Topic Overview

What is cirrhosis?

Cirrhosis (say "suh-ROH-sus") is a very serious condition in which scarring damages the liver. The liver is a large organ that is part of the digestive system. It does a wide range of complex jobs that are vital for life. For example, the liver:

• Makes many important substances, including bile to help digest food and clotting factors to help stop bleeding.
• Controls the amounts of sugar, protein, and fat in the bloodstream.
• Stores important vitamins and minerals, including iron.
• Filters poisons from the blood.
• Breaks down (metabolizes) alcohol and many drugs.

When a person has cirrhosis, scar tissue (fibrosis) replaces healthy tissue and prevents the liver from working as it should. For example, the liver may stop producing enough clotting factors, which can lead to bleeding and bruising. Bile and poisons may build up in the blood. Scarring can also cause high blood pressure in the vein that carries blood from the intestines through the liver (portal hypertension). This can lead to severe bleeding in the digestive tract and other serious problems.

Cirrhosis can be deadly. But early treatment can help stop damage to the liver.

What causes cirrhosis?

Cirrhosis can have many causes. Some of the main ones include:

• Long-term, heavy use of alcohol.
• Chronic viral hepatitis.
• Autoimmune diseases, such as autoimmune hepatitis or primary sclerosing cholangitis (PSC).
• Nonalcoholic steatohepatitis (NASH).
• Blocked bile ducts. A disease called primary biliary cirrhosis develops when the ducts that carry bile out of the liver become inflamed and blocked.
• Inherited diseases, such as Wilson's disease, cystic fibrosis, or hemochromatosis.

Less common causes of cirrhosis include severe reactions to medicines or long-term exposure to poisons, such as arsenic. Some people have cirrhosis without an obvious cause.

What are the symptoms?

You may not have symptoms in the early stages of cirrhosis. As it progresses, it can cause a number of symptoms, including:

• Extreme tiredness and weakness.
• Nosebleeds and easy bruising.
• Weight loss.
• Belly pain or discomfort.
• Yellowing of the skin (jaundice).
• Itching.
• Fluid buildup in the legs, called edema (say "ih-DEE-muh"), and in the belly, called ascites (say "uh-SIGH-teez").
• Bleeding in the stomach or in the esophagus, the tube that leads from the mouth to the stomach.
• Confusion.

How is cirrhosis diagnosed?

The doctor will start with a physical exam and questions about your symptoms and past health. If the doctor suspects cirrhosis, you may have blood tests and imaging tests, such as an ultrasound or CT scan. These tests can help your doctor find out what is causing the liver damage and how severe it is.