Cirrhosis of the Liver

What Are the Symptoms of Cirrhosis of the Liver?

The symptoms of cirrhosis of the liver vary with the stage of the illness. In the beginning stages, there may not be any symptoms. As the disease worsens, symptoms may include:

• Loss of appetite.
• Lack of energy (fatigue) which may be debilitating.
• Weight loss or sudden weight gain.
• Bruises.
• Yellowing of skin or the whites of eyes (jaundice).
• Itchy skin.
• Fluid retention (edema) and swelling in the ankles, legs, and abdomen (often an early sign).
• A brownish or orange tint to the urine.
• Light colored stools.
• Confusion, disorientation, personality changes.
• Blood in the stool.
• Fever.

How Is Cirrhosis of the Liver Diagnosed?

Cirrhosis of the liver is diagnosed through several methods:

• Physical exam. During a physical exam, your doctor can observe changes in how your liver feels or how large it is (a cirrhotic liver is bumpy and irregular instead of smooth).
• Blood tests. If your doctor suspects cirrhosis, you will be given blood tests to find out if liver disease is present.
• Other tests. In some cases, other tests that take pictures of the liver are performed such as a computerized tomography (CT scan), an ultrasound, or another specialized procedure called a radioisotope liver/spleen scan.
• Biopsy. Your doctor may decide to confirm the diagnosis by taking a sample of tissue (biopsy) from the liver.
• Surgery. In some cases, cirrhosis is diagnosed during surgery when the doctor is able to see the entire liver. The liver also can be inspected through a laparoscope, a viewing device that is inserted through a tiny incision in the abdomen.

What Complications Are Caused by Cirrhosis of the Liver?

Complications associated with cirrhosis of the liver include:

• Variceal bleeding. Variceal bleeding is caused by portal hypertension, which is an increase in the pressure within the portal vein (the large vessel that carries blood from the digestive organs to the liver). This increase in pressure is caused by a blockage of blood flow through the liver as a result of cirrhosis. Increased pressure in the portal vein causes other veins in the body to enlarge (varices), such as those in the esophagus and stomach, to bypass the blockage. These varices become fragile and can bleed easily, causing severe hemorrhaging and fluid in the abdomen.
• Confused thinking and other mental changes (hepatic encephalopathy). Hepatic encephalopathy most often occurs when cirrhosis has been present for a long time. Toxins produced in our intestines are normally detoxified by the liver, but once cirrhosis occurs, the liver cannot detoxify as well. Toxins get into the bloodstream and can cause confusion, changes in behavior, and even coma.

Other serious complications of cirrhosis of the liver include:

• Kidney failure.
• Reduced oxygen in the blood.
• Diabetes.
• Changes in blood counts.
• Increased risk of infections.
• Excessive bleeding and bruising.
• Breast enlargement in men.
• Premature menopause.
• Loss of muscle mass.

Most of these complications can initially be treated with medicines or dietary changes. Once treatment for these complications becomes ineffective, a liver transplant is considered. Almost all of the complications can be cured by liver transplantation; however, in many circumstances, careful management can reduce the harmful affects of cirrhosis, which can delay or even prevent the need for a liver transplant.