Cirrhosis of the liver
Cirrhosis is scarring of the liver after long-term damage. Cirrhosis of the liver is often caused by long-term alcohol abuse or hepatitis C infection. Scar tissue replaces healthy liver tissue and stops it from working properly.
The liver is the biggest solid organ in the body and is important for fighting infections and filtering and cleaning blood.
Cirrhosis of the liver causes around 4,000 deaths in the UK each year.
Around 700 people have liver transplants to survive cirrhosis.
What causes cirrhosis of the liver?
As well as hepatitis C and alcohol abuse, cirrhosis can be caused by:
- Non-alcoholic fatty liver disease or NAFLD, associated with obesity and diabetes.
- Chronic viral infections of the liver from other types or hepatitis.
- Blockage of the bile duct, which carries bile formed in the liver to the intestines, where it helps in the digestion of fats. In babies this can be caused by biliary atresia, in which bile ducts are missing or damaged, causing bile to back up in the liver. In adults bile ducts may become inflamed, blocked or scarred, due to another liver disease called primary biliary cirrhosis. Cancer of the bile ducts or gall bladder can cause a similar blockage.
- Repeated bouts of heart failure with fluid backing up into the liver.
- Certain inherited diseases such as:
- Cystic fibrosis.
- Glycogen storage diseases, in which the body is unable to process glycogen, a form of sugar that is converted to glucose and serves as a source of energy for the body.
- Alpha-1 antitrypsin deficiency, an absence of a specific enzyme in the liver.
- Diseases caused by abnormal liver function, such as haemochromatosis, a condition in which excessive iron is absorbed and deposited into the liver and other organs; and Wilson's disease, caused by the abnormal storage of copper in the liver.
Although less likely, other causes of cirrhosis include reactions to prescription drugs, prolonged exposure to environmental toxins, or parasitic infections.
Do people who drink large amounts of alcohol always develop cirrhosis of the liver?
Most people who drink large amounts of alcohol harm their livers in some way, but not all of these people get cirrhosis of the liver. Women who are heavy drinkers are at a higher risk than men. People who have hepatitis B or hepatitis C are more likely to suffer liver damage from alcohol.
What are the symptoms of cirrhosis of the liver?
The symptoms of cirrhosis of the liver vary with the stage of the illness. In the early stages, there may not be any symptoms. As the scarring becomes worse and liver function is impaired, symptoms develop and may include:
- Loss of appetite.
- Lack of energy or fatigue that may be debilitating.
- Weight loss or sudden weight gain.
- Bruising easily.
- Yellowing of skin or the whites of eyes (jaundice).
- Itchy skin.
- Fluid retention (oedema) and swelling in the ankles, legs and abdomen (often an early sign).
- A brownish or orange tint to the urine.
- Light coloured stools.
- Confusion, disorientation, personality changes.
- Blood in the stool.