What Is Cirrhosis of the Liver? A Guide to Its Causes, Symptoms, and Treatments

Your liver is responsible for many functions in the body — from manufacturing glucose to clearing toxins. When liver cells become injured, as with long-term alcohol use, the body creates inflammation to try to fix the problem. The longer the inflammation continues, the more likely scar tissue will develop. And this permanent scarring of the liver is called cirrhosis. 

Read on to learn more about liver cirrhosis and what you can do to recognize and prevent it.

What are some of the common causes of cirrhosis?

Several different things cause liver inflammation and increase the risk of liver cirrhosis. The most common causes include: 

• Long-term alcohol use: The liver processes alcohol, and even small amounts of alcohol can cause liver damage.  

• Non-alcoholic fatty liver disease (NAFLD): In this condition, excess fat builds up in the liver. People who have Type 2 diabetes and obesity are at a high risk for developing NAFLD.

• Hepatitis B and C: These viral infections cause inflammation in the liver and can lead to cirrhosis or liver cancer.

Other causes of liver cirrhosis include:

• Drug-induced liver injury caused by certain medications, like methotrexate and amiodarone 

• Some genetic conditions, like as Alpha 1 antitrypsin deficiency, hemochromatosis, Wilson’s disease, and cystic fibrosis

• Autoimmune hepatitis, a condition in which your body’s immune system attacks liver cells

• Congestive heart failure, which occurs when your heart loses its ability to pump enough blood to meet your body’s needs

• Primary sclerosing cholangitis, an autoimmune disease that causes inflammation and scarring of the bile ducts in the liver

What are the symptoms of liver cirrhosis? 

In the earlier stages of liver cirrhosis, you may experience no symptoms at all. As the disease progresses, though, you may feel:

• Pain in the upper-right side of the abdomen

• Fatigue

• Nausea and vomiting 

During the later stages of cirrhosis, you may experience other symptoms, such as:

• Yellowing in the white part of the eye (scleral icterus)

• Yellowing of the skin (jaundice)

• Itching     

• Easy bruising

• Easy bleeding

• Internal bleeding from varices, or enlarged vessels in the esophagus or stomach that form by blood being pushed back from the liver 

• Swelling of the legs (edema) and abdomen (ascites)

• Hepatic encephalopathy, in which mental confusion is caused by the liver not being able to clear toxins from the blood 

How is liver cirrhosis diagnosed?

Damage to your liver is assessed by different tests, which include:

• Liver function tests: These tests check for inflammation and damage to the liver.

• Basic metabolic panel: This panel checks electrolytes and kidney function, since liver failure can also affect kidney function.

• Blood tests: These tests look for hepatitis B and C. 

• Imaging tests: These tests of your abdomen, like a CT scan or MRI, help determine the extent of damage to the liver and assess fluid collections or swelling in the abdomen.

• A liver biopsy: This is where a small sample of your liver is looked at under a microscope to determine the extent of cell damage.

What are the stages of liver cirrhosis?

Typically, during stages of early liver damage there are no symptoms, and the liver still functions relatively well. These are called compensated stages. Decompensated stages occur as there is more liver damage and other signs of liver failure.

The chart below shows the different stages of liver cirrhosis:

What are the treatments for liver cirrhosis?

Since liver scarring can’t be reversed, treatments for liver cirrhosis focus on the different issues you may experience, such as:

• Fluid build-up: Swelling in your legs and abdomen can be treated with a water pill (diuretic) and a low salt diet.

• Portal hypertension: A TIPS (transjugular intrahepatic portosystemic shunt) procedure relieves increased blood pressure in the liver and reduces the risk of bleeding varices.

• Liver failure: If treatments are not working and your liver no longer functions, you may need a liver transplant.

Treatments for underlying causes of cirrhosis

You may need additional treatments if your liver cirrhosis is due to certain conditions. For example, if your liver cirrhosis was caused by hepatitis B or C, then you may be prescribed antiviral drugs. Or if you have primary sclerosing cholangitis, you may be prescribed medications like actigall (Ursodiol) and obeticholic acid. 

Preventing further liver damage 

If you have liver cirrhosis, the following are ways you can preserve remaining liver function and prevent further damage to you liver:

• Stop all alcohol consumption. If you have issues with alcohol dependence you may need rehabilitation. 

• Stop any medications that can cause liver damage.

• Get vaccinated against hepatitis A and hepatitis B to decrease your risk of developing these infections that affect the liver. There is no vaccine for hepatitis C.

How can you prevent liver cirrhosis?

Did you know that you can help prevent some of the causes of liver damage that may lead to cirrhosis? Tips include: 

• Avoid excess alcohol use. As mentioned earlier, long-term alcohol use is one of the most common causes of liver cirrhosis.

• Eat a healthy diet to prevent fat build-up in your liver. Limiting the amounts of fried foods, saturated fats, trans fats, and processed sugar can be part of a wholesome diet that is good for your overall health.

• Exercise can also prevent fat build-up in the liver. Both diet and exercise prevent obesity and Type 2 diabetes. These conditions increase the risk of non-alcoholic fatty liver disease.  

• Avoid IV drug use and sharing needles with others. These measures prevent hepatitis B and C infections.

• Use protection during sex. This can prevent hepatitis B and C infections.

• Get vaccinated against hepatitis B. Do this if you are at high risk for hepatitis.

Why trust our experts?

Written by:

David L. Miller, DO, FACOI

David L. Miller, DO, FACOI, is a retired internal medicine physician with over 20 years of clinical experience. He attended the University of New England College of Osteopathic Medicine and completed his residency in Detroit at the Henry Ford/Horizon Health System.

Edited by:

Patricia Pinto-Garcia, MD, MPH

Patricia Pinto-Garcia, MD, MPH, is a medical editor at GoodRx. She is a licensed, board-certified pediatrician with more than a decade of experience in academic medicine.

Reviewed by:

Aunna Pourang, MD

Aunna Pourang, MD, graduated from the University of Florida College of Medicine’s Medical Honors Program and is board-certified in family medicine (Mayo Clinic). She is also fellowship-trained in integrative medicine (Academy of Integrative Health and Medicine).

Our editorial standards

Meet our experts