Cirrhosis

Many people who have cirrhosis do not have symptoms, especially early on.

Early symptoms of cirrhosis may include:

• feeling tired or unwell all the time
• loss of appetite or losing weight without trying
• feeling or being sick
• tummy pain
• visible blood vessels on the skin
• blotchy red palms of the hands – the redness may be harder to see on brown or black skin

As cirrhosis gets worse, you may have other symptoms including:

• bleeding or bruising easily
• itchy skin
• changes to your fingers, such as them getting wider and curved (clubbed), or white nails
• yellow skin and whites of the eyes (jaundice) – yellowing of the skin may be harder to see on brown or black skin
• swollen tummy, legs, ankles or feet
• trembling hands
• slurred speech
• feeling confused or difficulty concentrating
• vomiting blood
• very dark or black poo

Men may also have bigger breasts than usual (gynaecomastia) or their testicles may get smaller.

Cirrhosis is caused by long-term damage to your liver.

You may be more likely to have cirrhosis if you:

• regularly drink a lot of alcohol (over 50 units of alcohol a week if you're a man and over 35 units a week if you're a woman)
• have hepatitis B or hepatitis C
• live with obesity
• have type 2 diabetes
• have non-alcoholic fatty liver disease (NAFLD)
• have an autoimmune liver condition, such as autoimmune hepatitis, primary biliary cholangitis or primary sclerosing cholangitis
• have a genetic condition, such as haemochromatosis, Wilson's disease, alpha-1 antitrypsin deficiency or cystic fibrosis

• you think you might have cirrhosis

How serious cirrhosis is depends on things like what's causing it and how early it's diagnosed and treated.

Many people with cirrhosis can feel well and live for many years. But it can cause complications which can be serious or life-threatening.

Complications include:

• not getting enough nutrients (malnutrition)
• weakened and fragile bones (osteoporosis)
• infections, such as urinary tract infections (UTIs) and pneumonia
• sepsis
• jaundice
• a condition that causes fluid to build up in the tummy (called ascites)
• changes in the brain that can cause problems like confusion
• internal bleeding
• liver failure
• a blood clot in the blood vessel that brings blood to the liver
• liver cancer

Cirrhosis cannot be cured, but there are treatments that can help slow it down or stop it getting worse.

This usually involves treating the cause, for example, antiviral medicines if it's caused by hepatitis B or C.

You usually also have treatment to help prevent and treat complications of cirrhosis. This may include:

• laxative medicine to help remove toxins from your body
• medicines such as beta blockers to reduce bleeding
• medicine to make you pee more and help reduce swelling
• antibiotics to help treat or prevent infections and treat internal bleeding
• treatment for weakened bones
• a liver transplant, if your cirrhosis is very severe

It's also strongly recommended to make healthy lifestyle changes, including to stop drinking alcohol.

You'll be supported by different healthcare professionals. This may include a liver specialist (hepatologist), digestive system specialist (gastroenterologist), nutrition specialists (nutritionist or dietician), and alcohol support services.

There are some things you can do that may help stop your cirrhosis getting worse and help you to stay healthy.

• have a healthy, balanced diet

• exercise regularly

• try to keep to a healthy weight

• check with a pharmacist or doctor before taking any medicines, including herbal medicines – they may not be suitable if you have cirrhosis

• stay up to date with vaccinations, such as the flu vaccine and pneumococcal vaccine

• do not drink alcohol

• do not smoke

If you have cirrhosis, you will be supported by a group of specialists.

There are also national charities that offer support and information about cirrhosis.

Liver UK

Liver UK provides information and support for anyone affected by liver disease.

• Website: www.liveruk.org
• Helpline: 0800 652 7330 (open Monday to Friday, 9am to 3pm)
• Support groups (Liver UK)
• Online community (Liver UK)

Symptoms of cirrhosis include loss of appetite, losing weight, feeling or being sick, tummy pain, bleeding or bruising easily and itchy skin.

You may be more likely to have cirrhosis if you regularly drink a lot of alcohol, have hepatitis B or C, live with obesity or have type 2 diabetes.

Treatments for cirrhosis include medicines, such as laxatives, beta blockers or diuretics. If cirrhosis is severe, you may need a liver transplant.

If you have cirrhosis, try to have a healthy diet, exercise regularly and keep to a healthy weight. Do not drink alcohol or smoke.