Alternate Names: Liver cirrhosis

Causes and Risks:

The causes of cirrhosis are those that cause chronic liver disease, with long-standing alcohol use(See Alcoholic liver disease.) being the most common cause in the US. Other causes of cirrhosis include viral infections (Hepatitis B and Hepatitis C), medications, autoimmune inflammation of the liver, disorders of the drainage system of the liver (the biliary system), and metabolic disorders of iron and copper (hemochromatosis and Wilson’s disease).

Prevention:

Control alcohol use and other causative factors.

Symptoms:

• Weakness
• Weight loss
• Nausea
• Vomiting
• Confusion
• Impotence and loss of interest in sex
• Bleeding hemorrhoids
• Vomiting blood
• Jaundice
• Small, red spider-like blood vessels under the skin

Additional symptoms that may be associated with this disease:

• Urine output, decreased
• Swelling, overall
• Stools, pale or clay colored
• Nosebleed or bleeding gums
• Gynecomastia (breast development in males)
• Abdominal pain
• Abdominal indigestion
• Abdominal fullness, gaseous
• Fevers

Note: Symptoms may develop gradually; or there may be no symptoms.

Signs and Tests:

A physical examination may reveal an enlarged liver or spleen, distended abdomen, yellow eyes or skin (jaundice), red spider-like blood vessels on the skin, excess breast tissue, small testicles in men, reddened palms, contracted fingers, and/or dilated abdominal wall veins.
Blood tests that reveal liver injury include:

• Anemia on a CBC.
• Coagulation abnormalities.
• Elevated liver enzymes.
• Elevated bilirubin.
• Serum albumin low.
• An abdominal X-ray shows an enlarged liver.
• A liver biopsy confirms cirrhosis.

This disease may also alter the results of the following tests:

• Cholesterol test
• Complement
• Alpha-fetoprotein
• Renin
• Serum magnesium - test
• Sedimentation rate

Treatment:

Treatment is directed at the complication of cirrhosis and preventing further damage.

• Offending medications and alcohol are stopped.
• Bleeding varices are treated by upper endoscopy with banding or sclerosis.
• Ascites (excess abdominal fluid) is treated with diuretics, fluid and salt restriction, and removal of fluid (paracentesis).
• Coagulopathy may be treated with blood products or vitamin K.
• Encephalopathy is treated with the medication lactulose; sometimes antibiotics are used and patients should avoid a diet high in protein.
• Infections are treated with antibiotics.

Support Groups: The stress of illness can often be helped by joining support groups where members share common experiences and problems. See liver disease - support group.

Prognosis:

Survival depends on the severity of complications of cirrhosis and the underlying causes.

Complications:

• Bleeding esophageal varices
• Portal hypertension
• Hepatic encephalopathy
• Mental confusion
• Coma
• Abdominal fluid retention (ascites) and infection of the fluid (bacterial peritonitis)
• Sepsis
• Liver cancer (hepatocellular carcinoma)
• Kidney failure (hepatorenal syndrome)

Call your health care provider if symptoms develop that are suggestive of cirrhosis.

Call your health care provider, or go to the emergency room or call the local emergency number (such as 911) if vomiting blood or if rapid changes in alertness or consciousness occur.