Patient education: Cirrhosis (The Basics)

What is cirrhosis? — 

This is a disease that scars the liver. The liver is a big organ in the upper right side of the belly (figure 1). Liver damage can cause heavy bleeding, swelling, and breathing problems.

What are the symptoms of cirrhosis? — 

Some people have no symptoms.

When symptoms do happen, they can include:

●Swelling in the belly and legs, and fluid buildup in the lungs

●Heavy bleeding from blood vessels in the esophagus (the tube that connects the mouth to the stomach)

●Bruising or bleeding easily

●Trouble breathing

●Feeling full

●Feeling tired

●Trouble sleeping, or sleeping too much

●Yellowing of the skin or whites of the eyes, called "jaundice"

●Confusion that can start suddenly

●Coma

Cirrhosis makes it more likely you will get infections. It can also increase your risk of liver cancer.

What causes cirrhosis? — 

When something harms the liver, the organ tries to fix itself. In the process, scars form.

Causes of liver damage include:

●Heavy alcohol use – People who drink a lot of alcohol are at higher risk for cirrhosis.

●Hepatitis B or hepatitis C – These are liver diseases caused by viruses. The viruses can spread by sharing needles or having sex with people who are infected.

●Metabolic dysfunction-associated steatohepatitis ("MASH") – People with this condition often do not have heavy alcohol use. Doctors aren't completely sure what causes MASH. But many people who have it have excess body weight and diabetes.

Is there a test for cirrhosis? — 

Yes. Tests include:

●Liver biopsy – A doctor puts a needle into the liver. They use the needle to take out a small sample of tissue. The sample will show how severe the liver damage is.

●Blood tests – The results can show what is causing the disease.

●Imaging tests, like an ultrasound or MRI – These create pictures of the liver.

What can I do on my own? — 

To help prevent further liver damage, you should:

●Avoid alcohol.

●Talk to your doctor before you start taking any new medicines. This includes pain medicines such as ibuprofen (sample brand names: Advil, Motrin), naproxen (sample brand name: Aleve), and acetaminophen (sample brand name: Tylenol). Also, talk to your doctor before taking any herbs, vitamins, or supplements. Some medicines and supplements can damage the liver.

●Ask your doctor if you should be vaccinated against hepatitis A or B.

How is cirrhosis treated? — 

Treatments depend on the cause of the cirrhosis, how severe it is, and the symptoms.

Treatments fall into a few main categories. They can:

●Treat the cause of the disease – Some causes of cirrhosis can be treated. For example, people with cirrhosis caused by heavy alcohol use can stop drinking alcohol. People with chronic hepatitis C or B can take medicines.

●Lower the risk of bleeding – Cirrhosis can cause the blood vessels around the esophagus to swell or even burst and bleed (figure 2). To prevent this, doctors can:

•Prescribe "beta blocker" medicines. These reduce blood pressure in the liver, and help reduce the chance of bleeding.

•Place tiny bands around the swollen blood vessels. This procedure is called "variceal band ligation."

●Decrease fluid buildup in the belly – In people with cirrhosis, the belly sometimes fills with fluid. To decrease fluid buildup, doctors can:

•Prescribe "diuretic" medicines, also called "water pills." These make you urinate a lot. People who take diuretic medicines often must also eat less salt.

•Drain the fluid from the belly using a needle. This procedure is called a "paracentesis."

•Implant a device in the liver that reduces fluid buildup in the belly. This procedure is called "TIPS."

●Treat or prevent infection – People with cirrhosis have a higher-than-normal chance of getting infections. When they get an infection, they can also get much sicker than people without cirrhosis. So people with cirrhosis sometimes need antibiotics to either treat or prevent infection. Most people with cirrhosis should also get the flu vaccine and other vaccines to prevent common infections.

●Treat confusion – Cirrhosis can lead to confusion. Doctors can prescribe different medicines to treat the confusion.

Will I need a new liver? — 

Some people with severe cirrhosis need surgery to get a new liver. This is called a "liver transplant." Talk to your doctor about this before you get too sick, to find out if a liver transplant might be an option for you. People often have to wait for up to 2 years to get a new liver.

Can cirrhosis be prevented? — 

You can lower your chances of getting cirrhosis if you:

●Get help if you have an alcohol problem.

●Get the hepatitis B and hepatitis A vaccines, if you haven't already.

●Use condoms when having sex.

●Do not share drug needles.

When should I call the doctor? — 

If you have cirrhosis, call your doctor or nurse if you have:

●Problems with bleeding, like:

•Blood in your stool

•Vomiting blood

•Bleeding or bruising

●Symptoms of infection, such as fever over 100.4°F (38°C) or chills

●Belly pain

●Swollen legs or ankles

●Trouble breathing

●Extreme tiredness

●Confusion

●Jaundice

More on this topic

Patient education: Fluid in the belly from cirrhosis (ascites) (The Basics)
Patient education: Diet for adults with cirrhosis (The Basics)
Patient education: Alcohol use – When is drinking a problem? (The Basics)
Patient education: Hepatitis B (The Basics)
Patient education: Hepatitis C (The Basics)
Patient education: Metabolic dysfunction-associated steatotic liver disease (The Basics)
Patient education: Liver cancer (The Basics)
Patient education: Liver biopsy (The Basics)
Patient education: Liver panel (The Basics)
Patient education: Albumin blood test (The Basics)
Patient education: Aminotransferase tests (The Basics)
Patient education: Abdominal ultrasound (The Basics)
Patient education: Esophageal varices (The Basics)
Patient education: Abdominal paracentesis (The Basics)
Patient education: Hepatic encephalopathy (The Basics)
Patient education: Liver transplant (The Basics)

Patient education: Cirrhosis (Beyond the Basics)
Patient education: Alcohol use — when is drinking a problem? (Beyond the Basics)
Patient education: Hepatitis B (Beyond the Basics)
Patient education: Hepatitis C (Beyond the Basics)
Patient education: Metabolic dysfunction-associated steatotic liver disease (Beyond the Basics)
Patient education: Liver biopsy (Beyond the Basics)
Patient education: Esophageal varices (Beyond the Basics)