Untreated
chronic hepatitis damages liver cells over years or even decades, leading the
liver to become scarred and hardened. When this scarring is advanced it is
known as ‘cirrhosis’.
The liver
can continue to carry out its functions despite the scarring for a long time
and can compensate for the damage ('compensated cirrhosis'). Later, however,
the liver becomes restricted in its functions ('decompensated cirrhosis').
Symptoms
of cirrhosis may include:
Glossary
- ascites
An accumulation of fluid in the abdomen; may be caused by liver damage, especially cirrhosis.
- cirrhosis
Scarring of the liver – the structure of the liver is altered. See also
‘fibrosis’, which is moderate scarring. See also ‘compensated cirrhosis’ and
‘decompensated cirrhosis’.
- compensated cirrhosis
The earlier stage of
cirrhosis, during which the liver is damaged but still able to perform most of
its functions. See also ‘cirrhosis’ and ‘decompensated cirrhosis’.
- decompensated cirrhosis
The later stage of
cirrhosis, during which the liver cannot perform some vital functions and
complications occur. See also ‘cirrhosis’ and ‘compensated cirrhosis’.
- encephalopathy
-
A disease or infection affecting the brain.
- oedema
Accumulation
of fluid below the skin or in the cavities of the body.
- varices
Stretched veins which may burst and cause severe bleeding; a complication of cirrhosis.
- Muscle wasting.
- Swollen spleen.
- Ascites: swelling of the
abdomen, caused by the accumulation of fluid. It is treated by reduced
salt intake, controlled fluid intake and diuretics (drugs which promote
urination). If this fails to improve the ascites, fluid may be withdrawn
via paracentesis.1 A device called ALFApump
may reduce ascites by channelling the fluid from the abdomen to the
bladder.
- Oedema: swelling, usually of
the feet, ankles, and lower legs, due to the accumulation of fluid.
- Varices (abnormally
distended blood vessels). Blood vessels around the gullet and stomach
enlarge because the blood is trying to find a way around the scarred
liver. Varices can bleed into the stomach, causing vomiting of blood or
passing of black stools. Burst varices require immediate medical
attention.
- Circulatory changes. The
damaged liver may fail to produce blood-clotting proteins, leading to easy
bruising and prolonged bleeding. Patients may also develop high blood
pressure (portal hypertension) as blood backs up in the scarred liver.
Drugs called beta-blockers may be used to relieve portal hypertension.
- Pruritis (itching). People
with cirrhosis may experience an itching sensation of the skin or internal
organs due to the build-up of bile and other toxic chemicals.
- Encephalopathy. Patients may
experience impaired mental function and personality changes because the
liver is not breaking down waste products such as ammonia in the blood as
efficiently as it should or because blood is bypassing the liver. At its
most severe, this can lead to coma or death. Laxatives (lactulose), ornithin
aspartate or a specific antibiotic (rifaximin) are sometimes used to treat
this.