Cirrhosis of the liver occurs when scar tissue replaces normal, healthy tissue. This blocks normal blood flow through the liver which in turn prevents the liver from working as it should.
In the early stages of the disease, many people have no symptoms. Yet, as more and more scar tissue replaces normal, healthy tissue, the liver starts to fail and may cause the following symptoms:
- loss of appetite
- abdominal pain
- weight loss
- spider angiomas (spider-like blood vessels that develop on the skin)
As a vital organ that cleans the blood and makes important proteins, the loss of liver function affects the body in many ways. Here are some common problems, or complications, caused by cirrhosis:
Jaundice is a yellowing of the skin and eyes that is caused by unabsorbed bile products (bilirubin) being deposited in the skin.
Bile products deposited in the skin can cause intense itching.
- Portal hypertension
Blood from the spleen and intestines is carried to the liver through a large blood vessel called the portal vein. Cirrhosis slows the flow of blood through the portal vein causing the pressure inside it to increase. This is called portal hypertension, or high blood pressure of the portal vein.
A varix is an enlarged blood vessel with thin walls. Varices form in veins subjected to but not built to handle prolonged, elevated blood pressure. With cirrhosis, when blood flow through the portal vein slows, "upstream" blood from the intestine and spleen backs up in veins of the stomach and esophagus. Over time, these veins enlarge and become more prone to burst. A rupture of these varices can cause severe bleeding (a serious emergency that requires immediate medical attention).
- Bruising and bleeding
Some of the proteins made by the liver are important clotting factors - that is, they help blood form clots. As the liver loses its ability to make these proteins, a person will bleed or bruise more easily, and for a longer period of time. Signs of this are reddish or blotchy palms, a condition called palmar erythema.
- Edema and ascites
The protein albumin is also made by the liver and important in bodily fluid regulation. As the liver loses its ability to make this protein, water accumulates in the abdomen (ascites) and legs (edema).
Bile is produced in the liver and is important for the digestion of fats. If bile is not transported to the gallbladder due to cirrhosis, gallstones may develop.
- Insulin resistance and diabetes
Insulin is a hormone produced by the pancreas that helps regulate glucose intake (‘blood sugar') by your bodies' cells (all of your cells use glucose for energy). Cirrhosis of the liver can lead to resistance to insulin. Thus, a vicious cycle begins where a rise in blood sugar causes the pancreas to produce more insulin in an attempt to control the elevated glucose levels. This then causes the body to become even more resistant to insulin, and the cycle repeats.
- Sensitivity to medication
Cirrhosis causes one to be more sensitive to certain medications and their side effects. This is because certain drugs are cleared from the system via the liver and a cirrhotic liver filters these medications from the blood more slowly than a healthy liver. Therefore, drugs stay active for longer than expected and build up in the body.
- Liver cancer
Hepatocellular carcinoma is a type of high-mortality cancer that begins in the liver and is commonly caused by cirrhosis.
- Toxins in the blood or brain
Toxins build up in the blood and brain because a cirrhotic liver is ineffective at removing them. When in the brain, toxins can slow mental functioning and cause changes in personality. Eventually, toxins in the brain can cause coma and even death. Signs to watch for include forgetfulness, trouble concentrating, neglect of personal appearance, changes in sleep habits, or unresponsiveness.
- Problems in other organs
Cirrhosis can affect many other organs and parts of the body. It can weaken the immune system and lead to infection. For example, fluid in the abdomen (ascites) may become infected with opportunistic bacteria normally only present in the intestines. Cirrhosis can also lead to kidney dysfunction, kidney failure, impotence, and even osteoporosis.
To learn more about cirrhosis including causes of the disease and how it is diagnosed and treated, click on the links below.