Cirrhosis living day to day in adults

Overview

Cirrhosis is a condition where the liver becomes scarred and damaged over many years. The scarring stops the liver from working properly, but with care and treatment, its progress can be slowed and symptoms managed.

Cirrhosis is a common liver problem around the world. It affects millions of people, especially in countries where alcohol use or viral hepatitis is widespread.

Cirrhosis mostly affects adults, particularly those who drink a lot of alcohol, are overweight, or have chronic hepatitis B or C. It can also occur due to genetic conditions or autoimmune liver disease.

Symptoms

Common symptoms

• Feeling very tired or weak
• Loss of appetite and weight loss
• Nausea or vomiting
• Swelling in the legs, ankles, or belly (called oedema or ascites)
• Yellowing of the skin or eyes (jaundice)
• Itchy skin
• Easy bruising or bleeding

Symptoms in older adults

• Same symptoms as adults, but older adults may also have confusion or memory problems (hepatic encephalopathy) more often
• Increased risk of falls because of muscle loss and weakness
• More side effects from medicines because the liver processes them slowly

Causes

Main causes

• Long-term heavy alcohol use
• Non-alcoholic fatty liver disease (often related to being overweight, diabetes, or high cholesterol)
• Chronic viral hepatitis (hepatitis B or C)
• Autoimmune hepatitis (the body attacks its own liver cells)
• Genetic diseases such as haemochromatosis or Wilson's disease

Risk factors

• Drinking too much alcohol over many years
• Being overweight or having type 2 diabetes
• Having chronic hepatitis B or C infection
• Having a family history of liver disease
• Taking certain medicines long-term (talk to your doctor about any concerns)

When to see a doctor

See a doctor urgently if:

• If you have any symptoms listed under 'emergency' above, call your local emergency number or go to the nearest accident and emergency (A&E) department.
• New or worsening jaundice, confusion, or bleeding should be checked urgently.

Book a routine appointment if:

• If you have been diagnosed with a condition that can lead to cirrhosis (like fatty liver or hepatitis), see your GP or specialist regularly.
• If you notice new symptoms like fatigue, weight loss, or swelling in your feet, make an appointment to discuss them.
• Even if you feel well, keep up with follow-up appointments to monitor your liver health.

Diagnosis

Doctors use a combination of your medical history, a physical exam, blood tests, and imaging scans to diagnose cirrhosis. Sometimes a small sample of liver tissue (biopsy) is taken to confirm how much scarring there is.

Tests that may be done

• Blood tests to check liver function and look for signs of damage
• Ultrasound, CT scan, or MRI to see the liver and check for swelling or other problems
• Fibroscan – a special ultrasound that measures liver stiffness (a sign of scarring)
• Liver biopsy – a small sample of liver taken with a needle (not always needed)

What to expect at your appointment

If your doctor suspects cirrhosis, they will talk with you about your symptoms and risk factors. You may be referred to a liver specialist (hepatologist). The tests are usually done as an outpatient, and results take a few days to a few weeks.

Treatment

Treatment for cirrhosis focuses on slowing down the liver damage, managing symptoms, and preventing complications. There is no cure, but many treatments can help you feel better and live longer.

Self-care at home

• Stop drinking alcohol completely – this is the most important step for alcohol-related cirrhosis.
• Eat a healthy, balanced diet with less salt to help control swelling.
• Get enough rest and try to stay active within your limits.
• Avoid medicines that can harm the liver, like too much paracetamol or some herbal supplements – always check with your doctor.
• Get vaccinated against hepatitis A and B (and flu and pneumonia) to protect your liver.

Medical treatments

Your doctor may prescribe medicines to reduce fluid buildup, control blood pressure in the liver, or manage itching. For viral hepatitis, antiviral treatments are used. If cirrhosis leads to liver failure, a liver transplant may be an option for some people. All treatments should be discussed with your healthcare team.

When is surgery considered?

Surgery is rarely needed for cirrhosis itself. The main surgical option is a liver transplant, which is considered when the liver fails and other treatments no longer help. Transplant is a major operation and requires careful evaluation.

Living with this condition

Living with cirrhosis means making daily choices that protect your liver. Avoiding alcohol, eating well, staying active, and taking medicines as prescribed are key. You may need to adapt your routine to manage fatigue or other symptoms. Many people learn to listen to their bodies and rest when needed.

Lifestyle tips

• Never drink alcohol – even small amounts can worsen liver damage.
• Eat a diet low in salt and processed foods to reduce fluid buildup.
• Maintain a healthy weight – losing weight can help if fatty liver is a cause.
• Get regular, gentle exercise like walking or swimming, as your energy allows.
• Check with your doctor before taking any over-the-counter medicines, vitamins, or supplements.

Diet and exercise

A balanced diet rich in fruits, vegetables, whole grains, and lean protein is recommended. Limit salt to help control swelling. If you have advanced cirrhosis, a dietitian may advise eating small, frequent meals and possibly adding protein supplements. Moderate exercise, such as walking for 20–30 minutes most days, can improve your energy and mood – but always follow your doctor’s advice.

Mental health and emotional wellbeing

Living with a chronic illness like cirrhosis can be stressful and may cause anxiety or depression. It is normal to feel worried or frustrated at times. Talk to your healthcare team about your feelings – they can refer you to a counsellor, psychologist, or support group. Remember, you are not alone.

Prevention

Cirrhosis can often be prevented by avoiding the things that harm the liver. The main ways are: limit or avoid alcohol, maintain a healthy weight, get vaccinated against hepatitis, and avoid sharing needles or unprotected sex that could spread hepatitis. If you already have a liver condition, careful treatment can stop it from turning into cirrhosis.

Vaccines

The hepatitis B vaccine is recommended for everyone. Ask your doctor if you also need the hepatitis A vaccine or other vaccines like flu and pneumonia to protect your liver.

Screening programmes

If you have risk factors such as heavy drinking, obesity, or a family history of liver disease, talk to your doctor about screening for liver problems. Blood tests and ultrasound can detect early liver damage before it becomes cirrhosis.

Complications

If left untreated

• Ascites – fluid buildup in the belly that can cause discomfort and breathing problems
• Varices – enlarged veins in the oesophagus that can burst and cause life-threatening bleeding
• Hepatic encephalopathy – confusion, drowsiness, and personality changes due to toxins building up in the brain
• Jaundice – yellowing of the skin and eyes, a sign that the liver is failing
• Liver cancer (hepatocellular carcinoma) – a serious but treatable complication if caught early
• Kidney failure or lung problems in advanced stages

Long-term outlook

While cirrhosis is serious, many people live for years with a good quality of life if they follow their treatment plan, avoid alcohol, and stay on top of symptoms. The outlook depends on the cause, how much damage there is, and how well you manage the condition. Your healthcare team will work with you to give you the best possible outcome.

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