and what complications may have resulted from your cirrhosis and treat them accordingly. What’s the life expectancy for people with cirrhosis?Life expectancy depends on several factors including the cause and severity of your cirrhosis, your response to treatments, the presence of cirrhosis complications, your age and any other existing general health problems. Ask your liver specialist about your life expectancy since every person is unique, with unique overall health issues and specific liver health issues. If your cirrhosis is advanced, liver transplantation may be an option. You and your doctors will discuss if this is an option for you. What’s a Child-Turcotte-Pugh score and MELD score?A Child-Turcotte-Pugh (CTP) score, also known simply as the Child-Pugh score, is a clinical score that tells your doctors how severe your liver disease is and forecasts your expected survival rate. The scoring system provides a score on the presence of five clinical measures (the lab values of bilirubin, serum albumin and prothrombin time; presence of ascites and hepatic encephalopathy) and the degree of severity of each of these measures.
The Model for End-stage Liver Disease (MELD) score is a score that is used to rank the urgency for a liver transplant. The worse your liver function is, the higher your MELD score and the higher your position is on the transplant list. The Pediatric End-stage Liver Disease (PELD) score is similar to MELD but is a scoring system for children under the age of 12. Living WithWhen should I call 911 or go to the emergency room?If you have cirrhosis and experience the following, call 911:
What type of healthcare providers will treat my cirrhosis?Depending on the stage of your cirrhosis, different healthcare providers may be involved in your care. Healthcare professionals likely to be part of your care team include:
A note from Cleveland Clinic Cirrhosis of the liver is a late-stage result of liver disease and its complications. Cirrhosis causes your liver to not function properly. Your liver plays a vital role in many of the processes and functions that keep you alive. Although scarring from liver disease causes permanent damage, it’s still possible to live a long life. Depending on the underlying cause, it’s possible to slow or stop cirrhosis from worsening. Many of the causes and complications that lead to cirrhosis are treatable or manageable. If you drink alcohol, stop. If you have non-alcohol related fatty liver disease, lose weight and control your metabolic risk factors. If you have diabetes, make sure you are following your healthcare provider’s management recommendations. Take all medications for all your medical conditions as directed by your healthcare team. Get vaccinated for hepatitis A and B. If you have end-stage cirrhosis, don’t lose hope. You and your healthcare team will work together to closely manage your condition and put you on a wait list for a donor liver. Can you recover from Stage 4 cirrhosis of the liver?No, there is no cure for cirrhosis. The damage already done to your liver is permanent. However, depending on the underlying cause of your cirrhosis, there may be actions you can take to keep your cirrhosis from getting worse.
How long does final stage of cirrhosis last?Patients with compensated cirrhosis have a median survival that may extend beyond 12 years. Patients with decompensated cirrhosis have a worse prognosis than do those with compensated cirrhosis; the average survival without transplantation is approximately two years [13,14].
What can be done for Stage 4 cirrhosis of the liver?If cirrhosis progresses and your liver is severely damaged, a liver transplant may be the only treatment option. This is a major operation that involves removing your diseased liver and replacing it with a healthy liver from a donor.
What are the signs of endSymptoms of end-stage liver disease may include:. Easy bleeding or bruising.. Persistent or recurring yellowing of your skin and eyes (jaundice). Intense itching.. Abdominal pain.. Loss of appetite.. Nausea.. Swelling due to fluid buildup in your abdomen and legs.. Problems with concentration and memory.. |