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Cirrhosis of the Liver



The American Liver Foundation receives contributions and funding from clinical trial and study sponsors but does not evaluate or endorse any clinical trials or studies, and is not affiliated with any of the sponsors.

  1. Cirrhosis refers to the replacement of normal liver tissue with non-living scar tissue. It is always related to other liver diseases.
  2. The most common causes of Cirrhosis are Hepatitis C, Alcohol-related Liver Disease, Non-Alcoholic Fatty Liver Disease, and Hepatitis B.
  3. Many people with Cirrhosis have no symptoms in the early stages of the disease.
  4. Alcohol remains the second most common cause of liver Cirrhosis after hepatitis C virus.

What is cirrhosis?

Cirrhosis is the scarring of the liver – hard scar tissue replaces soft healthy tissue. It is caused by swelling and inflammation.

As cirrhosis becomes worse, the liver will have less healthy tissue. If cirrhosis is not treated, the liver will fail and will not be able to work well or at all.

What causes cirrhosis?

Cirrhosis is caused by chronic (long-term) liver diseases that damage liver tissue. It can take many years for liver damage to lead to cirrhosis.

Chronic Alcoholism
Chronic alcoholism is one of the leading causes of cirrhosis in the United States. Drinking too much alcohol can cause the liver to swell, which over time can lead to cirrhosis. The amount of alcohol that causes cirrhosis is different for each person.

Chronic Viral Hepatitis
Chronic hepatitis C is the another leading cause of cirrhosis in the United States. Hepatitis C causes the liver to swell, which over time can lead to cirrhosis. About one in four people with chronic hepatitis C develop cirrhosis. Chronic hepatitis B and hepatitis D also can cause cirrhosis.

Nonalcoholic steatohepatitis (NASH)
Fat build up in the liver that is not caused by alcohol use, is called Non-Alcoholic Fatty Liver Disease (NAFLD), which can lead to nonalcoholic steatohepatitis (NASH). NASH can cause the liver to swell and can lead to cirrhosis. People with NASH often have other health issues including diabetes, obesity, high cholesterol, coronary artery disease and poor eating habits.

Bile Duct Disease
Bile duct disease limits or stops bile from flowing to the small intestine. The bile backs up in the liver causing the liver to swell and can lead to cirrhosis. Two common bile duct diseases are primary sclerosing cholangitis and primary biliary cirrhosis.

Genetic diseases
Some genetic diseases can lead to cirrhosis. These diseases include Wilson disease, hemochromatosis, glycogen storage diseases, Alpha-1 antitrypsin deficiency, and autoimmune hepatitis.

What are the symptoms and complications of cirrhosis?

There are usually no symptoms of cirrhosis in its early stage. Over time, cirrhosis may cause symptoms and complications:


  • Loss of appetite
  • Tiredness
  • Nausea
  • Weight loss
  • Abdominal pain
  • Spider-like blood vessels
  • Severe itching


  • Jaundice, a yellow discoloration of the skin and whites of the eyes
  • Bruising and bleeding easily
  • Fluid build up and painful swelling of the legs (edema) and abdomen (ascites)
  • Hepatic Encephalopathy (HE), a buildup of toxins in the brain that causes confusion, as well as both mental and physical complications
  • Liver Cancer

How is cirrhosis diagnosed?

Cirrhosis is diagnosed by symptoms, blood tests, medical history, and physical examination. A liver biopsy may be needed to check how much of the liver has been damaged. During a biopsy, a small piece of liver tissue is removed and studied in the lab, and additional imaging may be needed.

How is cirrhosis treated?

Treatment options for cirrhosis depend on the cause and the level of liver damage. Depending on the disease causing cirrhosis, medications or lifestyle changes may be used for treatment. The goals of treatment are to prevent further liver damage and reduce complications.

When cirrhosis cannot be treated, the condition is known as End-Stage Liver Disease, or ESLD. ESLD includes a subgroup of patients with cirrhosis who have signs of decompensation that is generally irreversible with medical management other than transplant. Decompensation includes hepatic encephalopathy, variceal bleed, kidney impairment, ascites, lung issues. The decompensated liver disease allows these ESLD patients to be prioritized on the transplant list

What’s the best way to manage cirrhosis?

It is possible to prevent further liver damage with proper management of cirrhosis.

  • Maintain a healthy lifestyle (eat a healthy diet and exercise regularly)
  • Limit salt in your diet to prevent or reduce fluid buildup
  • Avoid raw shellfish
  • Stop drinking alcohol
  • Talk to your doctor about all of the medications, vitamins and supplements you take.
  • Talk to your doctor about hepatitis A and hepatitis B vaccinations
  • Practice safe sex
  • Use clean needles for tattoos or piercings
  • Do not share needles, razors, toothbrushes or other personal items with others
  • What is the severity of my cirrhosis? What stage am I in?
  • What is the underlying cause of my cirrhosis?
  • Will I need a liver biopsy?
  • Will I need a liver transplant?
  • What kinds of lifestyle changes should I be making?
  • Will I have routine labs and scans to check my risks of developing liver cancer?
  • Can we review which medications I am prescribed and make sure I am on the appropriate?
Silhouette Woman

Becky B.

Liver Transplant, NASH

Bob R.

Hepatitis C

Bradley R.

Acute Liver Failure
Brenda Chapman

Brenda C.

Autoimmune Hepatitis/Primary Biliary Cholangitis




Liver Cancer

Charlie R.

Liver Transplant

Christy G.


Improving Cirrhosis Care in the PCP Environment

Date Recorded December 3rd, 2019 at 1pm EST Program Improving Cirrhosis Care in the PCP Environment was a CME provided in the form of a webinar to provide tools that will equip clinicians to provide efficient patient-centered care, even on an interdisciplinary team, to cirrhotic patients and those who are

View a series of helpful cirrhosis training videos for caregivers, friends and family

Healthy and Sick Livers

The Healthy Liver

A healthy liver has the amazing ability to grow back, or regenerate when damaged.


When treated successfully at this stage, there’s a chance your liver can heal itself.

Liver Cancer

Cirrhosis and hepatitis B are leading risk factors for primary liver cancer.

Liver Transplant

Removal of unhealthy liver and replace with a whole or portion of a healthy liver.

There are many different types of liver disease. But no matter what type you have, the damage to your liver is likely to progress in a similar way.

Whether your liver is infected with a virus, injured by chemicals, or under attack from your own immune system, the basic danger is the same – that your liver will become so damaged that it can no longer work to keep you alive.

Cirrhosis, liver cancer, and liver failure are serious conditions that can threaten your life. Once you have reached these stages of liver disease, your treatment options may be very limited.

That’s why it’s important to catch liver disease early, in the inflammation and fibrosis stages. If you are treated successfully at these stages, your liver may have a chance to heal itself and recover.

Talk to your doctor about liver disease. Find out if you are at risk or if you should undergo any tests or vaccinations.

Clinical trials are research studies that test how well new medical approaches work in people. Before an experimental treatment can be tested on human subjects in a clinical trial, it must have shown benefit in laboratory testing or animal research studies. The most promising treatments are then moved into clinical trials, with the goal of identifying new ways to safely and effectively prevent, screen for, diagnose, or treat a disease.

Speak with your doctor about the ongoing progress and results of these trials to get the most up-to-date information on new treatments. Participating in a clinical trial is a great way to contribute to curing, preventing and treating liver disease and its complications.

Start your search here to find clinical trials that need people like you.

Last Updated on March 30, 2022


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