The liver is also where most drugs and toxins, including alcohol, are metabolized. Cirrhosis results from damage to liver cells from toxins, inflammation, metabolic derangements and other causes. Liver cells regenerate in an abnormal pattern primarily forming nodules that are surrounded by fibrous tissue. Grossly abnormal liver architecture eventually ensues that can lead to decreased blood flow to and through the liver. Decreased blood flow to the liver and blood back up in the portal vein and portal circulation leads to some of the serious complications of cirrhosis.
Blood can back up in the spleen causing it to enlarge and sequester blood cells.
Most often, the platelet count falls because of splenic sequestration leading to abnormal bleeding. Gastric and esophageal varices can rupture, bleed massively and even cause death. Decreased bilirubin secretion from hepatocytes in cirrhosis leads to the back up of bilirubin in the blood. This leads to jaundice, the yellow discoloration of the skin and eyes. As the water-soluble form of bilirubin also backs up in the blood, bilirubin can also spill into the urine giving it a bright yellow to dark brown color.