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What is cirrhosis?
Cirrhosis* is scarring of the liver. Scar tissue forms because of injury or long-term disease. Scar tissue replaces healthy liver tissue and blocks the normal flow of blood through the liver.
A healthy liver
- makes proteins
- helps fight infections
- cleans the blood
- helps digest food
- stores a form of sugar that your body uses for energy
A liver with too much scar tissue cannot work properly. You cannot live without a liver that works. But early treatment can control symptoms and keep cirrhosis from getting worse.
*See the Pronunciation Guide for tips on how to say the words in bold type.
What causes cirrhosis?
Causes of cirrhosis include
- heavy alcohol use
- some drugs, medicines, and harmful chemicals
- chronic hepatitis B, C, or D—viral infections that attack the liver
- autoimmune hepatitis, which causes the body’s immune system to destroy liver cells
- nonalcoholic fatty liver disease, which is often caused by obesity
- diseases that damage or destroy bile ducts—tubes that carry bile from the liver
Some inherited diseases—diseases that are passed from parent to child—can cause cirrhosis:
- hemochromatosis, a disease that causes iron to collect in the liver
- Wilson disease, a condition that causes copper to build up in the liver
- porphyria, a disorder that affects the skin, bone marrow, and liver
What are the symptoms of cirrhosis?
You may have no symptoms in the early stages of cirrhosis. As cirrhosis gets worse you may
- feel tired or weak
- lose your appetite
- feel sick to your stomach
- lose weight
- notice red, spider-shaped blood vessels under your skin
Cirrhosis can lead to other serious problems:
- You may bruise or bleed easily, or have nosebleeds.
- Bloating or swelling may occur as fluid builds up in your legs or abdomen—the area between your chest and hips. Fluid buildup in your legs is called edema; buildup in your abdomen is called ascites.
- Medicines, including those you can buy over the counter such as vitamins and herbal supplements, may have a stronger effect on you. Your liver does not break medicines down as quickly as a healthy liver would.
- Waste materials from food may build up in your blood or brain and cause confusion or difficulty thinking.
- Blood pressure may increase in the vein entering your liver, a condition called portal hypertension.
- Enlarged veins, called varices, may develop in your esophagus and stomach. Varices can bleed suddenly, causing you to throw up blood or pass blood in a bowel movement.
- Your kidneys may not work properly or may fail.
- Your skin and the whites of your eyes may turn yellow, a condition called jaundice.
- You may develop severe itching.
- You may develop gallstones.
In the early stages, cirrhosis causes your liver to swell. Then, as more scar tissue replaces healthy tissue, your liver shrinks.
A small number of people with cirrhosis also get liver cancer.
How is cirrhosis diagnosed?
Your doctor will examine you and may perform
- blood tests to see whether your liver is working properly
- imaging tests, which may show the size of your liver and show swelling or shrinkage
- a liver biopsy, in which a doctor uses a needle to take a small piece of liver tissue to view with a microscope to look for scar tissue
How is cirrhosis treated?
Once you have cirrhosis, nothing can make all the scar tissue go away. But treating the cause will keep cirrhosis from getting worse. For example, if cirrhosis is from heavy alcohol use, the treatment is to completely stop drinking alcohol. If cirrhosis is caused by hepatitis C, then the hepatitis C virus is treated with medicine.
Your doctor will suggest treatment based on the cause of your cirrhosis and your symptoms. Being diagnosed early and carefully following a treatment plan can help many people with cirrhosis. In the late stages of cirrhosis, certain treatments may not be effective. In that case, your doctor will work with you to prevent or manage the problems that cirrhosis can cause.
What if the cirrhosis treatment doesn’t work?
If too much scar tissue forms, your liver could fail. Then you will need a liver transplant. A liver transplant can return you to good health. For information about liver transplantation, see the booklet What I need to know about Liver Transplantation from the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK).
How can I prevent cirrhosis if I already have liver disease?
To prevent cirrhosis,
- see your doctor for treatment of your liver disease. Many of the causes of cirrhosis are treatable. Early treatment may prevent cirrhosis.
- try to keep your weight in the normal range. Being overweight can make several liver diseases worse.
- do not drink any alcohol. Alcohol can harm liver cells. Drinking large amounts of alcohol over many years is one of the major causes of cirrhosis.
- do not use illegal drugs, which can increase your chances of getting hepatitis B or hepatitis C.
- see your doctor if you have hepatitis. Treatments for hepatitis B, C, and D are available. If you are on treatment, carefully follow your treatment directions.
- if you have autoimmune hepatitis, take your medicines and have regular checkups as recommended by your doctor or a liver specialist.
What can I do to keep cirrhosis from getting worse?
To keep cirrhosis from getting worse,
- do not drink any alcohol.
- talk with your doctor before taking any medicines, including those you can buy over the counter such as vitamins and herbal supplements. Cirrhosis makes your liver sensitive to certain medicines.
- get vaccinated against hepatitis A and hepatitis B. Although hepatitis A does not cause cirrhosis, it can damage your liver.
- ask your doctor about getting a flu shot and being vaccinated against pneumonia.
- avoid eating raw oysters or other raw shellfish. Raw shellfish can have bacteria that cause severe infections in people with cirrhosis.
Points to Remember
- Cirrhosis is scarring of the liver. Scar tissue replaces healthy liver tissue.
- Some common causes of cirrhosis include heavy alcohol use, hepatitis infections, and nonalcoholic fatty liver disease.
- In the early stages of cirrhosis, you may have no symptoms. As the disease gets worse, cirrhosis can cause serious problems.
- Once you have cirrhosis, nothing can make all the scar tissue go away. But treatment can prevent cirrhosis from getting worse.
- If too much scar tissue forms and your liver fails, you will need a liver transplant.
- You can take steps to prevent cirrhosis or keep it from getting worse.
The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and other components of the National Institutes of Health (NIH) conduct and support research into many diseases and conditions.
What are clinical trials, and are they right for you?
Clinical trials are part of clinical research and at the heart of all medical advances. Clinical trials look at new ways to prevent, detect, or treat disease. Researchers also use clinical trials to look at other aspects of care, such as improving the quality of life for people with chronic illnesses. Find out if clinical trials are right for you.
What clinical trials are open?
Clinical trials that are currently open and are recruiting can be viewed at www.ClinicalTrials.gov.
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portal hypertension (POR-tuhl) (HY-pur-TEN-shuhn)
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. The NIDDK translates and disseminates research findings through its clearinghouses and education programs to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by the NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank:
Herbert L. Bonkovsky, M.D., University of Connecticut at Hartford; Michael W. Fried, M.D., University of North Carolina at Chapel Hill; Timothy R. Morgan, M.D., VA Medical Center, Long Beach, CA; Rebecca McBurney, R.N., and Yoon Park, R.N., at the Liver Diseases Branch and Clinical Center, National Institutes of Health
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