Cirrhosis of the Live

NATIONAL INSTITUTES OF HEALTH 

National Digestive Diseases Information Clearinghouse 

Cirrhosis of the Live

What I need to know a

Cirrhosis of the Liver 

NATIONAL INSTITUTES OF HEALTH 

National Digestive Diseases Information Clearinghouse 
What is cirrhosis of the liver? ....................

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

What causes cirrhosis? ...............................

How is cirrhosis diagnosed? ......................

How is cirrhosis treated? ...........................

How can I prevent cirrhosis if I already ha

liver disease? ...............................................

What can I do to keep cirrhosis from
 

getting worse? .............................................

For More Information................................

Acknowledgments ......................................
Cirrhosis refers to scarring of the liver. S

forms because of injury or long-term dise

replaces healthy tissue. 

Scar tissue cannot do what healthy liver ti

does—make protein, help fight infections

the blood, help digest
 

food, and store energy
 

for when you need it.
 

Scar tissue also blocks
 

the normal flow of blood
 

through the liver. Too
 

much scar tissue means
 

that your liver cannot
 

work properly. To live,
 

you need a liver that
 

works.
 

Cirrhosis can be lifethreatening, but it can 

also be controlled if 

treated early. 

Liver 
You may have no symptoms at all in the e

stages. As cirrhosis progresses you may
 

●	 feel tired or weak 

●	 lose your appetite 

●	 feel sick to your stomach 

●	 lose weight 

Cirrhosis can also lead to other problems

●	 You may bruise or bleed easily, or have 

nosebleeds. 

●	 Bloating or swelling may occur as fluid 

in the abdomen or legs. Fluid build up 

abdomen is called ascites (ah-SI-teez) a

the legs is called edema. 

●	 Medications may have a stronger effect 

because your liver does not break them 

as quickly. 

●	 Waste materials from food may build u

blood or brain and may cause confusion 

difficulty thinking. For example, protei

you eat breaks down into chemicals like 

ammonia. When red blood cells get old

break down and leave a substance calle

bilirubin (bil-ih-ROO-bun). A healthy 

removes these byproducts, but a disease

leaves them in the body. 

2 
●	 Enlarged veins, called varices (VARE-a

may develop in the esophagus and stom

Varices can bleed suddenly, causing vom

blood or passing of blood in a bowel mo

●	 The kidneys may not work properly or 

As cirrhosis progresses, your skin and the 

your eyes may turn yellow, a condition ca

jaundice (JON-diss). You may also devel

itching or gallstones. 

In the early stages, cirrhosis causes your l

swell. Then, as more scar tissue replaces 

tissue, the liver shrinks. 

About 5 percent of patients with cirrhosis 

cancer of the liver. 

What causes cirrhosis? 

Cirrhosis has many causes, including 

●	 alcohol abuse (alcoholic liver disease) 

●	 chronic viral hepatitis (hepatitis B, C, o

●	 autoimmune hepatitis, which is destruc

liver cells by the body’s immune system 

●	 nonalcoholic fatty liver disease or nona

steatohepatitis (NASH), which is fat de

and inflammation in the liver 
●	 blocked bile ducts, the tubes that carry 

from the liver 

●	 some inherited diseases such as 

• hemochromatosis (HEE-moh-KROH

TOH-sus), a disease that occurs when 

body absorbs too much iron and stor

excess iron in the liver, pancreas, and 

organs 

• Wilson disease, which is caused by th

of too much copper in the liver 

• protoporphyria (PROH-toh-pour-FE

ee-uh), a disorder that affects the ski

bone marrow, and liver
 

Sometimes the cause of cirrhosis remains 

even after a thorough medical examinatio

How is cirrhosis diagnosed? 

Your symptoms, a physical examination, a

certain tests can help your doctor diagnos

cirrhosis. Some tests are 


●	 Blood tests to see whether your liver is 

properly. Routine blood tests may be n

cirrhosis. However, with advanced cirr

blood tests may reveal abnormal levels 

bilirubin and other substances. 

4 
from sound waves, may show an enlarg

shrunken liver. 

●	 Liver biopsy, an examination of a piece 

liver under a microscope, to look for sc

This is the most accurate way to diagno

cirrhosis. 

Healthy liver 

Diseased liver 

S

Sc

In a liver biopsy, a needle is used to take a small 

liver tissue. That sample is then examined unde

microscope. 
Once you have cirrhosis, nothing can mak

scar tissue go away completely. However

the cause will keep cirrhosis from getting 

For example, if cirrhosis is due to alcohol

disease, the treatment is to completely sto

drinking alcohol. If cirrhosis is caused by 

hepatitis C, then that disease may be trea

with medication. 

Your doctor will suggest treatment based 

cause of your cirrhosis and your symptom

diagnosis and carefully following an appro

treatment plan can help many people with 

cirrhosis. In very advanced cirrhosis, how

certain treatments may not be possible. I

situation, your doctors will work with you 

prevent or manage the complications that 

cirrhosis can cause. 

What if the treatment doesn’t work

If too much scar tissue forms, your liver 

fail. Then you may need to consider a l

transplant. A liver transplant can retur

to good health. For information about 

transplantation, please see the What I n

know about Liver Transplantation bookl

from the National Institute of Diabetes 

Digestive and Kidney Diseases. 

6 
y 

●	 See your doctor for treatment of your l

disease. Many of the causes of cirrhosi

treatable, and early treatment may prev

cirrhosis.
 

●	 Follow a healthy lifestyle, eat a healthy 

and stay active. 

●	 Try to keep your weight in the normal r

Being overweight can make several live

diseases worse. 

●	 Do not drink alcohol. Alcohol can harm 

cells, and chronic alcohol use is one of 

major causes of cirrhosis. 

●	 Stay away from illegal (street) drugs, wh

increase your chances of getting hepatit

hepatitis C. 

●	 See your doctor if you have chronic vira

hepatitis. Effective treatments for both 

B and hepatitis C are available. If you 

treatment, follow your treatment direct

exactly. 

●	 If you have autoimmune hepatitis, take 

medications and have regular check-up

recommended by your doctor or a liver 

specialist (hepatologist). 
gg 

●	 Stop drinking alcohol completely. 

●	 Do not take any medications, including 

you can buy without a prescription such 

vitamins and herbal supplements, witho

discussing them with your doctor. Cirrh

makes your liver sensitive to certain me

●	 Get vaccinated against hepatitis A and 

B. These forms of liver disease are pre

Also, ask your doctor about getting a fl

and being vaccinated against pneumoni

●	 Avoid eating raw oysters or other raw s

Raw shellfish can harbor bacteria (Vibr

vulnificus) that cause severe infections 

people with cirrhosis. 

8 
American Liver Foundation 

75 Maiden Lane, Suite 603 

New York, NY 10038–4810 

24-hour helpline (7 days/week): 1–800–4

or 1–888–443–7872 

Phone: 1–800–676–9340 or 212–668–100

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 301–622–420

Email: hfi@comcast.net 

Internet: www.hepfi.org 
The National Digestive Diseases Informa

Clearinghouse (NDDIC) would like to th

following individuals for assisting with sci

and editorial review of this publication. 

Herbert L. Bonkovsky, M.D.
 

University of Connecticut at Hartford
 

Michael W. Fried, M.D.
 

University of North Carolina at Chapel 

Timothy R. Morgan, M.D.
 

VA Medical Center
 

Long Beach, CA
 

Thanks also to the following individuals fo

facilitating field-testing of this publication

Rebecca McBurney, R.N. 

Yoon Park, R.N. 

Liver Diseases Branch and Clinical Cen

National Institutes of Health 

Bethesda, MD 

10
 
g

2 Information Way 

Bethesda, MD 20892–3570 

Phone: 1–800–891–5389 

Fax: 703–738–4929 

Email: nddic@info.niddk.nih.gov 

Internet: www.digestive.niddk.nih.gov 

The National Digestive Diseases Information Cle

(NDDIC) is a service of the National Institute of 

and Digestive and Kidney Diseases (NIDDK). T

is part of the National Institutes of Health under 

Department of Health and Human Services. Est

in 1980, the Clearinghouse provides information 

digestive diseases to people with digestive disord

their families, health care professionals, and the 

The NDDIC answers inquiries, develops and dist

publications, and works closely with professional 

organizations and Government agencies to coord

resources about digestive diseases. 

Publications produced by the Clearinghouse are c

reviewed by both NIDDK scientists and outside e

This publication is not copyrighted. The Clear

encourages users of this booklet to duplicate a

distribute as many copies as desired. 

This booklet is also available at www.digestive.nid
U.S. DEPARTMENT OF HEALTH 

AND HUMAN SERVICES 

National Institutes of Health 

National Institute of Diabetes and 

Digestive and Kidney Diseases 

NIH Publication No. 06–5166 

October 2005