Find information on thousands of medical conditions and prescription drugs.

Liver cirrhosis

Cirrhosis is a chronic disease of the liver in which liver tissue is replaced by connective tissue, resulting in the loss of liver function. Cirrhosis is caused by damage from toxins (including alcohol), metabolic problems, chronic viral hepatitis or other causes. Cirrhosis is sometimes referred to by its obsolete eponym Laennec's cirrhosis after René Laënnec. Cirrhosis is irreversible but treatment of the causative disease will slow or even halt the damage. more...

Amyotrophic lateral...
Bardet-Biedl syndrome
Lafora disease
Landau-Kleffner syndrome
Langer-Giedion syndrome
Laryngeal papillomatosis
Lassa fever
LCHAD deficiency
Leber optic atrophy
Ledderhose disease
Legg-Calvé-Perthes syndrome
Legionnaire's disease
Lemierre's syndrome
Lennox-Gastaut syndrome
Lesch-Nyhan syndrome
Leukocyte adhesion...
Li-Fraumeni syndrome
Lichen planus
Limb-girdle muscular...
Lipoid congenital adrenal...
Lissencephaly syndrome...
Liver cirrhosis
Lobster hand
Locked-In syndrome
Long QT Syndrome
Long QT syndrome type 1
Long QT syndrome type 2
Long QT syndrome type 3
Lung cancer
Lupus erythematosus
Lyell's syndrome
Lyme disease
Lysinuric protein...

Cirrhosis may refer to chronic interstitial inflammation of any tissue, but is rarely used for other diseases than cirrhosis of the liver.


Initial symptoms

Early symptoms include red palms, spider angioma (red spots on the upper body), hypertrophy of the parotid glands, and fibrosis of tendons in the hands. Clubbing may develop.

Many people with cirrhosis have no symptoms in the early stages of the disease. However, as scar tissue replaces healthy cells, liver function starts to fail and a person may experience the following symptoms:

  • exhaustion
  • fatigue
  • loss of appetite
  • nausea
  • weakness
  • weight loss
  • abdominal pain


As the disease progresses, complications may develop. In some people, these may be the first signs of the disease.

  • Bruising and bleeding due to decreased production of coagulation factors.
  • Jaundice due to decreased processing of bilirubin.
  • Itching due to bile products deposited in the skin.
  • Hepatic encephalopathy - the liver does not clear ammonia and related nitrogenous substances from the blood, which affect cerebral functioning: neglect of personal appearance, unresponsiveness, forgetfulness, trouble concentrating, or changes in sleep habits.
  • Sensitivity to medication due to decreased metabolism of the active compounds.
  • Hepatocellular carcinoma is primary liver cancer, commonly caused by cirrhosis. It has a high mortality rate.
  • Portal hypertension - blood normally carried from the intestines and spleen through the portal vein flows more slowly and the pressure increases; this leads to the following complications:
    • Ascites - fluid leaks through the vasculature into the abdominal cavity.
    • Esophageal varices - collateral portal blood flow through vessels in the stomach and esophagus. These blood vessels may become enlarged and are more likely to burst.
  • Problems in other organs. Cirrhosis can cause immune system dysfunction, leading to infection. Fluid in the abdomen (ascites) may become infected with bacteria normally present in the intestines (spontaneous bacterial peritonitis). Cirrhosis can also lead to impotence, kidney dysfunction and renal failure (hepatorenal syndrome) and osteoporosis.


Cirrhosis has many possible causes; sometimes more than one cause are present in the same patient. In the Western World, chronic alcoholism and hepatitis C are the most common causes.

  • Alcoholic liver disease (ALD). Alcoholic cirrhosis develops after more than a decade of heavy drinking in 15% of all alcoholics. There is great variability in the amount of alcohol needed to cause cirrhosis (3-4 drinks a day in some men and 2-3 in some women). Alcohol seems to injure the liver by blocking the normal metabolism of protein, fats, and carbohydrates.
  • Chronic hepatitis B (with or without D agent). The hepatitis B virus is probably the most common cause of cirrhosis worldwide, especially South-East Asia, but it is less common in the United States and the Western world. Hepatitis B causes liver inflammation and injury that over several decades can lead to cirrhosis. Hepatitis D is dependant on the presence of hepatitis B, but accelerates cirrhosis in co-infection.
  • Chronic hepatitis C. The hepatitis C virus ranks with alcohol as a major cause of chronic liver disease and cirrhosis. Infection with this virus causes inflammation of and low grade damage to the liver that over several decades can lead to cirrhosis.
  • Autoimmune hepatitis. This disease is caused by the immune system attacking the liver and causing inflammation, damage, and eventually scarring and cirrhosis.
  • Inherited diseases. These interfere with the way the liver produces, processes, and stores enzymes, proteins, metals, and other substances the body needs to function properly.
    • Alpha 1-antitrypsin deficiency
    • Hemochromatosis (iron accumulation)
    • Wilson's disease (copper accumulation)
    • Galactosemia
    • Glycogen storage diseases
    • Cystic fibrosis
  • Non-alcoholic steatohepatitis (NASH). In NASH, fat builds up in the liver and eventually causes scar tissue. This type of hepatitis appears to be associated with diabetes, protein malnutrition, obesity, coronary artery disease, and treatment with corticosteroid medications.
  • Diseases that lead to chronic obstruction of the bile ducts. Accumulated bile damages liver tissue:
    • In babies, blocked bile ducts are most commonly caused by biliary atresia, a disease in which the bile ducts are absent or injured.
    • In adults, the most common cause is primary biliary cirrhosis, a disease in which the ducts become inflamed, blocked, and scarred.
    • Secondary biliary cirrhosis can happen after gallbladder surgery if the ducts are inadvertently tied off or injured.
  • Drugs or toxins, including chronic use of acetaminophen.
  • Repeated bouts of heart failure with liver congestion.
  • Certain parasitic infections (like schistosomiasis).
  • "Cardiac cirrosis" (ICD-10 K76.1) is not a true cirrosis. It is more accurately referenced as "congestive hepatopathy", but the old name is still commonly used.


[List your site here Free!]

Nutritional assessment and liver cirrhosis - Liver Disease - Brief Article
From Nutrition Research Newsletter, 11/1/01

Malnutrition is a risk factor in patients with chronic liver disease. Poor nutritional status also increases perioperative mortality and morbidity during transplantation and abdominal surgery. However, the prevalence of protein-calorie malnutrition (PCM) in this population has varied between 10 percent and 100 percent in different studies. Only one present study has defined the prevalence and characteristics of malnutrition and its relationship with nutritional status and the severity of liver disease. Therefore, the goals of the present study were to determine the prevalence of PCM characteristics, and clinical importance of nutrition disorders in patients with liver cirrhosis according to the severity of the disease.

Sixty Thai patients with cirrhosis, who attended an out-patient clinic in Bangkok, Thailand, were included in this study. Child-Pugh criteria were used to establish the severity of liver disease. Nutritional assessments, including a 24-hour recall, were performed on all subjects by an experienced nutritionist. Skinfold thicknesses and immunocompetency (through normal or abnormal response to skin tests) were also recorded. Blood was collected to test for liver and renal function, prealbumin, and thiamine and riboflavin levels.

In terms of energy malnutrition, 13.3 percent of patients had ideal body weights below 90 percent and 11.7 percent had body mass indexes below 18.5 kg/sq m. Protein malnutrition (seen by low albumin stores) and immunoincompetence were found much more frequently than energy malnutrition, 45 percent and 22 percent, respectively. The origin of liver disease was alcohol related in 50 percent of patients. Most cases of nonalcoholic cirrhosis were caused by viral hepatitis. Fat mass in the alcoholic group was significantly lower than in the nonalcoholic group. There were fixe patients with thiamin deficiency, three were in the alcoholic group, and 13 patients with riboflavin deficiency, seven of those being in the alcoholic group. Serum protein directly correlated with the degree of liver-function impairment, but immunologic tests correlated inversely in cirrhosis patients.

The results showed that protein-energy malnutrition is a common complication of liver cirrhosis and that nutritional disorders are related to the degree of liver injury. The authors also acknowledge that the prevalence of PCM might be underestimated in this study. When body weight and BMI are used, these measures tend to be overestimated in cirrhotic patients because of fluid overload. This would then cause the prevalence of PCM to be underestimated. It is also clear from this study that the nutritional disorders were more severe with alcoholic cirrhosis than with nonalcoholic liver disease. This data is important so that medical professionals treating these patients have a better understanding of the characteristics of the disorder.

Chulaporn Roongpisuthipong, Aphasnee Sobhonslidsuk, Kanokrat Nantiruj, and Sriwatana Songchitsomboon. Nutritional assessment in various stages of liver cirrhosis. Nutrition 17: 761-765 (September 2001) [Correspondence to: Chulaporn Roongpisuthipong, MD, Department of Medicine, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Rama VI Road, Bangkok 10400, Thailand. E-mail:]

COPYRIGHT 2001 Frost & Sullivan
COPYRIGHT 2002 Gale Group

Return to Liver cirrhosis
Home Contact Resources Exchange Links ebay