Overview
- Cirrhosis occurs when the liver is permanently scarred or injured by chronic conditions and diseases.
- Common causes of cirrhosis include:
- The liver is one of the most important organs in your body and weighs about three pounds. It sits in the upper-right side of the abdomen, below the ribs.
- The functions of the liver include:
- Changing food into energy.
- Cleaning out your body (metabolizing, or helping your body use, medications and removing alcohol and poisons from your system).
- Making bile. (Bile is a yellow-brown liquid made by the liver from bile salts, cholesterol, bilirubin and lecithin.)
- The scar tissue that forms in cirrhosis harms the structure of the liver, blocking the flow of blood through the organ.
- There are many ways to manage advanced cirrhosis:
- Treat the underlying disease.
- Avoid alcohol.
- Practice good nutrition.
- Work closely with a doctor.
- Anticipate and treat complications.

Symptoms
Patients with cirrhosis
often have few symptoms at first. The two major problems that end up causing symptoms are loss of working liver cells and distortion of the liver caused by scarring. Patients may have:
- Extreme tiredness.
- Weakness.
- Loss pf appetite, often with upset belly and weight loss.
- Water building up in the legs (edema) or belly (ascites).
- Easy bruising or bleeding.
- For females, absent or rare periods not related to menopause.
- For men, loss of sex drive or tender, enlarged breasts.
Late-Stage or Advanced Cirrhosis
Symptoms include:
- Yellow skin, called jaundice.
- Intense itching.
- Trouble digesting certain proteins, resulting in unsafe levels of ammonia in the blood (hepatic encephalopathy), which can cause:
- Mild sleep disturbances.
- Trouble focusing.
- Unresponsiveness.
- Coma.
- Vomiting blood due to bleeding from the stomach or esophagus.
Causes
Cirrhosis has many causes. It can come from certain illnesses or disorders, direct harm to the liver cells, indirect harm by inflammation, or swelling, or a block in the bile ducts, which drain the liver cells of bile.
Common Causes of Direct Liver Harm
- Long-term alcohol abuse.
- Chronic viral hepatitis (types B, C and D).
- Nonalcoholic fatty liver disease (NAFLD).
- Autoimmune hepatitis.
- Obesity.
- Inherited (passed down through family) illnesses, such as alpha-1-antitrypsin deficiency, among others.
As the rate of obesity rises, liver disease that may lead to cirrhosis, such as nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), may become more widespread. These health problems look like alcoholic liver disease, but they happen in people who drink little to no alcohol.
- Patients with NAFLD have fatty livers without inflammation or damage, which may not show any symptoms.
- NASH involves the buildup of fat in the liver cells, as well as inflammation of the liver, which can kill the liver cells and lead to cirrhosis.
Inherited Illnesses
Two inherited illnesses result in the abnormal storage of metals in the liver, leading to tissue damage and cirrhosis.
Wilson’s disease
- Patients store too much copper in the liver, brain, kidneys and corneas of the eyes.
- This is a rare health issue most often seen in children or young adults, not older patients.
Hemochromatosis
- Too much iron is taken in by the body, and the extra iron is deposited in the liver and other organs, such as the pancreas, skin, intestinal lining, heart and endocrine glands.
Common Causes of Indirect Harm by Way of Bile Duct Damage
The bile ducts carry bile formed in the liver to the intestines, where the bile helps the body digest fat.
- Primary biliary cirrhosis: the liver’s microscopic bile ducts are slowly destroyed.
- Primary sclerosing cholangitis: bile ducts inside and outside the liver become swollen and scarred.
- Biliary atresia: injury and loss of the bile ducts that are used for draining bile from the liver; found in newborn infants.
Rarely, medications may cause chronic liver disease and cirrhosis. Talk to your doctor about which ones may pose a risk.
There are many causes of cirrhosis that are less often seen, such as veno-occlusive disease, sarcoidosis (granulomatous liver disease), heart failure and chronic infections, like schistosomiasis and others.
If the cause of cirrhosis is still not clear after a full set of testing, it is termed “cryptogenic cirrhosis.” As many as 10 percent of patients with cirrhosis fall into this grouping.