Cirrhosis
What is Cirrhosis?
Cirrhosis is a late stage of liver scarring caused by long-term damage to this vital organ. When your liver gets injured repeatedly over months or years, it tries to repair itself by forming scar tissue. Over time, this scar tissue replaces healthy liver tissue and makes it harder for your liver to work properly. Think of it like a road with too many patches, eventually it becomes too damaged to drive on smoothly.
Your liver performs over 500 essential jobs in your body. It filters toxins from your blood, makes proteins that help your blood clot, stores energy, and produces bile to help digest food. When cirrhosis develops, these functions slowly break down. The condition develops gradually, often over 10 to 20 years, and early stages may cause no symptoms at all.
Once cirrhosis develops, the damage cannot be reversed. However, catching liver damage early through blood testing can help you stop progression and prevent serious complications. The goal is to identify liver problems before they advance to cirrhosis, when treatment options are more effective.
Symptoms
- Fatigue and weakness that does not improve with rest
- Easy bruising or bleeding that takes longer to stop
- Yellowing of the skin and eyes, called jaundice
- Itchy skin that may feel worse at night
- Swelling in the legs, ankles, or feet
- Fluid buildup in the abdomen, called ascites
- Loss of appetite and unintended weight loss
- Nausea or vomiting
- Confusion, difficulty thinking, or memory problems
- Spider-like blood vessels visible on the skin
- Redness in the palms of the hands
Many people with early cirrhosis have no symptoms at all. The liver can continue functioning even when significantly damaged. Symptoms often appear only when cirrhosis becomes advanced, which is why regular blood testing is so important for people at risk.
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Causes and risk factors
Cirrhosis develops when the liver gets damaged repeatedly over time. The most common causes include long-term alcohol use, chronic hepatitis C infection, and fatty liver disease. Alcohol damages liver cells directly, while hepatitis C causes ongoing inflammation. Fatty liver disease, which affects about 25% of adults, occurs when too much fat builds up in liver cells. This can happen even in people who drink little or no alcohol.
Other risk factors include hepatitis B infection, autoimmune liver diseases, inherited conditions like hemochromatosis or Wilson disease, and long-term use of certain medications. Obesity, type 2 diabetes, and metabolic syndrome significantly increase your risk of developing fatty liver disease and cirrhosis. Some people develop cirrhosis from multiple causes working together, such as having fatty liver disease while also drinking alcohol regularly.
How it's diagnosed
Cirrhosis is diagnosed through a combination of medical history, physical examination, blood tests, and imaging. Blood tests are essential because they can detect liver damage before symptoms appear. Key blood markers include liver enzymes like ALT and GGT, which rise when liver cells are damaged. Bilirubin levels increase when the liver cannot process this waste product properly. AFP, or alpha fetoprotein, may be elevated in cirrhosis and is also monitored to screen for liver cancer.
Rite Aid offers testing for liver health markers that can help detect cirrhosis early. Our annual blood panel includes over 200 biomarkers and tests liver function through multiple measurements. If blood tests suggest cirrhosis, your doctor may order imaging like ultrasound, CT scan, or MRI to examine the liver structure. In some cases, a liver biopsy may be needed to confirm the diagnosis and determine how much scarring exists.
Treatment options
- Stop drinking alcohol completely, even if alcohol was not the original cause
- Lose weight gradually if you have fatty liver disease, aiming for 7 to 10% weight reduction
- Eat a balanced diet rich in fruits, vegetables, whole grains, and lean protein
- Limit sodium intake to reduce fluid retention and swelling
- Get vaccinated for hepatitis A and B to prevent additional liver damage
- Take antiviral medications if you have hepatitis B or C infection
- Use medications to manage complications like fluid buildup, itching, or confusion
- Get regular screening for liver cancer, which occurs more often in people with cirrhosis
- Avoid medications that can harm the liver, including certain pain relievers
- Consider liver transplant evaluation if cirrhosis becomes severe
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- Simple blood draw at your nearest lab
- Results in days, not weeks
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Frequently asked questions
Liver fibrosis is an earlier stage of liver scarring that can still be reversed with treatment. Cirrhosis is advanced, permanent scarring where the liver structure has been significantly changed. While cirrhosis cannot be reversed, treatment can prevent it from getting worse and reduce complications.
Many people with early-stage cirrhosis live for years with good quality of life when they follow treatment plans. This includes stopping alcohol use, managing underlying causes, eating well, and getting regular monitoring. Advanced cirrhosis requires more intensive treatment and may eventually need a liver transplant.
Cirrhosis typically develops over 10 to 20 years of ongoing liver damage. However, the timeline varies based on the cause and individual factors. Heavy alcohol use can cause cirrhosis in as little as 5 years, while fatty liver disease may take decades to progress.
Several blood tests help detect cirrhosis, including liver enzymes like ALT and GGT, bilirubin levels, and alpha fetoprotein. These markers show how well your liver is functioning and whether cells are being damaged. Blood tests also check for hepatitis infections and measure proteins the liver produces.
The scar tissue of cirrhosis itself cannot be reversed. However, stopping the cause of liver damage and making lifestyle changes can prevent cirrhosis from getting worse. In early stages, the liver can still function well enough to support a good quality of life with proper care.
No, cirrhosis has many causes beyond alcohol. Chronic hepatitis C, fatty liver disease, hepatitis B, autoimmune diseases, and inherited conditions can all cause cirrhosis. In fact, fatty liver disease is now becoming the leading cause of cirrhosis in many countries.
Early cirrhosis often has no symptoms, which makes blood testing so important. When symptoms do appear, they may include fatigue, easy bruising, mild abdominal discomfort, or loss of appetite. Regular blood tests can detect liver damage before you feel sick.
If you have risk factors like fatty liver disease, hepatitis, or past heavy alcohol use, get liver blood tests at least once per year. Your doctor may recommend testing every 6 months if you have active liver disease. Early detection allows you to take action before permanent damage occurs.
Yes, people with cirrhosis have a higher risk of developing liver cancer, also called hepatocellular carcinoma. The risk increases with time and severity of cirrhosis. This is why doctors recommend regular screening with blood tests for alpha fetoprotein and imaging for people with cirrhosis.
Untreated cirrhosis can lead to serious complications including liver failure, bleeding from enlarged blood vessels, kidney failure, and confusion from toxins building up in the blood. These complications can be life-threatening. However, treatment and monitoring can prevent or manage many of these problems.