BACK TOTOP Browse A-ZSearchBrowse A-ZABCDEFGHIJKLMNOPQRSTUVWXYZ0-9 E-mail FormEmail ResultsName:Email address:Recipients Name:Recipients address:Message: Print-FriendlyBookmarksbookmarks-menuCirrhosisLiver cirrhosis; Chronic liver disease; End-stage liver disease; Liver failure - cirrhosis; Ascites - cirrhosisCirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease. Causes Cirrhosis is most often the end result of chronic liver damage caused by long-term (chronic) liver disease. Common causes of chronic liver disease in the United States are:Hepatitis B or hepatitis C infection. Hepatitis BHepatitis B is irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV). Other types of viral hepatitis ...ImageRead Article Now Book Mark Article Hepatitis CHepatitis C is a viral disease that leads to swelling (inflammation) of the liver. Other types of viral hepatitis include:Hepatitis AHepatitis BHepat...ImageRead Article Now Book Mark Article Alcohol overuse. Alcohol overuseAlcohol use involves drinking beer, wine, or hard liquor.Read Article Now Book Mark Article Buildup of fat in the liver that is NOT caused by drinking too much alcohol (called nonalcoholic fatty liver disease [NAFLD] and nonalcoholic steatohepatitis [NASH]). It is closely related to being overweight, having high blood pressure, diabetes or pre-diabetes, and high cholesterol. Buildup of fat in the liver that is NOT...Nonalcoholic fatty liver disease (NAFLD) is the buildup of fat in the liver that is not caused by drinking too much alcohol. People who have it do n...ImageRead Article Now Book Mark Article Less common causes of cirrhosis include:When immune cells mistake the liver's normal cells for harmful invaders and attack them, called autoimmune hepatitis (AH) When immune cells mistake the liver's n...Autoimmune hepatitis causes inflammation of the liver. It occurs when immune cells mistake the liver's normal cells for harmful invaders and attack ...ImageRead Article Now Book Mark Article Bile duct disorders Some medicines Liver diseases passed down in families Symptoms There may be no symptoms, or symptoms may come on slowly, depending on how well the liver is working. Often, it is discovered by chance when an abdominal ultrasound exam is done or blood is drawn for another reason.Early symptoms include: Fatigue and loss of energy Poor appetite and weight loss Nausea or belly pain Small, red spider-like blood vessels on the skin As liver function worsens, symptoms may include: Fluid buildup in the legs (edema) and in the abdomen (ascites) Yellow color in the skin, mucous membranes, or eyes (jaundice) Redness on the palms of the hands In men, impotence, shrinking of the testicles, and breast swelling Easy bruising and abnormal bleeding, most often from swollen veins in the digestive tract Swollen veins in the digestive tractThe esophagus (food pipe) is the tube that connects your throat to your stomach. Varices are enlarged veins that may be found in the esophagus in pe...ImageRead Article Now Book Mark Article Confusion or problems thinking Confusion or problems thinkingLoss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy (HE). This problem ma...Read Article Now Book Mark Article Pale or clay-colored stools Bleeding from upper or lower gastrointestinal tract Exams and Tests Your health care provider will do a physical exam to look for:An enlarged liver or spleen Excess breast tissue (in men) Swollen abdomen, as a result of too much fluid Swollen abdomenAscites is the build-up of fluid in the space between the lining of the abdomen and abdominal organs.ImageRead Article Now Book Mark Article Reddened palms Red spider-like blood vessels on the skin Small testicles (in men) Widened veins in the abdomen wall Yellow eyes or skin (jaundice) You may have the following tests to determine the cause of your cirrhosis:Hepatitis virus testing Antibody testing for autoimmune hepatitis Serum iron saturation and ferritin levels Serum ceruloplasmin level Genetic testing for liver disordersYou may have the following tests to measure liver function:Complete blood count Complete blood countA complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...ImageRead Article Now Book Mark Article Prothrombin time Prothrombin timeLiver function tests are common tests that are used to see how well the liver is working. Tests include:AlbuminAlpha-1 antitrypsinAlkaline phosphata...ImageRead Article Now Book Mark Article Liver function tests Liver function testsLiver function tests are common tests that are used to see how well the liver is working. Tests include:AlbuminAlpha-1 antitrypsinAlkaline phosphata...ImageRead Article Now Book Mark Article Blood albumin level Blood albuminAlbumin is a protein made by the liver. A serum albumin test measures the amount of this protein in the clear liquid portion of the blood. Albumin c...ImageRead Article Now Book Mark Article Other tests to check for liver damage include:Computed tomography (CT) of the abdomen Computed tomography (CT) of the abdomenAn abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...ImageRead Article Now Book Mark Article Magnetic resonance imaging (MRI) of the abdomen Magnetic resonance imaging (MRI) of the...An abdominal magnetic resonance imaging scan is an imaging test that uses powerful magnets and radio waves. The waves create pictures of the inside ...ImageRead Article Now Book Mark Article Endoscopy to check for abnormal veins in the esophagus or stomach EndoscopyEndoscopy is a way of looking inside the body using a flexible tube that has a small camera and light on the end of it. This instrument is called an...ImageRead Article Now Book Mark Article Ultrasound of the abdomenUltrasound of the abdomenAbdominal ultrasound is a type of imaging test. It is used to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and...ImageRead Article Now Book Mark Article You might need a liver biopsy to confirm the diagnosis.Liver biopsyA liver biopsy is a test that takes a sample of tissue from the liver for examination.ImageRead Article Now Book Mark Article Treatment LIFESTYLE CHANGESSome things you can do to help take care of your liver disease are: Drink no alcohol. Eat a healthy diet that is low in salt, fat, and simple carbohydrates. Low in saltToo much sodium in your diet can be bad for you. If you have high blood pressure or heart failure, you may be asked to limit the amount of salt (whi...ImageRead Article Now Book Mark Article Get vaccinated for diseases such as influenza, COVID-19, hepatitis A and B, and pneumococcal disease. Talk to your provider about all medicines you take, including herbs and supplements and over-the-counter medicines. Exercise. Control your underlying metabolic problems, such as high blood pressure, diabetes, and high cholesterol.MEDICINES FROM YOUR PROVIDERWater pills (diuretics) to get rid of fluid build-up Vitamin K or blood products to prevent excess bleeding Medicines for mental confusion Antibiotics for infections OTHER TREATMENTSEndoscopic treatments for enlarged veins in the esophagus (varices) Removal of fluid from the abdomen (paracentesis) Placement of a transjugular intrahepatic portosystemic shunt (TIPS) to improve blood flow in the liver Transjugular intrahepatic portosystemic...Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure to create new connections between two blood vessels in your liver. You may need ...ImageRead Article Now Book Mark Article When cirrhosis progresses to end-stage liver disease, a liver transplant may be needed. Support Groups You can often ease the stress of illness by joining a liver disease support group whose members share common experiences and problems.Liver disease support groupThe following organizations are good resources for information on liver disease:American Liver Foundation -- liverfoundation. orgCenters for Disease ...ImageRead Article Now Book Mark Article Outlook (Prognosis) Cirrhosis is caused by scarring of the liver. In most cases, the liver cannot heal or return to normal function once the damage is severe. Cirrhosis can lead to serious complications. Possible Complications Complications may include:Bleeding disorders Buildup of fluid in the abdomen (ascites) and infection of the fluid (spontaneous bacterial peritonitis) Enlarged veins in the esophagus, stomach, or intestines that bleed easily (varices) Increased pressure in the blood vessels of the liver (portal hypertension) HypertensionBlood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...ImageRead Article Now Book Mark Article Kidney failure (hepatorenal syndrome) Hepatorenal syndromeHepatorenal syndrome is a condition in which there is progressive kidney failure that occurs in a person with cirrhosis of the liver. It is a seriou...Read Article Now Book Mark Article Liver cancer (hepatocellular carcinoma) Hepatocellular carcinomaHepatocellular carcinoma is cancer that starts in the liver.ImageRead Article Now Book Mark Article Mental confusion, change in the level of consciousness, or coma (hepatic encephalopathy) Hepatic encephalopathyLoss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy (HE). This problem ma...Read Article Now Book Mark Article When to Contact a Medical Professional Contact your provider if you develop symptoms of cirrhosis.Get emergency medical help right away if you have:Abdominal or chest pain Abdominal swelling or ascites that is new or suddenly becomes worse A fever (temperature greater than 101°F or 38.3°C) Diarrhea Confusion or a change in alertness, or it gets worse Rectal bleeding, vomiting blood, or blood in the urine Shortness of breath Vomiting more than once a day Yellowing skin or eyes (jaundice) that is new or gets worse quickly Prevention DO NOT drink alcohol. Talk to your provider if you are worried about your drinking. Take steps to prevent getting hepatitis B or C or passing it to other people.Worried about your drinkingMany people with alcohol problems cannot tell when their drinking is a problem or out of control. It is important to be aware of how much you are dr...Read Article Now Book Mark Article Hepatitis B or CHepatitis B and hepatitis C infections cause irritation (inflammation) and swelling of the liver. You should take steps to prevent catching or sprea...Read Article Now Book Mark Article Open ReferencesReferencesGarcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 139.Kamath PS, Shah VH. Overview of cirrhosis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 74.AllVideoImagesTogCirrhosis of the liver - illustration A chronic liver disease which causes damage to liver tissue, scarring of the liver (fibrosis; nodular regeneration), progressive decrease in liver function, excessive fluid in the abdomen (ascites), bleeding disorders (coagulopathy), increased pressure in the blood vessels (portal hypertension), and brain function disorders (hepatic encephalopathy). Excessive alcohol use is the leading cause of cirrhosis.Cirrhosis of the liverillustrationDigestive system organs - illustration The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.Digestive system organsillustrationDigestive system - illustration The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.Digestive systemillustrationLiver cirrhosis - CT scan - illustration A CT scan of the upper abdomen showing cirrhosis of the liver.Liver cirrhosis - CT scanillustrationCirrhosis of the liver - illustration A chronic liver disease which causes damage to liver tissue, scarring of the liver (fibrosis; nodular regeneration), progressive decrease in liver function, excessive fluid in the abdomen (ascites), bleeding disorders (coagulopathy), increased pressure in the blood vessels (portal hypertension), and brain function disorders (hepatic encephalopathy). Excessive alcohol use is the leading cause of cirrhosis.Cirrhosis of the liverillustrationDigestive system organs - illustration The digestive system organs in the abdominal cavity include the liver, gallbladder, stomach, small intestine and large intestine.Digestive system organsillustrationDigestive system - illustration The esophagus, stomach, large and small intestine, aided by the liver, gallbladder and pancreas convert the nutritive components of food into energy and break down the non-nutritive components into waste to be excreted.Digestive systemillustrationLiver cirrhosis - CT scan - illustration A CT scan of the upper abdomen showing cirrhosis of the liver.Liver cirrhosis - CT scanillustrationA Closer Look Cirrhosis(Alt. Medicine)Cirrhosis - InDepth(In-Depth)Related Information Liver disease(Condition)Ascites(Condition)Bleeding disorders(Condition)High blood pressure in adults – hypertension(Condition)Loss of brain function - liver disease(Condition)Alcohol use and safe drinking(Special Topic)Alcoholic liver disease(Condition)Bleeding esophageal varices(Condition)Decreased alertness(Symptoms)Sepsis(Condition)Cirrhosis - discharge(Discharge)Cirrhosis - InDepth(In-Depth)High blood pressure - InDepth(In-Depth) Review Date: 2/6/2022 Reviewed By: Michael M. Phillips, MD, Emeritus Professor of Medicine, The George Washington University School of Medicine, Washington, DC. Internal review and update on 02/10/2024 by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. No warranty of any kind, either expressed or implied, is made as to the accuracy, reliability, timeliness, or correctness of any translations made by a third-party service of the information provided herein into any other language. © 1997- A.D.A.M., a business unit of Ebix, Inc. Any duplication or distribution of the information contained herein is strictly prohibited. © 1997- All rights reserved. A.D.A.M. content is best viewed in IE9 or above, Firefox and Google Chrome browser.Content is best viewed in IE9 or above, Firefox and Google Chrome browser.
CirrhosisLiver cirrhosis; Chronic liver disease; End-stage liver disease; Liver failure - cirrhosis; Ascites - cirrhosisCirrhosis is scarring of the liver and poor liver function. It is the last stage of chronic liver disease. Causes Cirrhosis is most often the end result of chronic liver damage caused by long-term (chronic) liver disease. Common causes of chronic liver disease in the United States are:Hepatitis B or hepatitis C infection. Hepatitis BHepatitis B is irritation and swelling (inflammation) of the liver due to infection with the hepatitis B virus (HBV). Other types of viral hepatitis ...ImageRead Article Now Book Mark Article Hepatitis CHepatitis C is a viral disease that leads to swelling (inflammation) of the liver. Other types of viral hepatitis include:Hepatitis AHepatitis BHepat...ImageRead Article Now Book Mark Article Alcohol overuse. Alcohol overuseAlcohol use involves drinking beer, wine, or hard liquor.Read Article Now Book Mark Article Buildup of fat in the liver that is NOT caused by drinking too much alcohol (called nonalcoholic fatty liver disease [NAFLD] and nonalcoholic steatohepatitis [NASH]). It is closely related to being overweight, having high blood pressure, diabetes or pre-diabetes, and high cholesterol. Buildup of fat in the liver that is NOT...Nonalcoholic fatty liver disease (NAFLD) is the buildup of fat in the liver that is not caused by drinking too much alcohol. People who have it do n...ImageRead Article Now Book Mark Article Less common causes of cirrhosis include:When immune cells mistake the liver's normal cells for harmful invaders and attack them, called autoimmune hepatitis (AH) When immune cells mistake the liver's n...Autoimmune hepatitis causes inflammation of the liver. It occurs when immune cells mistake the liver's normal cells for harmful invaders and attack ...ImageRead Article Now Book Mark Article Bile duct disorders Some medicines Liver diseases passed down in families Symptoms There may be no symptoms, or symptoms may come on slowly, depending on how well the liver is working. Often, it is discovered by chance when an abdominal ultrasound exam is done or blood is drawn for another reason.Early symptoms include: Fatigue and loss of energy Poor appetite and weight loss Nausea or belly pain Small, red spider-like blood vessels on the skin As liver function worsens, symptoms may include: Fluid buildup in the legs (edema) and in the abdomen (ascites) Yellow color in the skin, mucous membranes, or eyes (jaundice) Redness on the palms of the hands In men, impotence, shrinking of the testicles, and breast swelling Easy bruising and abnormal bleeding, most often from swollen veins in the digestive tract Swollen veins in the digestive tractThe esophagus (food pipe) is the tube that connects your throat to your stomach. Varices are enlarged veins that may be found in the esophagus in pe...ImageRead Article Now Book Mark Article Confusion or problems thinking Confusion or problems thinkingLoss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy (HE). This problem ma...Read Article Now Book Mark Article Pale or clay-colored stools Bleeding from upper or lower gastrointestinal tract Exams and Tests Your health care provider will do a physical exam to look for:An enlarged liver or spleen Excess breast tissue (in men) Swollen abdomen, as a result of too much fluid Swollen abdomenAscites is the build-up of fluid in the space between the lining of the abdomen and abdominal organs.ImageRead Article Now Book Mark Article Reddened palms Red spider-like blood vessels on the skin Small testicles (in men) Widened veins in the abdomen wall Yellow eyes or skin (jaundice) You may have the following tests to determine the cause of your cirrhosis:Hepatitis virus testing Antibody testing for autoimmune hepatitis Serum iron saturation and ferritin levels Serum ceruloplasmin level Genetic testing for liver disordersYou may have the following tests to measure liver function:Complete blood count Complete blood countA complete blood count (CBC) test measures the following:The number of white blood cells (WBC count)The number of red blood cells (RBC count)The numb...ImageRead Article Now Book Mark Article Prothrombin time Prothrombin timeLiver function tests are common tests that are used to see how well the liver is working. Tests include:AlbuminAlpha-1 antitrypsinAlkaline phosphata...ImageRead Article Now Book Mark Article Liver function tests Liver function testsLiver function tests are common tests that are used to see how well the liver is working. Tests include:AlbuminAlpha-1 antitrypsinAlkaline phosphata...ImageRead Article Now Book Mark Article Blood albumin level Blood albuminAlbumin is a protein made by the liver. A serum albumin test measures the amount of this protein in the clear liquid portion of the blood. Albumin c...ImageRead Article Now Book Mark Article Other tests to check for liver damage include:Computed tomography (CT) of the abdomen Computed tomography (CT) of the abdomenAn abdominal CT scan is an imaging method. This test uses x-rays to create cross-sectional pictures of the belly area. CT stands for computed tomog...ImageRead Article Now Book Mark Article Magnetic resonance imaging (MRI) of the abdomen Magnetic resonance imaging (MRI) of the...An abdominal magnetic resonance imaging scan is an imaging test that uses powerful magnets and radio waves. The waves create pictures of the inside ...ImageRead Article Now Book Mark Article Endoscopy to check for abnormal veins in the esophagus or stomach EndoscopyEndoscopy is a way of looking inside the body using a flexible tube that has a small camera and light on the end of it. This instrument is called an...ImageRead Article Now Book Mark Article Ultrasound of the abdomenUltrasound of the abdomenAbdominal ultrasound is a type of imaging test. It is used to look at organs in the abdomen, including the liver, gallbladder, spleen, pancreas, and...ImageRead Article Now Book Mark Article You might need a liver biopsy to confirm the diagnosis.Liver biopsyA liver biopsy is a test that takes a sample of tissue from the liver for examination.ImageRead Article Now Book Mark Article Treatment LIFESTYLE CHANGESSome things you can do to help take care of your liver disease are: Drink no alcohol. Eat a healthy diet that is low in salt, fat, and simple carbohydrates. Low in saltToo much sodium in your diet can be bad for you. If you have high blood pressure or heart failure, you may be asked to limit the amount of salt (whi...ImageRead Article Now Book Mark Article Get vaccinated for diseases such as influenza, COVID-19, hepatitis A and B, and pneumococcal disease. Talk to your provider about all medicines you take, including herbs and supplements and over-the-counter medicines. Exercise. Control your underlying metabolic problems, such as high blood pressure, diabetes, and high cholesterol.MEDICINES FROM YOUR PROVIDERWater pills (diuretics) to get rid of fluid build-up Vitamin K or blood products to prevent excess bleeding Medicines for mental confusion Antibiotics for infections OTHER TREATMENTSEndoscopic treatments for enlarged veins in the esophagus (varices) Removal of fluid from the abdomen (paracentesis) Placement of a transjugular intrahepatic portosystemic shunt (TIPS) to improve blood flow in the liver Transjugular intrahepatic portosystemic...Transjugular intrahepatic portosystemic shunt (TIPS) is a procedure to create new connections between two blood vessels in your liver. You may need ...ImageRead Article Now Book Mark Article When cirrhosis progresses to end-stage liver disease, a liver transplant may be needed. Support Groups You can often ease the stress of illness by joining a liver disease support group whose members share common experiences and problems.Liver disease support groupThe following organizations are good resources for information on liver disease:American Liver Foundation -- liverfoundation. orgCenters for Disease ...ImageRead Article Now Book Mark Article Outlook (Prognosis) Cirrhosis is caused by scarring of the liver. In most cases, the liver cannot heal or return to normal function once the damage is severe. Cirrhosis can lead to serious complications. Possible Complications Complications may include:Bleeding disorders Buildup of fluid in the abdomen (ascites) and infection of the fluid (spontaneous bacterial peritonitis) Enlarged veins in the esophagus, stomach, or intestines that bleed easily (varices) Increased pressure in the blood vessels of the liver (portal hypertension) HypertensionBlood pressure is a measurement of the force exerted against the walls of your arteries as your heart pumps blood to your body. Hypertension is the ...ImageRead Article Now Book Mark Article Kidney failure (hepatorenal syndrome) Hepatorenal syndromeHepatorenal syndrome is a condition in which there is progressive kidney failure that occurs in a person with cirrhosis of the liver. It is a seriou...Read Article Now Book Mark Article Liver cancer (hepatocellular carcinoma) Hepatocellular carcinomaHepatocellular carcinoma is cancer that starts in the liver.ImageRead Article Now Book Mark Article Mental confusion, change in the level of consciousness, or coma (hepatic encephalopathy) Hepatic encephalopathyLoss of brain function occurs when the liver is unable to remove toxins from the blood. This is called hepatic encephalopathy (HE). This problem ma...Read Article Now Book Mark Article When to Contact a Medical Professional Contact your provider if you develop symptoms of cirrhosis.Get emergency medical help right away if you have:Abdominal or chest pain Abdominal swelling or ascites that is new or suddenly becomes worse A fever (temperature greater than 101°F or 38.3°C) Diarrhea Confusion or a change in alertness, or it gets worse Rectal bleeding, vomiting blood, or blood in the urine Shortness of breath Vomiting more than once a day Yellowing skin or eyes (jaundice) that is new or gets worse quickly Prevention DO NOT drink alcohol. Talk to your provider if you are worried about your drinking. Take steps to prevent getting hepatitis B or C or passing it to other people.Worried about your drinkingMany people with alcohol problems cannot tell when their drinking is a problem or out of control. It is important to be aware of how much you are dr...Read Article Now Book Mark Article Hepatitis B or CHepatitis B and hepatitis C infections cause irritation (inflammation) and swelling of the liver. You should take steps to prevent catching or sprea...Read Article Now Book Mark Article Open ReferencesReferencesGarcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 139.Kamath PS, Shah VH. Overview of cirrhosis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 74.