Symptoms & Causes of Cirrhosis of the Liver
What is Cirrhosis of the Liver?
Cirrhosis is a liver disease characterized by extensive scarring and disruption of normal liver structure.1 Over time, in response to injury, the liver tries to repair itself by forming scar tissue in place of damaged liver tissue. When repeated, this process leads to ever-increasing amounts of scar tissue. Excessive scar tissue impedes blood flow through the liver,2 impairing its ability to:
- Filter the blood from toxins
- Process nutrients and hormones
- Detoxify chemicals
- Metabolize drugs
- Create bile used by the body to absorb fats
As cirrhosis progresses additional scar tissue will form, further declining liver function until the condition eventually becomes life-threatening.
What Causes Liver Cirrhosis?
Cirrhosis is most commonly caused by chronic viral infections of the liver (hepatitis B, C, and D), chronic alcoholism, and fatty liver associated with obesity and diabetes. According to data published in Alcohol Research & Health, between 10-15% of people with alcoholism develop cirrhosis.3 The amount of alcohol you consume is an important risk factor for developing alcoholic cirrhosis, with recent findings showing an association between binge drinking and increased risk for advanced liver disease.4
In addition to these common causes, anything that damages the liver can cause cirrhosis. A wide range of diseases and conditions that can lead to cirrhosis include:
- Cystic fibrosis
- Glycogen storage diseases
- Alpha-1 antitrypsin deficiency
- Autoimmune liver diseases
- Iron buildup in the body
- Copper accumulation in the liver
- Genetic digestive disorder
- Bile duct blockage
- Repeated bouts of heart failure
- Reactions to medications
- Lengthy exposure to environmental toxins
- Infections by parasites
What Symptoms are Associated with Cirrhosis?
The symptoms of cirrhosis depend on the stage of the disease. Many people with cirrhosis often have no symptoms in the early stages of the disease. Symptoms usually do not appear until liver damage becomes extensive. As the disease progresses, symptoms may include:5
- Loss of appetite
- Weight loss
- Itchy skin
- Swelling in the ankles, legs and abdomen
- Slurred speech
- Personality changes
- Blood in the stool
How is Cirrhosis Diagnosed and Treated?
Cirrhosis may be suspected based on a history of alcohol abuse or medical conditions related to alcohol abuse. If cirrhosis is suspected, your doctor may perform a physical exam or use radiologic tests to examine your liver. The liver can also be viewed using a laparoscope, a fiber-optic instrument that is inserted through a tiny incision in the abdomen. Blood tests are often used to rule out other liver diseases. A liver biopsy may be needed to confirm the diagnosis.
There is no cure for cirrhosis, but there are treatments that can delay its progression and decrease further damage to the liver. If you have been diagnosed with alcoholic cirrhosis, the single most important thing to do is stop drinking. Abstinence is the only way to possibly reverse liver damage, or at the minimum, prevent it from becoming worse. In some cases, a medically-supervised detox program may be required to safely reduce your alcohol levels and minimize symptoms of withdrawal. Nutrition therapy is often provided to address any nutritional deficiencies and medications may be given to help reduce liver inflammation.
Some people with advanced alcoholic cirrhosis may require a liver transplant. However, to qualify as a suitable organ recipient you cannot be an active alcoholic. In order to meet the requirements of most transplant programs you must abstain from alcohol for six months prior to the transplant and agree not to resume drinking afterward.
- Schuppan, D., & Afdhal, N.H. (2008). Liver cirrhosis. Lancet, 371(9615), 838-51.
- Iwakiri, Y. (2014). Pathophysiology of portal hypertension. Clinics in Liver Disease, 18(2), 281-91.
- Mann, R.E., Smart, R.G., & Govoni, R. (2003). The Epidemiology of Alcoholic Liver Disease. Alcohol Research & Health, 27(3), 209-219.
- Aberg, F., Helenius-Hietala, J., Puukka, P., & Jula, A. (2017) Binge drinking and the risk of liver events: A population-based cohort study. Liver International, 37(9), 1373-1381.
- National Institute of Diabetes and Digestive and Kidney Diseases. (2018) Symptoms and causes of cirrhosis.