What Are the First Signs of Cirrhosis?

Medically Reviewed on 3/1/2022
First Signs of Cirrhosis
Here are ten early signs of liver cirrhosis, as well as other symptoms that may manifest as the condition worsens.

In the early stages, there are usually no symptoms. Despite being damaged, the liver can operate normally in the early stages. However, when the liver's function severely deteriorates or the triggering factor is not stopped, you may notice symptoms.

10 early signs and symptoms of liver cirrhosis

  1. Tiredness and weakness
  2. Fluid builds up in the legs and abdomen (swelling)
  3. Loss of appetite
  4. Feeling sick (nausea) and being sick (vomiting)
  5. Diarrhea
  6. Weight loss (although you may put on weight if you retain a lot of fluid)
  7. Visible spider-like blood vessels on the skin
  8. Sleep disturbances
  9. Getting sick often
  10. Redness in the palms of the hands

As the condition worsens, you may present with the following symptoms:

A dull discomfort in the upper right abdomen may be felt in the early stages. As the illness worsens, the pain becomes more intense. It progresses from mild to painful and stabbing under the ribcage followed by abdominal edema and spleen enlargement.

9 causes of liver cirrhosis

Cirrhosis of the liver can be caused by a variety of diseases and ailments. It manifests itself gradually and eventually leads to liver failure if not effectively managed.

  1. Long-term hepatitis infections (chronic):
    • Cirrhosis can develop as a result of a chronic liver infection that damages liver cells over time.
    • Cirrhosis is typically caused by hepatitis B and C virus infection.
  2. Chronic alcoholism:
    • Alcohol consumption promotes inflammation in liver cells, effectively poisoning them, resulting in scar tissue buildup in the liver.
    • Cirrhosis is caused by excessive alcohol consumption (typically over a decade).
    • The severity of the damage varies with people and is determined by familial susceptibility.
  3. Nonalcoholic fatty liver (or steatohepatitis): Cirrhosis can develop as a result of fat buildup in the liver over time. Scar tissue that develops due to various illnesses, such as:
  4. Toxic substances or medications: Some drugs, poisons, and environmental contaminants that are toxic to the liver can cause scarring and damage.
  5. Inherited (genetic) disorders: Genetic disorders can sometimes interfere with the liver's metabolism and its ability to handle iron (hemochromatosis) and copper (Wilson's disease) accumulation in the system.
  6. Autoimmune liver disease:
    • Autoimmune infections arise when the body's immune system, instead of attacking invasive organisms, such as bacteria, allergens, and viruses, attacks healthy tissues in the body, including organs (in this case, the liver).
    • Autoimmune hepatitis is one example of a condition in which the body's immune reaction malfunctions and attacks the liver's natural system, causing cell damage rather than battling an infection.
  7. Cardiac cirrhosis:
    • The inability of the heart to adequately pump blood can cause blood to accumulate in the liver.
    • This prolonged, passive congestion produces liver cell destruction, edema, and pain.
    • Infection of the heart muscle or the sac around the heart, heart valve failure, and smoking are factors that contribute to cardiac cirrhosis.
  8. Biliary cirrhosis: Bile is a substance produced by the liver that aids in the digestion of lipids. The bile ducts, which help to remove bile, can be affected by the listed illnesses. This can result in a buildup of bile and eventually inhibit liver function.
  9. Injury: Cirrhosis of the liver is a dangerous disorder in which scar tissue replaces healthy tissue due to long-term injury to the liver.
    • Scarring develops on the liver as a result of ongoing injury from (most commonly):
    • Scar tissue replaces healthy cells, so the liver's ability to function declines with time.
      • Fails to control the amount of fluid in the bloodstream and body
      • Fails to prepare enough substances to aid in blood clotting
      • As a result of the processing of waste chemicals, medicines, poisons and other compounds may fail, these may accumulate in the body

Your liver may eventually cease to function, which can be deadly.

Alcohol is a primary contributor to avoidable cirrhosis, with 5 to 15 percent of heavy drinkers acquiring it. Women who drink heavily appear to be more susceptible to cirrhosis than men.


Long-term heavy alcohol consumption can cause: See Answer

What are the treatment options for cirrhosis?

The initial step to treat cirrhosis is to avoid and treat the cause that is leading to liver damage. The overall goal of treatments is to halt the progression of the disease and prevent liver failure.

  • Weight loss is extremely important.
  • If autoimmune hepatitis is the root cause of liver damage, treatment of hepatitis would be the choice.
  • The treatment for alcohol-related liver damage would begin with abstaining from alcohol.
  • To treat nonalcoholic fatty liver, metabolic risk factors, such as obesity, medication history, or diabetes would be treated.
  • The treatment for hemochromatosis would attempt to reduce the systemic amount of iron in the blood.

In addition to any drug used to treat the underlying cause of cirrhosis, certain medications may be used to treat the complications that can arise as a result of it.

  • Lactulose may be recommended for patients with hepatic encephalopathy, which helps reduce the brain edema that may be caused by liver failure.
  • To treat ascites or the accumulation of fluid in the abdomen, diuretics or water pills may be prescribed.
  • Antibiotics are sometimes used to prevent or cure infections.
  • Blood pressure medications can help lower pressure in the portal vein, which transports blood to the liver. Lowering the pressure in the portal vein can reduce the risk of internal bleeding and spleen damage.
  • Itching caused by cirrhosis may be relieved with drugs prescribed by the doctor.

Liver transplantation

  • When treatment no longer effectively controls the problems of cirrhosis, a liver transplant may be considered.
  • A liver transplant is a major surgical procedure in which a diseased liver is replaced with a whole, healthy liver from a deceased donor or a portion of a healthy liver from a living donor.

As previously said, the treatment for liver cirrhosis will be determined by the cause of the liver damage. One of the most effective things you can do to treat many liver problems is to change your food and lifestyle.

  • Nutrition, along with exercise, is one of the most significant elements in liver health. 
  • You should avoid smoking and drinking alcohol because both are extremely detrimental to your liver.
  • If the liver injury has resulted in scarring, this will be a lifetime condition that cannot be corrected.

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Medically Reviewed on 3/1/2022
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National Institutes of Health. Symptoms & Causes of Cirrhosis. https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis/symptoms-causes

Cleveland Clinic. Cirrhosis of the Liver. https://my.clevelandclinic.org/health/diseases/15572-cirrhosis-of-the-liver

Stanford Health Care. Cirrhosis Symptoms. https://stanfordhealthcare.org/medical-conditions/liver-kidneys-and-urinary-system/chronic-liver-disease/symptoms.html

Chopra S. Patient education: Cirrhosis (Beyond the Basics). UpToDate. https://www.uptodate.com/contents/cirrhosis-beyond-the-basics

The National Digestive Diseases Information Clearinghouse. Cirrhosis of the Liver. https://www.mirecc.va.gov/cih-visn2/Documents/Provider_Education_Handouts/Cirrhosis_Information_Sheet_for_BHPs_Version_3.pdf