15572 Cirrhosis Of The Liver

Overview

Cirrhosis is a condition where the liver becomes scarred and damaged over time. The liver is one of the largest organs in your body. It helps filter your blood, fight infections, and process nutrients from food. When scar tissue builds up, it can block blood flow through the liver and make it harder for the liver to do its job.

Cirrhosis is becoming more common around the world, including in the UK. It is often linked to long-term liver damage caused by alcohol, hepatitis, or fat building up in the liver.

Cirrhosis can affect people of all ages, but it is most common in men and in people over 50. You are more likely to have it if you drink heavily, have had viral hepatitis B or C, have diabetes, or are obese.

Symptoms

Common symptoms

• Feeling very tired or weak
• Loss of appetite and weight loss
• Feeling or being sick
• Mild pain or discomfort in the upper right side of your belly
• Itchy skin
• Red palms or small spider-like blood vessels on the skin
• Swelling in the legs, ankles, or belly

Symptoms in children

• Very rare, but possible if a child has an inherited liver disease
• Yellowing of the skin or eyes (jaundice)
• Failure to grow or gain weight as expected
• Belly swelling or a constant tummy ache

Symptoms in older adults

• Symptoms can be vague and easily mistaken for aging
• Falls or unsteadiness
• Confusion or feeling very drowsy
• General weakness and fatigue
• Swelling in the belly or legs

Causes

Main causes

• Excessive alcohol consumption over many years
• Long-term infection with hepatitis B or hepatitis C virus
• Non-alcoholic fatty liver disease (fat build-up in the liver, often linked to obesity and diabetes)
• Autoimmune hepatitis, where the body attacks its own liver cells
• Inherited conditions such as hemochromatosis (too much iron in the body)
• Prolonged blockage of the bile ducts

Risk factors

• Heavy drinking or a long history of alcohol use
• Obesity or excess weight
• Type 2 diabetes or high blood fats
• A history of viral hepatitis or jaundice
• Family history of liver disease
• Certain medicines or herbal supplements that can harm the liver over time

When to see a doctor

See a doctor urgently if:

• If you have any of the emergency symptoms listed above
• If you start to vomit blood or have black stools
• If you feel confused, very drowsy, or cannot stay awake

Book a routine appointment if:

• If you have ongoing tiredness, nausea, or weight loss without a reason
• If you notice yellowing of your skin or eyes
• If you have a swollen belly or swollen legs
• If you have risk factors for liver disease and have never been tested

Diagnosis

Doctors usually diagnose cirrhosis after taking a detailed medical history, doing a physical exam, and arranging blood tests and scans. The diagnosis is based on finding scarring in the liver and signs that the liver isn't working as well as it should.

Tests that may be done

• Blood tests to check how well your liver is working
• An ultrasound scan of your belly
• A special type of ultrasound called elastography, which measures liver stiffness
• A CT scan or MRI scan for more detail
• A liver biopsy (a small sample of liver tissue is taken to confirm the damage)

What to expect at your appointment

Your doctor will ask about your symptoms, alcohol use, medical history, and family history. They may order several tests, and it can take a few weeks to get all the results. If cirrhosis is found, you will usually be referred to a liver specialist for ongoing care.

Treatment

There is no cure for cirrhosis, but treatment can slow the damage, manage symptoms, and prevent complications. The main goal is to treat the underlying cause, whether that means stopping alcohol, treating hepatitis, or working on weight and blood sugar control.

Self-care at home

• Stop drinking alcohol completely — even small amounts can be harmful
• Keep a healthy weight and be active in ways that suit you
• Eat a balanced diet and limit salt to reduce fluid build-up
• Ask your pharmacist or doctor before taking any over-the-counter medicines or supplements
• Make sure your doctor knows about every medicine you take

Medical treatments

Depending on the cause, your doctor may offer medicines to manage the underlying condition, such as antiviral treatment for hepatitis, or medicines to support liver function and reduce symptoms. You may also receive vitamin supplements, nutritional support, or treatments to reduce fluid build-up. You will likely be under the care of a liver specialist, and regular check-ups will be arranged.

When is surgery considered?

A liver transplant may be considered if the liver becomes severely damaged and other treatments are no longer enough. This is a major operation where the damaged liver is replaced with a healthy liver from a donor.

Living with this condition

Living with cirrhosis means adjusting to a daily routine that supports your liver. You may need to plan for regular medical appointments, take care with food and rest, and learn to notice early warning signs. It helps to pace yourself and save energy for the things that matter most.

Lifestyle tips

• Stay completely away from alcohol
• Do not smoke
• Keep up to date with recommended vaccines, including for flu and pneumonia
• Avoid medicines that can be hard on the liver, such as some painkillers — always check with your care team
• Weigh yourself regularly to spot sudden fluid build-up

Diet and exercise

Eat a healthy, balanced diet with plenty of vegetables, whole grains, and lean protein. Reduce salt to help prevent fluid retention. Your doctor or a dietitian can create a eating plan that fits you. Gentle exercise, like walking, swimming, or light stretching, can boost your energy and mood — start slowly and build up as you feel able.

Mental health and emotional wellbeing

Living with a chronic condition like cirrhosis can be stressful and may cause anxiety, low mood, or feelings of isolation. It is important to talk about how you feel. A mental health professional, a counsellor, or simply sharing with family and friends can make a big difference.

Prevention

Many cases of cirrhosis can be prevented. The most important steps are to limit or avoid alcohol, protect yourself from hepatitis, keep a healthy weight, and manage conditions like diabetes. If you already have liver damage, the same steps can stop it from getting worse.

Vaccines

Vaccines for hepatitis A and hepatitis B are available and can protect your liver from further harm. Ask your doctor or local health service whether you should have these vaccines.

Screening programmes

If you have a condition that puts you at higher risk, such as chronic hepatitis or fatty liver disease, your doctor may recommend regular blood tests and scans to check your liver health. Regular monitoring helps catch problems early.

Complications

If left untreated

• Fluid build-up in the belly, called ascites
• Internal bleeding from swollen veins in the food pipe or stomach
• Confusion and memory problems caused by toxins reaching the brain
• Serious infections
• Liver cancer

Long-term outlook

Cirrhosis is a serious condition, but it is not a sudden end. With good medical care, many people live active and meaningful lives for years. Treating the cause, staying healthy, and following your care plan can slow the disease and reduce complications. If the liver fails, a transplant offers real hope. Your healthcare team will support you at every step.

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