What I need to know about 

Cirrhosis 

NATIONAL INSTITUTES OF HEALTH 

U.S. Department 

of Health and 

Human Services National Digestive Diseases 

Information Clearinghouse

 

What I need to know about 

Cirrhosis 

U.S. Department 

of Health and
�

Human Services
�

NATIONAL INSTITUTES OF HEALTH 

National Digestive Diseases 

Information Clearinghouse

Contents 

What is cirrhosis? .................................................... 1
�

What causes cirrhosis?............................................ 3
�

What are the symptoms of cirrhosis? .................... 4
�

How is cirrhosis diagnosed? ................................... 6
�

How is cirrhosis treated? ........................................ 7
�

What if the cirrhosis treatment doesn’t work? ..... 8
�

How can I prevent cirrhosis if I already 

have liver disease?................................................... 9
�

What can I do to keep cirrhosis from 

getting worse?........................................................ 10
�

Points to Remember ............................................. 11
�

Hope through Research ....................................... 12
�

Pronunciation Guide..............................................13 

For More Information .......................................... 14
�

Acknowledgments ................................................. 15
�

 

 

 

 

 

 

What is cirrhosis? 

Cirrhosis* is scarring of the liver. Scar tissue 

forms because of injury or long-term disease. Scar 

tissue replaces healthy liver tissue and blocks the 

normal flow of blood through the liver. 

A healthy liver 

●	 makes proteins 

●	 helps fight infections 

●	 cleans the blood 

●	 helps digest food 

●	 stores a form of 

sugar that your 

body uses for 

energy Liver 

Cirrhosis is scarring of the liver. 

*See page 13 for tips on how to say the words in 

bold type. 

1 
 

 

 

 

A liver with too much scar tissue cannot work 

properly. You cannot live without a liver that 

works. But early treatment can control symptoms 

and keep cirrhosis from getting worse. 

Normal liver 

Cirrhotic liver 

2 
 

 

 

What causes cirrhosis? 

Causes of cirrhosis include 

●	 heavy alcohol use 

●	 some drugs, medicines, and harmful chemicals 

●	 infections 

●	 chronic hepatitis B, C, or D—viral infections 

that attack the liver 

●	 autoimmune hepatitis, which causes the body’s 

immune system to destroy liver cells 

●	 nonalcoholic fatty liver disease, which is often 

caused by obesity 

●	 diseases that damage or destroy bile ducts–– 

tubes that carry bile from the liver 

Some inherited diseases—diseases that are passed 

from parent to child—can cause cirrhosis: 

●	 hemochromatosis, a disease that causes iron to 

collect in the liver 

●	 Wilson disease, a condition that causes copper to 

build up in the liver 

●	 porphyria, a disorder that affects the skin, bone 

marrow, and liver 

3 
 

 

 

What are the symptoms of cirrhosis? 

You may have no symptoms in the early stages of 

cirrhosis. As cirrhosis gets worse you may 

●	 feel tired or weak 

●	 lose your appetite 

●	 feel sick to your stomach 

●	 lose weight 

●	 notice red, spider-shaped blood vessels under 

your skin 

Cirrhosis can lead to other serious problems: 

●	 You may bruise or bleed easily, or have 

nosebleeds. 

●	 Bloating or swelling may occur as fluid builds 

up in your legs or abdomen—the area between 

your chest and hips. Fluid buildup in your legs is 

called edema; buildup in your abdomen is called 

ascites. 

●	 Medicines, including those you can buy over 

the counter such as vitamins and herbal 

supplements, may have a stronger effect on you. 

Your liver does not break medicines down as 

quickly as a healthy liver would. 

4 
 

 

 

 

●	 Waste materials from food may build up in your 

blood or brain and cause confusion or difficulty 

thinking. 

●	 Blood pressure may increase in the vein 

entering your liver, a condition called portal 

hypertension. 

●	 Enlarged veins, called varices, may develop in 

your esophagus and stomach. Varices can bleed 

suddenly, causing you to throw up blood or pass 

blood in a bowel movement. 

●	 Your kidneys may not work properly or may fail. 

●	 Your skin and the whites of your eyes may turn 

yellow, a condition called jaundice. 

●	 You may develop severe itching. 

●	 You may develop gallstones. 

In the early stages, cirrhosis causes your liver to 

swell. Then, as more scar tissue replaces healthy 

tissue, your liver shrinks. 

A small number of people with cirrhosis also get 

liver cancer. 

5 
 

How is cirrhosis diagnosed? 

Your doctor will examine you and may perform 

●	 blood tests to see whether your liver is working 

properly 

●	 imaging tests, which may show the size of your 

liver and show swelling or shrinkage 

●	 a liver biopsy, in which a doctor uses a needle to 

take a small piece of liver tissue to view with a 

microscope to look for scar tissue 

Liver 

In a liver biopsy, a doctor uses a needle to take a small 

piece of liver tissue to view with a microscope. 

6 
 

 

 

 

 

 

 

How is cirrhosis treated? 

Once you have cirrhosis, nothing can make all the 

scar tissue go away. But treating the cause will 

keep cirrhosis from getting worse. For example, if 

cirrhosis is from heavy alcohol use, the treatment is 

to completely stop drinking alcohol. If cirrhosis is 

caused by hepatitis C, then the hepatitis C virus is 

treated with medicine. 

7 
 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Your doctor will suggest treatment based on the 

cause of your cirrhosis and your symptoms. Being 

diagnosed early and carefully following a treatment 

plan can help many people with cirrhosis. In the 

late stages of cirrhosis, certain treatments may not 

be effective. In that case, your doctor will work 

with you to prevent or manage the problems that 

cirrhosis can cause. 

What if the cirrhosis treatment doesn’t 

work? 

If too much scar tissue forms, your liver could 

fail. Then you will need a liver transplant. A 

liver transplant can return you to good health. 

For information about liver transplantation, 

see the booklet What I need to know about 

Liver Transplantation from the National 

Institute of Diabetes and Digestive and 

Kidney Diseases (NIDDK). 

8 
 

How can I prevent cirrhosis if I 

already have liver disease? 

To prevent cirrhosis, 

●	 see your doctor for treatment of your liver 

disease. Many of the causes of cirrhosis are 

treatable. Early treatment may prevent cirrhosis. 

●	 try to keep your weight in the normal range. 

Being overweight can make several liver diseases 

worse. 

●	 do not drink any alcohol. Alcohol can harm 

liver cells. Drinking large amounts of alcohol 

over many years is one of the major causes of 

cirrhosis. 

●	 do not use illegal drugs, which can increase your 

chances of getting hepatitis B or hepatitis C. 

●	 see your doctor if you have hepatitis. Treatments 

for hepatitis B, C, and D are available. If you 

are on treatment, carefully follow your treatment 

directions. 

●	 if you have autoimmune hepatitis, take 

your medicines and have regular checkups 

as recommended by your doctor or a liver 

specialist. 

9 
 

What can I do to keep cirrhosis from 

getting worse? 

To keep cirrhosis from getting worse, 

●	 do not drink any alcohol. 

●	 talk with your doctor before taking any 

medicines, including those you can buy over 

the counter such as vitamins and herbal 

supplements. Cirrhosis makes your liver 

sensitive to certain medicines. 

●	 get vaccinated against hepatitis A and 

hepatitis B. Although hepatitis A does not 

cause cirrhosis, it can damage your liver. 

●	 ask your doctor about getting a flu shot and 

being vaccinated against pneumonia. 

●	 avoid eating raw oysters or other raw shellfish. 

Raw shellfish can have bacteria that cause severe 

infections in people with cirrhosis. 

10
�
Points to Remember 

● Cirrhosis is scarring of the liver. Scar tissue 

replaces healthy liver tissue. 

● Some common causes of cirrhosis include 

heavy alcohol use, hepatitis infections, and 

nonalcoholic fatty liver disease. 

●	 In the early stages of cirrhosis, you may have no 

symptoms. As the disease gets worse, cirrhosis 

can cause serious problems. 

●	 Once you have cirrhosis, nothing can make 

all the scar tissue go away. But treatment can 

prevent cirrhosis from getting worse. 

●	 If too much scar tissue forms and your liver fails, 

you will need a liver transplant. 

●	 You can take steps to prevent cirrhosis or keep it 

from getting worse. 

11 
 

 

 

 

 

 

 

 

 

Hope through Research 

The NIDDK’s Division of Digestive Diseases and 

Nutrition supports research into liver diseases such 

as cirrhosis. Researchers are studying new ways to 

● prevent cirrhosis 

● prevent and treat symptoms of cirrhosis 

● reverse scarring of the liver 

Participants in clinical trials can play a more 

active role in their own health care, gain access to 

new research treatments before they are widely 

available, and help others by contributing to 

medical research. For information about current 

studies, visit www.ClinicalTrials.gov. 

12
�
 

 

Pronunciation Guide 

abdomen (AB-doh-men)

ascites (uh-SY-teez)

autoimmune (AW-toh-ih-MYOON)

cirrhosis (sur-ROH-siss)

edema (eh-DEE-muh)

esophagus (uh-SOF-uh-guhss)

hemochromatosis
�

(HEE-moh-KROH-muh-TOH-siss) 

hepatitis (HEP-uh-TY-tiss) 

inherited (in-HAIR-it-ed) 

jaundice (JAWN-diss) 

pneumonia (noo-MOH-nyuh) 

porphyria (por-FIHR-ee-uh) 

portal hypertension (POR-tuhl) 

(HY-pur-TEN-shuhn) 

supplements (SUH-pluh-muhnts) 

transplantation (TRANZ-plan-TAY-shuhn) 

vaccinated (VAK-sih-nayt-ed) 

varices (VAIR-ih-seez) 

13 
14 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

For More Information 

American Liver Foundation 

39 Broadway, Suite 2700 

New York, NY 10006 

Phone: 1–800–GO–LIVER (1–800–465–4837), 

1–888–4HEP–USA (1–888–443–7872), 

or 212–668–1000 

Fax: 212–483–8179 

Email: info@liverfoundation.org 

Internet: www.liverfoundation.org 

Hepatitis Foundation International 

504 Blick Drive 

Silver Spring, MD 20904–2901 

Phone: 1–800–891–0707 or 301–622–4200 

Fax: 301–622–4702 

Email: hfi@comcast.net 

Internet: www.hepfi.org 
15 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Acknowledgments 

Publications produced by the Clearinghouse are 

carefully reviewed by both NIDDK scientists and 

outside experts. The National Digestive Diseases 

Information Clearinghouse would like to thank the 

following individuals for assisting with the scientific 

and editorial review of the original version of this 

publication: 

Herbert L. Bonkovsky, M.D. 

University of Connecticut at Hartford 

Michael W. Fried, M.D. 

University of North Carolina at Chapel Hill 

Timothy R. Morgan, M.D. 

VA Medical Center 

Long Beach, CA 

Thank you also to Rebecca McBurney, R.N., and 

Yoon Park, R.N., at the Liver Diseases Branch 

and Clinical Center, National Institutes of Health, 

Bethesda, MD, for facilitating field-testing of the 

original version of this publication. 

 

 

 

 

 

 

 

 

 

 

National Digestive Diseases 

Information Clearinghouse 

2 Information Way 

Bethesda, MD 20892–3570 

Phone: 1–800–891–5389 

TTY: 1–866–569–1162 

Fax: 703–738–4929 

Email: nddic@info.niddk.nih.gov 

Internet: www.digestive.niddk.nih.gov 

The National Digestive Diseases Information Clearinghouse 

(NDDIC) is a service of the National Institute of Diabetes and 

Digestive and Kidney Diseases (NIDDK). The NIDDK is part of 

the National Institutes of Health of the U.S. Department of Health 

and Human Services. Established in 1980, the Clearinghouse 

provides information about digestive diseases to people with 

digestive disorders and to their families, health care professionals, 

and the public. The NDDIC answers inquiries, develops and 

distributes publications, and works closely with professional and 

patient organizations and Government agencies to coordinate 

resources about digestive diseases. 

This publication is not copyrighted. The Clearinghouse 

encourages users of this publication to duplicate and distribute 

as many copies as desired. 

This publication is available at www.digestive.niddk.nih.gov. 

This publication may contain information about medications. 

When prepared, this publication included the most current 

information available. For updates or for questions about any 

medications, contact the U.S. Food and Drug Administration 

toll-free at 1–888–INFO–FDA (1–888–463–6332) or visit 

www.fda.gov. Consult your health care provider for more 

information. 
U.S. DEpArTmENT OF HEALTH 

AND HUmAN SErvICES 

National Institutes of Health 

NIH Publication No. 11–5166

October 2010 

–

The NIDDK prints on recycled paper with bio - -based ink.