Cirrhosis Symptoms

In its early stages, cirrhosis may have no identifiable symptoms, a state known medically as compensated cirrhosis. As the disease progresses, however, the cirrhosis sufferer may experience a variety of symptoms and health complications.

Common early symptoms include fatigue, nausea, weakness, constipation, diarrhea, indigestion, weight loss and a loss of appetite. These symptoms are very general, and can be attributed to a range of disorders and diseases.

As the disease progresses, symptoms become more serious, and point with greater frequency towards a liver disorder. The urine may turn dark yellow or brown, stools may be bloody or black and the patient might experience vague abdominal pain.

The patient might also develop jaundice, a yellowish tinge to the skin and the whites of the eyes. Jaundice occurs when the liver cannot properly process bilirubin, a pigment generated during waste removal. The bilirubin enters the skin, giving it the classic yellowish tinge.

Another sign of advancing cirrhosis is the appearance of vascular spiders: spider-like blood vessels visible across the chest and shoulders. Anyone can develop vascular spiders, but the appearance of multiple spiders is an indicator of possible liver problems.

Cirrhosis Complications

As cirrhosis develops, a number of health complications may come into play. The list below covers some of the more common health concerns. Bear in mind, however, that the liver performs over 500 vital functions, so while this list strives to be as informative as possible, it cannot include every possible complication. The most common complications of the disease include ascites, hepatic encephalopathy and gastrointestinal bleeding.

Ascites and Edema: As the liver loses its ability to produce the water-soluble protein albumin that is an essential component of blood, fluid is lost from the circulatory system into tissues and cavities. Excess fluid in the tissues is called edema, while the accumulation of fluid in the abdominal cavity is called ascites.

Ascites may cause mild discomfort, but most people don’t experience any symptoms. A health hazard can arise if bacteria from the intestines contaminate the retained fluid.

Cancer: Chronic inflammation or scarring of the liver may result in cancer.

Changes in Sex Characteristics: A damaged liver can cause changes to sexual characteristics. Men may notice a loss of chest hair, breast enlargement and testicular shrinkage. Women are more likely to suffer from menstrual irregularities. Both sexes may experience a decreased sex drive.

Coagulation Difficulties: As the liver loses its ability to function, the production of blood clotting proteins drops. This often results in bruising and bleeding more often and more easily than normal.

Gallstones: If cirrhosis prevents bile from draining at a normal rate, gallstones may develop.

Gastrointestinal Bleeding: Gastric and esophageal varices can develop as a result of portal hypertension. These are essentially varicose veins in the stomach and esophagus. Bleeding occurs when these delicate veins rupture.

Hepatic Encephalopathy: As the liver loses its ability to remove harmful substances from the bloodstream, toxins such as ammonia slowly accumulate in the brain, causing a condition known as hepatic encephalopathy. Symptoms of hepatic encephalopathy include confusion, dementia and personality changes. The individual may experience tremors, forgetfulness, slurred speech and a change in sleeping habits. At its most serious, hepatic encephalopathy can cause coma and death.

Itching: If scarring leads to the obstruction of the bile ducts, bile products may begin to enter the skin. This can result in severely dry skin and intense itching.

Portal Hypertension: Portal hypertension is a serious health complication. Blood flows into the liver from the intestines through the portal vein. Damage from cirrhosis slows the flow of blood through this vein, causing a condition known as portal hypertension. Blood pressure in the portal vein rises as the blood flow slows, and the blood flows back into the stomach and esophageal blood vessels.

Since these blood vessels are not designed to move large quantities of blood, they then enlarge, become contorted due to the increase in pressure and the thin walls of the veins, and develop into varices (Latin for “twisted vein”). If varices burst under the pressure, life-threatening bleeding can occur in the esophagus or stomach.

Sensitivity to Medications: The liver plays an important role in removing medication from the bloodstream, and medication is prescribed in dosages that take this into account. If medication isn’t being removed from the body at the proper rate, drugs can build up in the body. As a result, these drugs accumulate faster, remain active for longer periods of time and produce more side effects.

Resources

Alpha-1 Association. (2002). Alpha-1-antitrypsin deficiency: A simplified Description.

American Hemochromatosis Society. (Updated 2002). FAQs about hemochromatosis/iron overload.

Beers, M. H.,