Cirrhosis
Cirrhosis is a condition where healthy liver tissue is gradually replaced by scar tissue, affecting how the liver works. It can result from long-term liver damage caused by conditions such as chronic alcohol use, viral hepatitis, or fatty liver disease. Early stages may have few symptoms, but as the scarring progresses, it can lead to fatigue, fluid buildup, and other complications. With medical management and lifestyle changes, further liver damage can often be slowed.
Overview | Symptoms & Causes | Diagnosis | Treatment Options
The Liver
The liver is a large organ located in the upper right part of the abdomen. It performs many important functions that keep the body healthy:
- Storing energy: The liver stores glucose from food as glycogen. When your body needs energy, the liver releases glucose back into the blood. It also stores iron and vitamins.
- Processing substances: The liver helps remove or break down alcohol, medicines, and other substances from the body.
- Making proteins: The liver produces proteins that are essential for blood to clot properly.
- Producing fats: It makes cholesterol, which the body needs, although too much can be harmful.
- Digesting fat: The liver produces bile, a fluid that helps break down fats in food so they can be absorbed in the intestines.
Cirrhosis is a progressive condition in which healthy liver cells are gradually replaced by scar tissue, a process known as fibrosis. As scar tissue builds up, the liver becomes stiff and less able to function properly. This impaired function can affect digestion, metabolism, and the body’s ability to clear toxins. Over time, cirrhosis can lead to complications such as fluid buildup in the abdomen (ascites), swelling in the legs, portal hypertension (increased blood pressure in the liver’s veins), and a higher risk of liver cancer.
Understanding Cirrhosis
Cirrhosis often develops slowly, so early stages may cause few or no noticeable symptoms. As the liver becomes more scarred and its function declines, symptoms may appear, including:
- Fatigue or feeling unusually tired
- Weakness or loss of appetite
- Nausea or weight loss
- Abdominal discomfort, particularly in the upper right side
- Swelling in the legs, ankles, or abdomen due to fluid retention
- Jaundice (yellowing of the skin and eyes)
- Itchy skin
- Easy bruising or bleeding
Some people may also notice darker urine, pale stools, or confusion and memory problems, which can indicate toxins building up in the bloodstream due to reduced liver function.
Even if symptoms are mild, cirrhosis can progress silently, so early detection is important.
Causes & Risk Factors
Cirrhosis occurs when the liver is repeatedly damaged over time, leading to scarring and reduced function. Common causes include:
| Chronic alcohol use | Long-term excessive drinking is a major cause of liver damage. |
| Chronic viral hepatitis | Hepatitis B and C infections can cause ongoing liver inflammation. |
| Non-alcoholic fatty liver disease (NAFLD) | Fat buildup in the liver, often linked to obesity, diabetes, or high cholesterol. |
| Autoimmune liver disease | Conditions where the immune system attacks the liver, such as autoimmune hepatitis or primary biliary cholangitis. |
| Genetic or metabolic conditions | Disorders like haemochromatosis (iron overload) or Wilson’s disease (copper buildup). |
| Medications or toxins | Long-term use of certain drugs or exposure to industrial chemicals. |
Even without obvious risk factors, repeated liver injury can silently lead to cirrhosis, which is why monitoring liver health is important.
Diagnosing Cirrhosis
Diagnosing cirrhosis involves a combination of medical history, physical examination, blood tests, and imaging.
A clinician will ask about symptoms (fatigue, jaundice, abdominal swelling) and risk factors, and examine for signs such as an enlarged liver, fluid in the abdomen, or spider veins.
| Blood tests | Liver function tests check how well the liver is working and can reveal patterns of liver injury. Additional tests may assess clotting ability, protein levels, and screen for underlying causes like viral hepatitis or autoimmune liver disease. |
| Ultrasound | This is often the first imaging test used to assess the liver. It can show changes in liver size and texture, detect scarring, nodules, or fluid in the abdomen, and help monitor for complications such as portal hypertension. |
| FibroScan® or elastography | A non-invasive scan that estimates the amount of scarring (fibrosis) in the liver. |
| MRI or CT scan | CT and MRI scans provide more detailed pictures of the liver and surrounding structures. They can help characterise any suspicious nodules, assess the extent of scarring, and evaluate complications that may not be fully visible on ultrasound. |
| Liver biopsy (if needed) | In certain cases, a small tissue sample may be taken to confirm the extent of scarring or determine the cause of liver disease. |
Treatment Options
Cirrhosis cannot be reversed, but with the right care, its progression can be slowed and complications managed. Treatment usually depends on the underlying cause of liver damage, the stage of cirrhosis, and the symptoms present.
| Addressing the underlying cause | Treating the condition that led to cirrhosis, such as stopping alcohol, managing viral hepatitis, or controlling metabolic conditions, can slow progression. |
| Medications | Drugs may be used to manage symptoms, prevent complications, or reduce liver inflammation. Examples include diuretics for fluid retention, beta-blockers to reduce portal hypertension, and antivirals for hepatitis. |
| Lifestyle measures | Maintaining a balanced diet, avoiding alcohol, staying active, and monitoring weight can support liver health and overall wellbeing. |
| Monitoring & follow-up | Regular blood tests, imaging, and clinical assessments help track liver function, detect complications early, and adjust treatment as needed. |
| Procedures for complications | Interventions may be required for ascites, varices, or other complications, sometimes including endoscopic or radiological procedures. |
| Specialist care | In advanced cases, referral to a hepatologist or liver transplant centre may be necessary for further management or evaluation for transplantation. |
Your healthcare team will work with you to tailor treatment and monitoring to your individual needs, helping to manage symptoms, prevent complications, and support your overall liver health.
How can Lanthorn help?
Liver Ultrasound - £300
A non-invasive scan to assess liver size, texture, and the presence of scarring or nodules. It can help detect complications such as fluid buildup or changes suggestive of cirrhosis progression.
Blood Tests - From £99
Routine liver function and other blood tests help assess liver health, detect early signs of inflammation or damage, and guide further investigation.
Additional imaging - From £450
Offers detailed views of liver structure, blood vessels, and surrounding organs. These scans are used when more precise information is needed or to investigate complications.
