Liver Cirrhosis

Liver cirrhosis is long-term scarring of the liver resulting from ongoing liver damage, most often due to chronic viral hepatitis or heavy alcohol use in this setting. Over time, it impairs the liver’s ability to function and can lead to serious complications.

• Fatigue and weakness
• Loss of appetite and weight loss
• Yellowing of the skin and eyes (jaundice)
• Swelling of the abdomen (ascites) and legs
• Easy bruising or bleeding
• In advanced disease: confusion (hepatic encephalopathy) or vomiting blood from swollen oesophageal veins (varices)

• Chronic hepatitis B or hepatitis C infection are major causes in this setting.
• Long-term heavy alcohol use is another leading cause.
• Less commonly, other chronic liver conditions can progress to cirrhosis over years.

• Suspected based on the clinical features above together with a relevant history, such as known chronic hepatitis B/C infection or long-term heavy alcohol use.
• Blood tests assess liver function and screen for underlying viral hepatitis.
• Abdominal ultrasound can show characteristic changes in liver texture and size, and detect ascites or an enlarged spleen.
• Upper endoscopy may be used to check for oesophageal varices, particularly in more advanced disease.

Treating the underlying cause is central to management — antiviral treatment for chronic hepatitis B or C, or complete abstinence from alcohol where alcohol is the cause, can slow or halt further liver damage.

Fluid and salt restriction, together with a diuretic, is used to manage abdominal and leg swelling.

Patients with confusion (hepatic encephalopathy) or vomiting blood require urgent hospital-level care, as these indicate serious complications.

Regular monitoring for liver cancer, which occurs more frequently in people with cirrhosis, is recommended where feasible.

Vaccination against hepatitis A and B (if not already immune) and avoiding further liver-damaging exposures, especially alcohol, are important parts of ongoing care.

• Avoid heavy alcohol use, and abstain completely if there is any existing liver disease.
• Complete hepatitis B vaccination and use safe practices to avoid hepatitis B and C transmission.
• Seek regular medical follow-up if living with chronic viral hepatitis, even without symptoms.
• Avoid unnecessary use of medicines that can further stress the liver without medical advice.