Cirrhosis is a form of advanced liver disease. In people with this condition, scar tissue forms throughout the liver. This interferes with its ability to function properly. In people with cirrhosis of the liver, swollen stomach and limbs, yellow eyes, and other symptoms may occur.
How do you know whether you’re at risk for cirrhosis? What are the signs that you might have this condition?
How do you get cirrhosis? - Causes of Cirrhosis
Cirrhosis represents the final stage of chronic liver disease. You can get cirrhosis from any type of liver disease. Some common causes include:
Alcohol. Drinking more than one to two alcoholic drinks per day can damage the liver, leading to cirrhosis.
Non-alcoholic fatty liver disease. This can occur in people who are significantly overweight. Fat tissue accumulates in the liver, causing damage.
Hepatitis B or C. These viruses can be acquired through unprotected sex, or from an infected person’s blood (usually by sharing needles and other drug injection equipment). They can cause chronic infections that slowly damage the liver over time.
In general, it takes years for liver disease to develop into cirrhosis.
There are two main types of cirrhosis, which are classified based on their appearance under the microscope. Micronodular cirrhosis (also known as Laennec’s cirrhosis) involves small nodules; this type is commonly caused by alcohol. Macronodular cirrhosis involves larger and more irregular nodules; this type is commonly caused by viral hepatitis or fatty liver disease. A mixed type can also occur. Whatever the cause, whether it’s macronodular or Laennec’s cirrhosis, symptoms of this condition are generally similar.
Cirrhosis of the Liver Signs and Symptoms
People with cirrhosis may experience a variety of symptoms. Some of the signs of cirrhosis of the liver include:
Yellowing of the skin and the whites of the eyes (jaundice). In people who have cirrhosis, jaundice is caused by a compound called bilirubin. This compound results from the normal breakdown of old red blood cells, and is usually cleared by the liver. When the liver can’t clear bilirubin, it accumulates in tissues, and its yellow color can be seen.
Swelling of the abdomen (ascites). Cirrhosis interferes with the flow of blood through the liver. The veins that carry blood from the abdominal organs back to the heart pass through the liver. When cirrhosis interferes with the flow of blood in this area, the pressure can cause fluid to build up in the abdomen, leading to abdominal swelling.
Swelling of the limbs. In people with cirrhosis, leg swelling is common, and results from changes in blood flow as well as reduced production of certain proteins (like albumin) by the liver.
Nausea and vomiting. These are caused by the buildup of waste products that are normally eliminated by the liver. This may also lead to a loss of appetite, which can in turn lead to weight loss.
Itchy skin. This is also caused by the buildup of waste products and toxins that the liver would normally eliminate.
Easy bruising. The liver produces proteins that are important for blood clotting. When the liver isn’t producing enough of these, then you may find that you bruise more easily, and that it takes longer to stop the bleeding from small cuts or scrapes.
Fatigue and weakness. There are a variety of reasons that liver disease can cause fatigue. The buildup of waste products may contribute. It’s believed that liver disease also causes changes in the function of the nervous system (including the brain), which leads to fatigue.
Advanced cirrhosis of the liver is often fatal. In fact, it’s among the top ten causes of death in the US.
Cirrhosis Early Stage Symptoms
Once you have cirrhosis, this is an indication that your liver has been experiencing damage over the course of many years. There may be no obvious early signs of cirrhosis. In many people, there are not apparent symptoms until the liver damage has progressed significantly.
In people with cirrhosis of the liver, yellow eyes, abdominal and leg swelling, and other symptoms are generally an indication that the disease has become advanced. However, in the earlier stages, blood tests can often show early signs of liver damage.
If you’re worried about your liver health, you can ask your doctor to order a liver panel, which looks at the levels of various proteins. You can also order this test yourself. You can either go to a laboratory to have your blood drawn, or you can order a home test kit, which involves taking your blood sample yourself through a fingerprick.
Can cirrhosis be reversed naturally?
Once liver disease has progressed to the point of cirrhosis, it’s very difficult to reverse the process. However, you can take steps to support your liver health. This can slow or even stop the progression of liver damage.
The best way to support your liver health is to remove the factors that were causing liver damage. For example, if your liver disease is caused by alcohol, quitting drinking will make a huge difference. If it’s caused by non-alcoholic fatty liver disease, losing weight will likely be helpful.
There are symptomatic treatments that can be helpful. For example, in a person with alcoholic cirrhosis of the liver with ascites, a doctor can drain the fluid using a needle inserted through the abdominal wall. This can make a big difference in terms of comfort, but it won’t cure the liver disease.
Some people try using herbal supplements for liver health. However, there’s currently no scientific evidence to support the idea that any herbal treatment can reverse cirrhosis. In fact, some herbal medications can even be unsafe for people with liver disease. If you’re considering using any supplement for liver health, it’s very important to discuss this with your doctor before you start taking it, to ensure that it’s safe for you.
Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis. Accessed 29 April 2023.
Hepatic Cirrhosis. National Library of Medicine. https://www.ncbi.nlm.nih.gov/books/NBK482419/. Accessed 29 April 2023.
FastStats: Chronic Liver Disease and Cirrhosis. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/nchs/fastats/liver-disease.htm. Accessed 29 April 2023.
Takahashi Y, Fukusato T. Histopathology of nonalcoholic fatty liver disease/nonalcoholic steatohepatitis. World J Gastroenterol. 2014 Nov 14; 20(42): 15539–15548. doi: 10.3748/wjg.v20.i42.15539
Swain MG. Fatigue in liver disease: Pathophysiology and clinical management. Can J Gastroenterol. 2006 Mar; 20(3): 181–188. doi: 10.1155/2006/624832