Cirrhosis is the result of long-term, continuous damage to the liver and may be due to many different causes, including long-term hepatitis C infection.
The damage leads to scarring, known as fibrosis. At the same time, irregular nodules replace the smooth liver tissue and the liver becomes harder. Together the scarring and the nodules are called cirrhosis. Cirrhosis can lead to complete liver failure.
Cirrhosis can affect anyone – man or woman, young or old. People most at risk of cirrhosis:
- have a long-term viral infections, such as hepatitis B or C
- have an inherited liver disease, such as haemochromatosis
- drink too much alcohol
- suffer from non-alcoholic fatty liver disease (usually associated with being overweight and/or diabetic).
Unfortunately, there are few symptoms to warn people that they are developing cirrhosis. Cirrhosis is a sign that the liver has been under attack and unable to repair itself properly for a long time. The liver will continue to attempt to fulfil its role within the body, but if the source of damage is not removed, without a transplant, liver failure leading to death may result.
It is now believed that when the root cause of the liver damage is removed, the liver may be able to recover slowly from cirrhosis. More research is needed, however, to confirm this.
Late effects of cirrhosis can include the following conditions.
Internal bleeding
If the blood which flows from the intestines to feed the liver before passing back into the general circulation cannot get through the hardened liver, it causes back pressure throughout the system. This results in enlarged (varicose) veins in the lining of the gulle (oesophageal varices) and stomach (gastric varices) as the blood tries to find a way round the scarred liver.
The varices can burst, causing severe internal bleeding which shows itself as vomited blood or altered blood in the stools (black, tarry bowel motions, known as melaena). Either of these symptoms must receive urgent medical treatment.
Effects on the brain
The liver normally breaks down waste products which would otherwise affect the brain. With severe liver disease the liver cannot remove these waste products and they are carried by the blood to the brain resulting in hepatic encephalopathy. Symptoms can range from minor lapses in memory to slurred speech, confusion and unconsciousness. With treatment these effects can be alleviated.
Fluid retention
Severe liver disease alters the way the body handles fluid so that excess water is retained in the body and may be obvious as swelling of the legs and/or swelling of the abdomen (due to fluid in the cavity which surrounds the bowel). This accumulation of fluid in the abdomen is called ascites.
Liver cancer
Once cirrhosis from hepatitis C is established there is about a 3% risk each year of liver cancer developing. It is rare in people with chronic hepatitis C who do not have cirrhosis.