Symptoms & Causes of Cirrhosis

What are the symptoms of cirrhosis?

You may have no symptoms in the earliest stage of cirrhosis. Symptoms of cirrhosis may not appear until the liver is badly damaged.

Early symptoms of cirrhosis may include

• feeling tired or weak
• itching of the skin
• poor appetite
• losing weight without trying
• nausea and vomiting
• mild pain or discomfort over the liver in the upper right side of the abdomen, or belly
• muscle loss and weakness
• muscle cramps
• sexual problems

As liver function gets worse, people with cirrhosis may have other symptoms, including

• bruising and bleeding easily
• confusion, difficulty thinking, memory loss, personality changes, or sleep disorders
• internal bleeding due to the bursting of enlarged veins—called varices—in the esophagus, stomach, or intestines
• swelling in the lower legs, ankles, or feet, called edema
• swelling of the abdomen from a buildup of fluid, called ascites
• severe itchy skin
• darkening of the color of the urine
• yellowish tint to the whites of the eyes and skin, called jaundice

What causes cirrhosis?

Cirrhosis has different causes. Some people with cirrhosis have more than one cause of liver damage. For some people, the cause of cirrhosis is not known.

Most common causes

The most common causes of cirrhosis are

• alcohol-associated liver disease, which is damage to the liver and its function from drinking too much alcohol
• buildup of fat in the liver, called nonalcoholic fatty liver disease, which is more common in people with overweight, obesity, or other diseases or health conditions such as metabolic syndrome or type 2 diabetes
• long-term, or chronic, infection with the hepatitis C or hepatitis B viruses

These health conditions don’t affect every person in the same way. Some people with these health conditions may have more liver damage than others. Research suggests that certain inherited genes affect how much these conditions damage the liver.

Less common causes

Some less common causes of cirrhosis include

• autoimmune hepatitis, a disease in which the immune system attacks the liver
• diseases that damage, destroy, or block bile ducts, such as primary biliary cholangitis and primary sclerosing cholangitis
• inherited liver diseases—diseases passed from parents to children through genes that affect how the liver works—such as Wilson disease, hemochromatosis, and alpha-1 antitrypsin deficiency
• long-term use of certain medicines and high doses of vitamin A daily
• chronic heart failure with liver congestion, a condition in which blood flow out of the liver is slowed