Cirrhosis

Early symptoms include:

• tiredness and weakness
• loss of appetite
• loss of weight and muscle wasting
• nausea and vomiting
• tenderness or pain in the liver area
• spider-like small blood capillaries on the skin above waist level (spider angiomas)
• disturbed sleep pattern

Later symptoms as the liver struggles to function include:

• swelling of the legs, ankles and feet (oedema) or abdomen (ascites)
• extreme fatigue (anaemia)
• irregular periods (amenorrhoea)
• rapid heartbeat (tachycardia)
• vomiting blood
• jaundice
• dark urine

Your consultant will discuss your symptoms with you and may recommend tests to aid diagnosis. Diagnosis is made through a combination of an assessment of your medical history, a physical examination and certain diagnostic tests. These might include:

• Blood tests, commonly liver function tests (LFTs) that measure, for example, levels of liver enzymes alanine aminotransferase (ALT) and aspartate aminotransferase (AST) which are elevated during inflammation.
• Imaging tests such as a CT or MRI scan.
• Fibroscan to assess liver fibrosis.
• A liver biopsy may be required, where a tiny piece of your liver is taken to determine the cause of cirrhosis.
• An endoscopy to check for varices (abnormally dilated vessels) in the oesophagus or stomach which may rupture and bleed.

Treatment will depend on the cause and stage of cirrhosis. The aims of treatment are usually to stop the cirrhosis from getting worse, to reverse any damage (if this is possible) and to treat any disabling or life-threatening complications. Treatment options may include:

• Making lifestyle changes such as sodium restriction and giving up alcohol.
• Antiviral medications or corticosteroids.
• Beta blockers which can reduce the risk of bleeding and the severity of any bleed, should it occur.

A liver transplant is usually only recommended if other treatments are no longer helpful and your life is threatened by end stage liver disease.