Cirrhosis is irreversible scarring of the liver, occurring in the late stages of various liver disorders. In cirrhosis, normal liver tissue is destroyed and replaced by fibrous scar tissue. Long-term excessive alcohol consumption is a risk factor.

Cirrhosis may be caused by several different disorders, including viral infections and excessive alcohol consumption. The liver damage is irreversible and prevents the liver from functioning properly. Some people with cirrhosis may feel well for years despite having severe liver damage. However, with time they may develop complications, such as liver failure and liver cancer.

In developed countries, cirrhosis is the third most common cause of death in people aged 45-65, after coronary artery disease and cancer. In the UK, chronic liver disease and cirrhosis are responsible for about 2,500 deaths each year. Cirrhosis is much more common in men than in women.

Causes of Cirrhosis

There are various causes of cirrhosis.

  • Worldwide, the most common cause is infection with a hepatitis virus, particularly the hepatitis B and C viruses.
  • However, in developed countries cirrhosis is most frequently caused by excessive alcohol consumption.
  • Cirrhosis may also be caused by sclerosing cholangitis, a condition in which the bile ducts inside the liver become inflamed. The cause of this condition is not known although it can be associated with some inflammatory
    bowel diseases, such as ulcerative colitis and Crohn’s disease.
  • Cirrhosis may develop as a result of a blockage of the bile ducts by gallstones.
  • Cirrhosis may follow bile duct surgery.

Symptoms of Cirrhosis

Cirrhosis often produces no symptoms and is only detected during a routine examination for another condition.

If there are symptoms, they include:

  • poor appetite and weight loss
  • nausea
  • yellowing of the skin and the whites of the eyes (jaundice).

Complications

In the long term, life-threatening complications may arise.

  • Cirrhosis can lead to high blood pressure in veins in the oesophagus, which causes them to be fragile and to bleed easily.
  • Malnutrition may also develop from being unable to absorb fats and certain vitamins.
  • Eventually, cirrhosis can lead to liver cancer or liver failure. The symptoms of liver failure include a swollen, fluid-filled abdomen and visible spider-like blood vessels in the skin, known as spider naevi.
  • A failing liver may also result in abnormal bleeding and easy bruising. This occurs as a result of reduced production of essential blood clotting factors in the liver.

Measures of Cirrhosis

  • If your doctor suspects that you have cirrhosis from your symptoms, blood samples will be taken to assess liver function and look for hepatitis viruses.
  • You may also have ultrasound scanning, computerized tomography (CT) scanning or magnetic resonance imaging (MRI) to assess the liver.
  • To confirm the diagnosis, you may have a liver biopsy, in which a small sample of tissue is removed from your liver for microscopic examination.
  • Damage to the liver caused by cirrhosis is always irreversible. However, if the underlying cause can be treated further deterioration may be prevented.

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