Cirrhosis is progressive scarring of the liver caused by injury over a period of time. It can be a consequence of any form of chronic hepatitis, excessive alcohol use, and other less common causes including infections, drug toxins, and inherited diseases. Cirrhosis may also result from nonalcoholic fatty liver disease, which is common in obese people.

The liver is unique in its ability to regenerate in response to injury. However, with repeated injury over time the liver becomes unable to function properly and scarring (or fibrosis) develops. When fibrosis is severe the liver becomes shrunken and nodular, a condition known as cirrhosis of the liver.

As cirrhosis worsens, liver function progressively diminishes and the organ becomes harder and smaller. In the absence of a healthy liver, fluid can accumulate in the abdomen and legs. Bile salts can build up in the skin causing itching and jaundice. Bleeding from large veins in the esophagus and GI tract may occur. Toxins can accumulate in the blood resulting in mental slowing and confusion.

The only treatment for advanced cirrhosis is a liver transplant.

Progression of Disease

Each patient's liver disease develops differently. This means that there is no one pattern of symptoms to anticipate. As the disease progresses, eventually the liver may be unable to perform its many functions adequately. Patients may develop any of the following symptoms:

  • Fatigue
  • Sleep reversal (inability to sleep at night but wanting to sleep all day)
  • Forgetfulness or mental confusion
  • Loss of consciousness (coma)
  • Ascites (fluid in the abdomen)
  • Spontaneous bacterial peritonitis (infection of the ascites)
  • Edema (swelling of the legs)
  • Bleeding gums
  • Vomiting of blood
  • Bleeding from rectum or passing black stools (from internal bleeding)
  • Itching of the skin
  • Enlarged breasts in male patients
  • Jaundice or "liver spots" (spider angiomata, and petechiae)