What is cirrhosis?

Cirrhosis is permanent scarring of the liver caused by many liver diseases and conditions, such as hepatitis and alcohol abuse.

Your liver is a vital organ that has many important functions for keeping your body healthy, including:

• removing toxins from your blood
• storing vitamins, extra glucose and iron
• making and breaking down hormones and proteins

When your liver is permanently damaged, scar tissue replaces healthy tissue. This is cirrhosis. It usually develops slowly over many years and can eventually stop your liver from working properly.

Although there is no cure for cirrhosis, early diagnosis and treatment can stop or delay its progress. This can lower the damage and reduce your chance of developing complications.

If cirrhosis becomes very serious it causes your liver to fail and can be life-threatening.

Aboriginal and/or Torres Strait Islander people have a higher risk of liver disease than non-Indigenous Australians.

What are the symptoms of cirrhosis?

Not everyone has the same symptoms. They can include:

• loss of appetite or weight loss
• weakness
• increased sensitivity to medicines and drugs
• confusion
• drowsiness
• slurred speech

They can also include visible symptoms such as:

• bruising and bleeding easily
• jaundice (yellowing of your skin and whites of your eyes)
• ascites (fluid build-up in your abdomen)
• skin conditions, such as liver spots (also called solar lentigo), spider veins and rashes
• oedema (swelling in legs)
• red palms of your hands

Some of these symptoms can be serious.

What causes cirrhosis?

Anything that damages your liver can cause cirrhosis, but the most common causes are:

• hepatitis B or hepatitis C infections
• drinking too much alcohol over many years (chronic alcohol dependence)
• being overweight or having too much fat in the liver (fatty liver), which is linked to obesity and diabetes

Less common causes of cirrhosis are:

• autoimmune liver disease, such as primary biliary cholangitis (previously known as primary biliary cirrhosis)
• inherited liver diseases, such as haemochromatosis

When should I see my doctor?

It’s important to speak to your doctor if you are experiencing symptoms of cirrhosis, especially if you have risk factors for liver problems.

When to seek urgent care

If your doctor has diagnosed you with cirrhosis, seek urgent medical attention if you experience:

• new or worsening jaundice (yellowing of your skin or the whites of your eyes)
• blood in your stools, or stools that are black and tar-like
• fresh blood in your vomit, or vomit that looks like ‘coffee grounds’
• confusion
• fever

Watch this video called Your Healthcare Team, from the Liver Foundation.

How is cirrhosis diagnosed?

If your doctor suspects you have cirrhosis, they will ask about your symptoms, examine you and refer you for tests.

Tests that help to diagnose cirrhosis include:

• blood tests, including liver function tests
• urine (wee) tests
• imaging tests, including ultrasound, CT scans or MRI scans
• liver biopsy (taking a small piece of tissue from your liver to be tested)

How is cirrhosis treated?

Treatment depends on the cause and stage of your cirrhosis.

Your doctor may advise that you:

• stop drinking alcohol permanently
• lose weight, if you are overweight
• maintain a healthy diet
• stay physically active
• take medicines prescribed to treat any underlying causes (such as hepatitis C, autoimmune disease, inherited liver disease)

Support groups like Alcoholics Anonymous Australia and Alcohol and Drug Foundation are available to help you reduce or stop drinking.

Very advanced cirrhosis can cause the liver to fail. In this case, a liver transplant is the only treatment option.

Can cirrhosis be prevented?

To help reduce your chance of developing liver diseases including cirrhosis:

• eat a balanced diet
• take care with how much alcohol you drink, and know your limit
• exercise regularly

You can reduce the risk of fatty liver by:

• exercising regularly
• eating healthily
• losing weight

Hepatitis infections can increase your chance of developing liver problems. You can reduce your chance of catching hepatitis by:

• getting vaccinated against hepatitis B
• practising safe sex
• use safe needle practices (for example, don’t share needles)

Lower your chance of getting infections by washing your hands properly and making sure your vaccinations are up to date.

Before using any over-the-counter medicines, talk to your doctor or pharmacist and let them know you have liver disease.

What are the complications of cirrhosis?

Without treatment, cirrhosis of the liver can lead to serious and life-threatening problems including:

• primary liver cancer — hepatocellular carcinoma is the most common type of cancer caused by cirrhosis
• liver failure
• fluid build-up in the abdomen, which can become infected
• osteoporosis (brittle bones)
• encephalopathy — which can cause changes in mood and behaviour, confusion or coma

Resources and support

For more information and support about cirrhosis, try these resources:

• Hepatitis Australia provides a fact sheet about cirrhosis. Call the National Hepatitis Infoline: 1800 437 222 (1800 HEP ABC) for confidential, free access to hepatitis information and support.
• The Liver Foundation provides a wide range of resources and support related to liver health and practical tips for living well with liver disease. Call the Liver Foundation's free support line on 1800 841 118 to speak to a liver nurse.

You can also call the healthdirect helpline on 1800 022 222 (known as NURSE-ON-CALL in Victoria). A registered nurse is available to speak with you 24 hours a day, 7 days a week.

Languages other than English

Health Translations has resources about liver health and liver disease available in multiple languages.

Information for Aboriginal and/or Torres Strait Islander peoples

LiverWELL works with Aboriginal and Torres Strait Islander Communities to improve access to support services for testing and treatment. Call the LiverLine on 1800 703 003.