Cirrhosis stages – how does cirrhosis develop?
It can be said that it takes quite a bit of effort to cause a cirrhotic liver. The liver is a fairly hardy organ in the body, which also functions as a gland. Any factors which cause such extensive damage usually present signs (i.e. loss of function) after a long period of time.
There are two stages by which cirrhosis is characterised – compensated and decompensated:
- Compensated cirrhosis: Signs of cirrhosis such as fluid build-up in the abdomen (ascites), bleeding in the oesophagus or stomach (variceal bleeding) and confusion (hepatic encephalopathy) may not be noticeable if enough healthy liver cells are functioning adequately enough to meet the needs required for the body. ‘Compensated cirrhosis’ is effectively a term given because at this stage the liver cells are capable of ‘compensating’ for the building up of scar tissue damage. Compensation is however a temporary state, and a person’s condition is likely to worsen without treatment. Damage to the liver is irreversible and ultimately the organ is already functioning at a loss.
- Decompensated cirrhosis: Signs of liver damage are evident during this stage as scarring has become more progressive and extensive in the organ.
General signs and symptoms of decompensated cirrhosis
- Bleeding oesophageal varices (this would present as vomiting fresh blood)
- Ascites (pale yellow or clear fluid build-up in the abdomen / peritoneal cavity)
- Bloating (increased fluid / water retention)
- Hepatic encephalopathy (build-up of toxins in the blood which alters brain function and may cause slurred speech and drowsiness)
- Jaundice (yellowing of the whites of the eyes and skin)
- Abdominal pain
- Bruising or bleeding easily (often bleeding takes longer than usual to stop)
- Itchy skin (the build-up of toxins in the blood irritates the skin)
- Redness in the palms of the hands
- Decreased appetite
- Weight loss / anorexia
- Weight gain (due to fluid retention)
- Nose bleeds or bleeding gums (due to impaired clotting function)
- Body weakness and loss of muscle mass
- Small spider-shaped blood vessels beneath the skin (telangiectasia)
- Oedema (swelling mainly in the lower legs and ankles)
- Concentration difficulties and confusion
- Impotence (erectile dysfunction in men)
- Gynecomastia (swollen male breast tissue due to hormonal imbalances)
- Testicular atrophy (male testes diminish in size and lose function) or scrotal swelling
- Abnormal menstrual periods (women)
- Fatigue / exhaustion
- Nausea and or / vomiting (sometimes may contain blood and may be severe / repeated)
- Sensitivity to medications (substances cannot easily be filtered from the blood) – newly developed or altered physical responses
- Diarrhoea (sometimes may contain blood)
- Hemorrhoids (varicose veins in the rectum)
- Difficulties with breathing (due to fluid retention)
- The development of gallstones (although this rarely occurs)
When to see the doctor if you think you have a liver problem
Any and all signs of possible cirrhosis must be evaluated, diagnosed and treated by a medical doctor. It can be difficult to determine signs specific to cirrhosis as many of the symptoms are similar to those of many other conditions (not all associated with impaired liver function).
Symptoms that do not resolve within a day or two should generally be checked out. For the most part, many are unaware of the extent of damage to their liver until such time as a complication arises. Symptoms associated with any kind of complication often lead to the seeking of medical assistance, resulting in a diagnosis.