liver cirrhosis

Liver cirrhosis is a term that refers to a group of chronic diseases of the liver in which normal liver cells are damaged and replaced by scar tissue.  When scar tissue develops in the liver, blood is unable to flow properly.

Liver cirrhosis is a serious condition. The liver is a very important part of the digestive system. When the liver doesn’t work properly, it is unable to:

  • Break down and remove drugs, toxins, and waste products made in the body
  • Process bile
  • Produce proteins that help blood clot
  • Produce a protein that helps prevent fluid from leaking out of blood vessels

How much do you have to drink to get cirrhosis of the liver?

It takes a long period (months or years) of steady drinking to develop cirrhosis of the liver.

Can cirrhosis of the liver be reversed?

Unfortunately, no cirrhosis is usually permanent. However, its progress can be slowed by completely abstaining from alcohol, changing your diet to include fresh fruits and vegetables along with whole grains, and carefully checking to make sure any drugs or medications you are taking are not toxic to the liver.

Decompensated liver cirrhosis

Decompensated liver cirrhosis involves the development of jaundice, ascites (swelling in the abdomen), variceal hemorrhage, or hepatic encephalopathy. Unfortunately it is difficult to treat and often results in death. A liver transplant offers the greatest opportunity for survival.


Liver cirrhosis does not develop overnight. It takes several years to develop. While liver cirrhosis is developing, there are usually no symptoms.

Symptoms usually appear when liver cirrhosis is fully developed. The symptoms will depend on how severe liver cirrhosis is.

The most common symptoms are:

  • weakness
  • loss of appetite
  • weight loss
  • dark skin color
  • intense, unexplained itching
  • confusion
  • nose bleeds
  • spider angioma
    • The spider veining on the skin is most common around the nose and cheeks.
  • swelling
    • Feet, ankles, and legs swell because of a buildup of fluid
  • abdominal bloating
    • Caused by a buildup of fluid in the belly
  • breast enlargement in men
  • constipation or diarrhea
  • fever
  • upset stomach
  • enlarged liver
  • red palms, swelling of the abdomen and legs
    • Fluid retention in the legs and abdomen.
      • Swelling occurs because the liver decreases its production of a protein called albumin. When the blood level of albumin decreases, swelling occurs.

Stages of liver cirrhosis

There are 4 main stages of liver cirrhosis. Stage 1 is the earliest and most easy to treat and stage 4 is the most difficult to treat and often ends in death.

  • Stage 1 cirrhosis
    • Stage 1 is characterized by extensive liver scarring. Liver failure has not yet developed and the cirrhosis it is not severe enough to cause swelling of the abdomen
  • Stage 2 cirrhosis
    • Stage 2 cirrhosis is characterized by the development of abnormal, enlarged veins in the esophagus. If not treated properly, there is a high risk of dying in the next 12 months.
  • Stage 3 cirrhosis
    • Stage 3 is characterized by swelling in the abdomen, extreme fatigue, persistent itchiness, and jaundice. An abdominal ultrasound is necessary to confirm. During this stage, scarring is irreversible and a liver transplant is recommended.
  • Stage 4 cirrhosis
    • Stage 4 is characterized by gastrointestinal bleeding. This is usually caused by a ruptured enlarged vein in the esophagus or stomach.


When the liver’s production of bile is compromised, bile can back up into the blood, causing the skin and eyes to turn yellow and the urine to become dark.


The abnormal production of bile causes gallstones to develop.

Blood clotting difficulties

The liver makes certain proteins that help the blood clot. When the proteins aren’t made properly, the blood doesn’t clot properly

Esophageal vein bleeding

Esophageal vein bleeding occurs in advanced cirrhosis.

What causes liver cirrhosis?

There are many causes of liver cirrhosis. The most common causes are:

  • Alcoholic liver disease. To many people, cirrhosis of the liver is synonymous with chronic alcoholism, but in fact, alcoholism is only one of the causes. Alcoholic cirrhosis usually develops after more than a decade of heavy drinking. The amount of alcohol that can injure the liver varies greatly from person to person. In women, as few as two to three drinks per day have been linked with cirrhosis and in men, as few as three to four drinks per day. Alcohol seems to injure the liver by blocking the normal metabolism of protein, fats, and carbohydrates.
  • Chronic hepatitis C (HCV). The hepatitis C virus ranks with alcohol as a major cause of chronic liver disease and cirrhosis in the United States. Infection with this virus causes inflammation of and low grade damage to the liver that over several decades can lead to cirrhosis. About 75 to 80% of people with hepatitis C will develop liver cirrhosis.
  • Chronic hepatitis B and D. The hepatitis B virus is probably the most common cause of cirrhosis worldwide, but it is less common in the United States and the Western world. Hepatitis B, like hepatitis C, causes liver inflammation and injury that over several decades can lead to cirrhosis. Hepatitis D is another virus that infects the liver, but only in people who already have hepatitis B.
  • Autoimmune hepatitis. This disease appears to be caused by the immune system attacking the liver and causing inflammation, damage, and eventually scarring and cirrhosis.
  • Inherited diseases. Alpha-1 antitrypsin deficiency, hemochromatosis, Wilson’s disease, galactosemia, and glycogen storage diseases are among the inherited diseases that interfere with the way the liver produces, processes, and stores enzymes, proteins, metals, and other substances the body needs to function properly.
  • Nonalcoholic steatohepatitis (NASH). In NASH, fat builds up in the liver and eventually causes scar tissue. This type of hepatitis appears to be associated with diabetes, protein malnutrition, obesity, coronary artery disease, and treatment with corticosteroid medications.
  • Blocked bile ducts. When the ducts that carry bile out of the liver are blocked, bile backs up and damages liver tissue. In babies, blocked bile ducts are most commonly caused by biliary atresia, a disease in which the bile ducts are absent or injured. In adults, the most common cause is primary biliary cirrhosis, a disease in which the ducts become inflamed, blocked, and scarred. Secondary biliary cirrhosis can happen after gallbladder surgery if the ducts are inadvertently tied off or injured.
  • Drugs, toxins, and infections. Severe reactions to prescription drugs, prolonged exposure to environmental toxins, the parasitic infection schistosomiasis, and repeated bouts of heart failure with liver congestion can all lead to cirrhosis.

Can Liver Cirrhosis be Treated?

Yes. Liver cirrhosis treatment is focused on the cause. In extreme cases, a liver transplant may be needed.

Complications of Liver Cirrhosis

If complications are present, the most common complications are:

  • impotence in men
  • severe internal bleeding
  • liver cancer
  • blood poisoning

3 thoughts on “Liver cirrhosis: stages of liver cirrhosis and treatment for liver damage”

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