Cirrhosis and liver failure

Drinking a lot of alcohol is a common cause of cirrhosis. But there are other causes, such as: 

• hepatitis B
• hepatitis C
• metabolic dysfunction-associated fatty liver disease (MAFLD).

You may not have any symptoms during the early stages of cirrhosis. But as your liver becomes more damaged, you may experience:

• feeling sick
• loss of appetite and weight loss
• itchy skin
• yellowing of your eyes and skin
• swelling in your ankles or tummy from a build-up of fluid
• confusion or drowsiness
• vomiting blood or passing blood in your bowel motions (poos).

If your healthcare provider suspects you have cirrhosis, they will do a physical examination to look for signs of long-term liver disease.

You may have tests to confirm the diagnosis such as:

• a Liver function test — this is a blood test to measure the levels of enzymes and proteins your liver is making
• scans such as an ultrasound, CT, MRI or FibroScan
• a liver biopsy – a fine needle is inserted between your ribs to remove a small sample of liver cells to send to a laboratory to be examined.

There is no cure for cirrhosis. But there are ways to manage your symptoms, and lifestyle changes that can help stop your cirrhosis getting worse.

You may be given medications to ease your symptoms, such as:

• water tablets (diuretics), which are often used with a low-salt diet to reduce the amount of fluid in your body
• medicines to reduce the blood pressure in the main vein that takes blood to your liver
• creams to reduce your itching.

You can make some lifestyle changes to manage your cirrhosis.

• Do not drink alcohol. Whether your cirrhosis was caused by long-term alcohol use or another disease, you should avoid alcohol.
• Cut back on the amount of salt in your food. This can help to reduce the chance of swelling in your legs, feet and tummy caused by a build-up of fluid.
• Eat well to get all the nutrients you need and to maintain your energy levels. You may need to have healthy snacks between meals or have three or four small meals each day rather than one or two large meals a day. Some people with cirrhosis become malnourished and lose weight. You may be referred to a dietitian for advice and support to eat well. Your healthcare provider or dietitian may prescribe vitamin supplements.
• Avoid infections. People with cirrhosis have an increased risk of getting infections and can become much sicker if they do get one. Keep up to date with flu and other vaccinations to avoid common infections.
• Be careful about using over-the-counter medications such as paracetamol, ibuprofen (and other non-steroidal anti-inflammatories) and herbal medicines, as they can make your condition worse. Ask your healthcare provider or pharmacist if it is OK for you to use them.