The liver is a vital organ that performs many important functions. Cirrhosis is permanent scarring of the liver caused by a range of liver diseases and conditions, such as hepatitis and alcohol abuse. Although incurable, early diagnosis and treatment can stop or delay its progress, minimise damage and reduce complications

What is cirrhosis?

Cirrhosis develops when the liver is permanently damaged and scar tissue replaces healthy tissue. It develops over many years, eventually preventing the liver from working properly.

If cirrhosis becomes so serious it causes the liver to fail, it can be life-threatening.

What are the symptoms of cirrhosis?

Symptoms come on gradually as the liver loses its ability to work properly. Not everyone experiences the same symptoms. They can include:

• loss of appetite, weight loss and weakness
• bruising and bleeding easily
• increased sensitivity to medicines and other drugs
• yellowing of skin and whites of eyes (jaundice)
• fluid build-up in abdomen (ascites)
• skin conditions, such as liver spots (solar lentigo), spider veins and rashes
• swelling in legs (oedema)
• confusion, drowsiness and slurred speech
• red palms of the hands

Some of these symptoms can be serious. It is important to speak to your doctor if you are experiencing symptoms of cirrhosis.

What causes cirrhosis?

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

• long-term hepatitis B and hepatitis C infection
• drinking too much alcohol over many years (chronic alcohol abuse)
• build-up of excess fat in the liver (fatty liver), which is associated with obesity and diabetes

Other causes include:

• autoimmune liver disease, such as primary biliary cholangitis (previously known as primary biliary cirrhosis), in which the bile ducts in the liver are slowly destroyed
• inherited liver diseases (such as haemochromatosis, a condition where iron builds up in the liver)

How is cirrhosis diagnosed?

If your doctor suspects you have cirrhosis, they will talk to you about your health and examine you, and order some tests.

Tests that help to diagnose cirrhosis include:

• blood tests, including liver function tests
• urine tests
• imaging tests, including ultrasound, CT scan or MRI scan
• liver biopsy (taking a small piece of tissue from the liver so that it can be tested)

How is cirrhosis treated?

Cirrhosis has no cure. However, it is possible to manage the symptoms and any complications, and slow its progression.

Your doctor may recommend that you:

• stop drinking alcohol for good (support groups can help for example Alcoholics Anonymous Australia and DrinkWise Australia)
• lose weight (healthy diet and exercise)
• taking prescription medicines to treat any underlying causes (such as hepatitis C, autoimmune disease, inherited liver disease)

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

If you have liver cirrhosis, it’s important to avoid drinking alcohol to prevent further liver damage. Cut down on salt and make sure you eat plenty of fresh fruit and vegetables as well as lean protein. It’s a good idea to eat protein-filled meals and snacks often — every 3 or 4 hours.

Make sure you avoid infections by washing your hands regularly and getting up to date on your vaccinations. Talk to your doctor or pharmacist before you use over-the-counter medications.

Can cirrhosis be prevented?

To help prevent cirrhosis, limit alcohol consumption to no more than the daily recommend amounts, and immunise against hepatitis B infection. Practise safe sex and use safe needle practices (i.e. no sharing) to prevent hepatitis infection.

Losing weight, having a healthy diet and regular physical activity can prevent fatty liver.

What are the complications of cirrhosis?

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

• primary liver cancer — the most common type of cancer that cirrhosis causes is hepatocellular carcinoma
• increased fluid retention in the stomach (ascites)
• liver failure
• infection of fluid in the abdominal cavity
• osteoporosis (brittle bones)
• encephalopathy, which can cause changes in mood and behaviour, confusion or coma

Resources and support

For more information and support, try these resources:

• Hepatitis Australia has a resource about cirrhosis and a hotline: 1800 437 222.
• The Liver Foundation has information about liver diseases.