What Are Compensated and Decompensated Cirrhosis?

When you find out that you have scarring of the liver called cirrhosis, your doctor will tell you what stage you're in. Depending on how well your liver is working, they'll say it's either "compensated" or "decompensated." Which one it is makes a difference in the kind of treatment you get.

Compensated Cirrhosis

If you have compensated cirrhosis, you won't have any symptoms. Your liver can still do its job because there are enough healthy cells to make up for the damaged cells and scar tissue caused by cirrhosis. You might stay in this stage for many years.

Since there aren't symptoms yet, you may first learn about your cirrhosis during a checkup or through regular blood testing that your doctor ordered. Once you get a diagnosis, you'll be treated to prevent it from getting worse. You may even be able to stop or slow down liver damage.

Cirrhosis always develops because of another liver problem or disease. If you don't treat the cause of your cirrhosis, it'll get worse, and over time your healthy liver cells won't be able to keep up. You might start to get tired, feel like you don't want to eat, and lose weight without trying. After a while, your liver may not be able to work well or at all.

It's important to know the cause of your cirrhosis so you can get the right treatment and keep it from getting worse. The most common causes are:

Alcohol abuse. If you have a drinking problem, it's important to get help. Alcohol harms your liver. Talk to your doctor. They may refer you to a treatment program.

Nonalcoholic fatty liver disease. If your cirrhosis is caused by this disease, you may improve your liver health if you lose weight and keep your blood sugar levels under control.

Hepatitis B or C. Medicines for these diseases can stop more damage from happening to your liver.

What you can do to take care of yourself:

  • Don't drink alcohol or use street drugs.
  • Take the medicines your doctor prescribes.
  • Keep all your doctor's appointments.
  • Eat enough protein. People with cirrhosis need more than most folks.
  • Get shots for flu, pneumonia, and hepatitis A and B.
  • Practice good hygiene. Wash your hands often.
  • Ask your doctor if it's OK to take over-the-counter medicines like acetaminophen, aspirin, or ibuprofen.


Decompensated Cirrhosis

Decompensated cirrhosis is the stage that comes after compensated cirrhosis. At this point, your liver has too much scarring and you develop complications.

Your doctor will know you have decompensated cirrhosis if you show signs of one or more of these conditions:

Jaundice. It's caused when your liver can't get rid of bilirubin, a blood waste product, which can make your skin and eyes yellow.

Ascites. Fluid buildup in your belly.

Bleeding varices. Varices are enlarged blood vessels. Signs that you have bleeding varices are black, tarry, or bloody stools or throwing up blood. This is an emergency that needs treatment right away.

Hepatic encephalopathy (HE). Toxins can build up in your brain and make you confused and very tired, and have trouble doing daily activities like driving or writing.

Your liver disease can also lead to a kidney disease called hepatorenal syndrome, a lung disease called hepatopulmonary syndrome, and liver cancer.

Treatment will focus on stopping complications from getting worse. You'll have tests to keep track of and help treat your health problems, and your doctor will prescribe medicines to help you feel better and handle your daily life more easily.

What you can do to take care of yourself:

  • Eat a low-salt diet if you have ascites.
  • Eat a high-protein, high-calorie diet. 
  • Take a diuretic (a water pill) if your doctor prescribes one to help manage ascites.
  • Take medicine your doctor prescribes if you have constipation (trouble moving your bowels).
  • Drink enough fluids even if you have ascites so you don't get dehydrated.
  • Get shots for flu, pneumonia, and hepatitis A and B.
  • Don't take pain pills like ibuprofen, especially if you have ascites.

Your doctor may talk to you about getting a liver transplant if treatment isn't working. It's major surgery where your liver is replaced with a healthy one from an organ donor.

WebMD Medical Reference Reviewed by Minesh Khatri, MD on June 27, 2020



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Mayoclinic.org: "Cirrhosis: Diagnosis," "Esophageal varices: Symptoms," "Cirrhosis: Causes."

Liverfoundation.org: "The Progression of Liver Disease: Cirrhosis," "Nonalcoholic Fatty Liver Disease."

Medlineplus.gov: "Cirrhosis."

U.S. Department of Veterans Affairs: "Viral Hepatitis -- Cirrhosis: A Patient's Guide."

Clevelandclinic.org: "What is portal hypertension?"

NIH.gov: "Management options in decompensated cirrhosis."

Britishlivertrust.org: "Cirrhosis and Advanced liver disease."

Hepatic Medicine: "Management options in decompensated cirrhosis."

Ucsf.edu: "When is a liver transplant indicated for cirrhosis?"

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