When something damages the liver, scar tissue begins to form. This scarring is called fibrosis. It happens little by little over many years. When the entire liver is scarred, it shrinks and gets hard. This is called cirrhosis. Cirrhosis is the final stage of fibrosis. It happens when long-term liver damage leads to extensive scarring that can no longer heal. While there is no cure for cirrhosis and damage isn’t fully reversible, treating the underlying cause can slow progression and even improve some scarring over time. Managing cirrhosis typically involves symptom control, protecting your liver from further harm, and regular check-ups for liver cancer, which is a common risk in cirrhosis. In advanced stages, liver transplantation may be considered, and for those at risk of hepatocellular carcinoma, ongoing monitoring is essential.
stages of cirrhosis
Cirrhosis can be divided into 2 stages, compensated cirrhosis and decompensated cirrhosis.
For most people, cirrhosis progresses (or gets worse) over time, but if the main cause of cirrhosis is treated, such as eliminating hepatitis C or quitting alcohol, it can help a lot.
Compensated cirrhosis
This is early stage cirrhosis, where the liver is damaged but still able to do its job. Many people don’t have symptoms in this stage and may not even know they have it. Although cirrhosis scarring cannot fully heal, with proper care like treating the cause, eating well, and avoiding alcohol, the liver can continue working well for many years. In some cases, and depending on its cause, cirrhosis may stabilize or partially heal.
Decompensated cirrhosis
This is a more advanced stage of cirrhosis where the liver is severely damaged and unable to do its job. Liver damage leads to blocked blood flow through the portal vein (portal hypertension), which impairs proper blood filtering. This stage is irreversible and often requires more intensive medical or surgical interventions and careful management of complications. While the liver has more damage, with the right care many people can manage their symptoms and improve their quality of life.
causes
Liver fibrosis and cirrhosis develop when the liver is repeatedly injured over time. This ongoing damage leads to scar tissue that affects how well the liver functions. Common causes include:
- Viral infections caused by chronic viral hepatitis
- Long-term and heavy consumption of alcohol
- Fatty liver disease (metabolic dysfunction-associated steatotic liver disease or metabolic dysfunction-associated steatohepatitis)
- Biliary tract diseases, such as primary biliary cholangitis and primary sclerosing cholangitis
- Inherited diseases, such as Wilson disease and hemochromatosis
- Toxic hepatitis, caused by severe reactions to prescription drugs or prolonged exposure to environmental toxins.
- Metabolic disease, such as alpha-1-antitrypsin deficiency, galactosemia and glycogen storage disorders
- Repeated bouts of heart failure with liver congestions
- Biliary atresia
Possible complications of cirrhosis
As cirrhosis progresses, the liver becomes heavily scarred and has a harder time doing its job. This can lead to health complications that need regular medical care and follow-up.
Common complications include:
- Weakened immune system: A damaged liver makes it harder to fight off infections. Even minor illnesses can become serious, so it’s important to stay on top of vaccinations and seek care when feeling unwell.
- Higher risk of liver cancer: Cirrhosis increases the chance of liver cancer. Regular check-ups, blood tests, and imaging can help detect it early, when it’s easier to treat.
- Kidney problems: Liver damage can affect how well the kidneys work, leading to fluid buildup or changes in blood pressure. Routine testing helps to monitor kidney health.
