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Capillaries can be seen on the face
Frequent nighttime urination
Liver failure
Fatigued
Frequent urination
Gained weight
Swelling
Not seeing your symptoms? No worries!
What is Liver Cirrhosis?
Cirrhosis refers to scarring of the liver which results in abnormal liver function as a consequence of chronic (long-term) liver injury. There are many different causes including infections, alcohol abuse, inherited disorders, and fatty liver.
Typical Symptoms of Liver Cirrhosis
- Visible veins on the stomach
- Nails white around the base
- Enlarged male breast tissue
- Fluid retention in my abdomen
- Swelling leaves a dent when pressed for at least 15 seconds
- Visible thin blood vessels on face
- History of liver problems
- Yellowish eyes or skin
Diagnostic Questions for Liver Cirrhosis
Your doctor may ask these questions to check for this disease:
- Do you have visible veins on your stomach?
- Are your nails white around the base?
- Have you noticed an unusual increase in your breast size?
- Have you been diagnosed with ascites?
- Does the swelling leave a dent when pressed for at least 15 seconds?
Treatment of Liver Cirrhosis
Medical care for patients with cirrhosis has several aims: (1) treating the underlying cause of liver disease when possible, (2) preventing cirrhosis-related complications, and (3) treating the symptoms of cirrhosis. Cirrhosis is a chronic disease, and patients with cirrhosis require ongoing medical care with a physician specializing in the care of patients with liver disease. In severe cases, a liver transplant may be the only effective treatment.
Reviewed By:
Samantha Nazareth, MD (Gastroenterology)
Board-certified gastroenterologist. Experience managing gastrointestinal conditions (GERD, IBS, ulcerative colitis, Crohn’s, celiac disease, NASH) within healthcare organizations (three ambulatory surgical centers, single-specialty practice, multi-specialty practice and solo practice).
Aiko Yoshioka, MD (Gastroenterology)
Dr. Yoshioka graduated from the Niigata University School of Medicine. He worked as a gastroenterologist at Saiseikai Niigata Hospital and Niigata University Medical & Dental Hospital before serving as the Deputy Chief of Gastroenterology at Tsubame Rosai Hospital and Nagaoka Red Cross Hospital. Dr. Yoshioka joined Saitama Saiseikai Kawaguchi General Hospital as Chief of Gastroenterology in April 2018.
Content updated on Feb 19, 2025
Following the Medical Content Editorial Policy
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Liver Cirrhosis?
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- I have veins in my stomach
- Nails are whiter
- There are blood vessels on the abdomen
- Gynecomastia
- Swollen veins around belly button
- Stomach is full of liquid
- Fingernail and/or toenails look “washed out” except for a thin red/brown strip near the tip
- Prominent veins on the abdomen
- Swollen veins around abdomen
- Swollen male breast
- Fingernail and/or toenails look like ground glass
- Swollen veins around tummy
- Blood vessels protrude from the belly
- Fluid in the abdomen
- Terry's nails
See full list
Symptoms Related to Liver Cirrhosis
Diseases Related to Liver Cirrhosis
FAQs
Q.
Can cirrhosis be caused by something other than alcohol?
A.
Yes, cirrhosis can be caused by things other than alcohol, such as nonalcoholic fatty liver disease and other conditions. See below to understand more.
References:
Li B, Zhang C, & Zhan YT. (2018). Nonalcoholic Fatty Liver Disease Cirrhosis: A Review of Its .... Canadian journal of gastroenterology & hepatology, 30065915.
https://pubmed.ncbi.nlm.nih.gov/30065915/
Kneeman JM, Misdraji J, & Corey KE. (2012). Secondary causes of nonalcoholic fatty liver disease. Therapeutic advances in gastroenterology, 22570680.
https://pubmed.ncbi.nlm.nih.gov/22570680/
Ginès P, Krag A, Abraldes JG, Solà E, Fabrellas N, & Kamath PS. (2021). Liver cirrhosis. Lancet (London, England), 34543610.
Q.
Can cirrhosis be stopped or reversed in stage 2 or 3?
A.
Cirrhosis in stages 2 or 3 can sometimes be slowed or improved if the cause is treated, but full reversal is rare. See below to understand more.
References:
Ginès P, Krag A, Abraldes JG, Solà E, Fabrellas N, & Kamath PS. (2021). Liver cirrhosis. Lancet (London, England), 34543610.
https://pubmed.ncbi.nlm.nih.gov/34543610/
Tsochatzis EA, Bosch J, & Burroughs AK. (2014). Liver cirrhosis. Lancet (London, England), 24480518.
https://pubmed.ncbi.nlm.nih.gov/24480518/
Wazir H, Abid M, Essani B, Saeed H, Ahmad Khan M, Nasrullah F, et al. (2023). Diagnosis and Treatment of Liver Disease: Current Trends .... Cureus, 38174191.
Q.
Can someone live a normal life after being diagnosed with cirrhosis of the liver?
A.
Living with cirrhosis can be challenging, but with proper management, some people can maintain a good quality of life. However, cirrhosis often leads to complications that can make life unpredictable. See below to understand more.
References:
Ginès P, Krag A, Abraldes JG, Solà E, Fabrellas N, & Kamath PS. (2021). Liver cirrhosis. Lancet (London, England), 34543610.
https://pubmed.ncbi.nlm.nih.gov/34543610/
Hjorth M, Svanberg A, Sjöberg D, Rorsman F, & Kaminsky E. (2020). Liver cirrhosis turns life into an unpredictable roller coaster. Journal of clinical nursing, 32888238.
https://pubmed.ncbi.nlm.nih.gov/32888238/
Heidelbaugh JJ, & Sherbondy M. (2006). Cirrhosis and chronic liver failure: part II. Complications .... American family physician, 16970020.
Q.
Can stage 3 liver disease still be reversed with medication or lifestyle changes?
A.
Stage 3 liver disease, known as fibrosis, can sometimes be improved with lifestyle changes and medication, but it's not always possible to reverse it completely. See below to understand more.
References:
Zoubek ME, Trautwein C, & Strnad P. (2017). Reversal of Liver Fibrosis: From Fiction to Reality. Best practice & research. Clinical gastroenterology, 28624101.
https://pubmed.ncbi.nlm.nih.gov/28624101/
Zimmermann HW, & Tacke F. (2015). can liver inflammation and fibrosis be reversed with .... Expert review of gastroenterology & hepatology, 26138749.
https://pubmed.ncbi.nlm.nih.gov/26138749/
Zhang CY, Liu S, & Yang M. (2023). Treatment of liver fibrosis: Past, current, and future. World journal of hepatology, 37397931.
Q.
Does cirrhosis of the liver cause pain?
A.
Yes, cirrhosis of the liver can cause pain, which is a common issue for people with this condition. See below to understand more.
References:
Rubin JB, Loeb R, Fenton C, Huang CY, Keyhani S, Seal KH, & Lai JC. (2024). The burden of significant pain in the cirrhosis population. Hepatology communications, 38780295.
https://pubmed.ncbi.nlm.nih.gov/38780295/
Holman A, Parikh N, Clauw DJ, Williams DA, & Tapper EB. (2023). Contemporary management of pain in cirrhosis. Hepatology (Baltimore, Md.), 35665522.
https://pubmed.ncbi.nlm.nih.gov/35665522/
Gorospe FFF 4th, Wong D, Lee E, Puts M, Brennenstuhl S, & Dale CM. (2025). Multidimensional Experience of Pain in Adults With Cirrhosis. Gastro hep advances, 40980074.
Q.
How can I tell if my cirrhosis is getting worse?
A.
Signs that cirrhosis is getting worse include increased swelling, confusion, and new bleeding. Regular check-ups and monitoring are important to manage the condition. See below to understand more.
References:
de Franchis R, & Dell'Era A. (2007). Non-invasive diagnosis of cirrhosis and the natural history .... Best practice & research. Clinical gastroenterology, 17223493.
https://pubmed.ncbi.nlm.nih.gov/17223493/
Jagdish RK, Roy A, Kumar K, Premkumar M, Sharma M, Rao PN, et al. (2023). from portal hypertension to acute-on-chronic liver failure. Frontiers in medicine, 37396918.
https://pubmed.ncbi.nlm.nih.gov/37396918/
D'Amico G, Morabito A, D'Amico M, Pasta L, Malizia G, Rebora P, & Valsecchi MG. (2018). Clinical states of cirrhosis and competing risks. Journal of hepatology, 29111320.
Q.
How is cirrhosis of the liver officially diagnosed?
A.
Cirrhosis of the liver is diagnosed using a combination of medical history, physical exams, blood tests, imaging tests, and sometimes a liver biopsy. See below to understand more.
References:
Smith A, Baumgartner K, & Bositis C. (2019). Cirrhosis: Diagnosis and Management. American family physician, 31845776.
https://pubmed.ncbi.nlm.nih.gov/31845776/
Gupta S, & Walker S. (2021). Testing for cirrhosis. Australian prescriber, 35002032.
https://pubmed.ncbi.nlm.nih.gov/35002032/
Heidelbaugh JJ, & Bruderly M. (2006). Cirrhosis and chronic liver failure: part I. Diagnosis and .... American family physician, 16970019.
Q.
How long can someone live with stage 4 cirrhosis?
A.
Stage 4 cirrhosis significantly affects life expectancy, with survival times varying widely based on individual health factors and treatment options. See below to understand more.
References:
Wedd J, Bambha KM, Stotts M, Laskey H, Colmenero J, Gralla J, & Biggins SW. (2014). Stage of cirrhosis predicts the risk of liver-related death in .... Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 24916539.
https://pubmed.ncbi.nlm.nih.gov/24916539/
Hasan I, Nababan SHH, Handayu AD, Aprilicia G, & Gani RA. (2023). Scoring system for predicting 90-day mortality of in-hospital .... BMC gastroenterology, 37264303.
https://pubmed.ncbi.nlm.nih.gov/37264303/
Goldberg D, Mantero A, Kaplan D, Delgado C, John B, Nuchovich N, et al. (2022). Accurate long-term prediction of death for patients with .... Hepatology (Baltimore, Md.), 35278226.
Q.
How often should someone with stage 3 liver disease get their liver checked?
A.
People with stage 3 liver disease should have their liver checked regularly, using non-invasive tests as recommended by their healthcare provider. See below to understand more.
References:
Liu SY, Wong VW, Wong SK, Wong GL, Lai CM, Lam CC, et al. (2021). A prospective 5-year study on the use of transient .... Scientific reports, 33686111.
https://pubmed.ncbi.nlm.nih.gov/33686111/
Balkhed W, Åberg FO, Nasr P, Ekstedt M, & Kechagias S. (2022). Repeated measurements of non-invasive fibrosis tests to .... Liver international : official journal of the International Association for the Study of the Liver, 35319156.
https://pubmed.ncbi.nlm.nih.gov/35319156/
Tincopa MA, & Loomba R. (2023). Non-invasive diagnosis and monitoring of non-alcoholic .... The lancet. Gastroenterology & hepatology, 37060912.
Q.
How quickly does stage 3 liver disease turn into cirrhosis?
A.
Stage 3 liver disease can progress to cirrhosis, but the time it takes varies for each person. Factors like the underlying cause of liver disease and lifestyle choices can influence this progression. See below to understand more.
References:
Axley P, Mudumbi S, Sarker S, Kuo YF, & Singal AK. (2018). Patients with stage 3 compared to stage 4 liver fibrosis .... PloS one, 29746540.
https://pubmed.ncbi.nlm.nih.gov/29746540/
Ng CH, Lim WH, Hui Lim GE, Hao Tan DJ, Syn N, Muthiah MD, et al. (2023). Mortality Outcomes by Fibrosis Stage in Nonalcoholic Fatty .... Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 35513235.
https://pubmed.ncbi.nlm.nih.gov/35513235/
Singh S, Allen AM, Wang Z, Prokop LJ, Murad MH, & Loomba R. (2015). Fibrosis progression in nonalcoholic fatty liver vs .... Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 24768810.
Q.
Is a liver transplant the only option at stage 4 cirrhosis?
A.
A liver transplant is a common treatment for stage 4 cirrhosis, but other options like auxiliary liver transplantation and potential therapies targeting HNF4α are being explored. See below to understand more.
References:
Lim C, Turco C, Balci D, Savier E, Goumard C, Perdigao F, et al. (2022). Auxiliary Liver Transplantation for Cirrhosis: From APOLT .... Annals of surgery, 34913893.
https://pubmed.ncbi.nlm.nih.gov/34913893/
Diaz-Aragon R, Coard MC, Amirneni S, Faccioli L, Haep N, Malizio MR, et al. (2021). Therapeutic Potential of HNF4α in End-stage Liver Disease. Organogenesis, 35114889.
https://pubmed.ncbi.nlm.nih.gov/35114889/
Settmacher U, Ali-Deeb A, Coubeau L, Cillo U, Line PD, Guba M, et al. (2023). Auxilliary Liver Transplantation According to the RAPID .... Annals of surgery, 36226590.
Q.
What are the first warning signs that cirrhosis of the liver is starting?
A.
Early signs of cirrhosis can include feeling very tired, losing your appetite, or noticing your skin and eyes turning yellow. See below to understand more.
References:
Smith A, Baumgartner K, & Bositis C. (2019). Cirrhosis: Diagnosis and Management. American family physician, 31845776.
https://pubmed.ncbi.nlm.nih.gov/31845776/
Grattagliano I, Ubaldi E, Portincasa P, & Palasciano G. (2009). Liver disease: early signs you may be missing. The Journal of family practice, 19874729.
https://pubmed.ncbi.nlm.nih.gov/19874729/
Ginès P, Krag A, Abraldes JG, Solà E, Fabrellas N, & Kamath PS. (2021). Liver cirrhosis. Lancet (London, England), 34543610.
Q.
What counts as stage 3 liver disease, and how is it different from stage 2 or stage 4?
A.
Stage 3 liver disease involves significant liver scarring. It's more advanced than stage 2 but not as severe as stage 4, which includes cirrhosis. See below to understand more.
References:
Sánchez-Azofra M, Fernández I, García-Buey ML, Domínguez-Domínguez L, Fernández-Rodríguez CM, Mancebo A, et al. (2021). Hepatocellular carcinoma risk in hepatitis C stage-3 .... Liver international : official journal of the International Association for the Study of the Liver, 34392590.
https://pubmed.ncbi.nlm.nih.gov/34392590/
Ekstedt M, Hagström H, Nasr P, Fredrikson M, Stål P, Kechagias S, & Hultcrantz R. (2015). Fibrosis stage is the strongest predictor for disease-specific .... Hepatology (Baltimore, Md.), 25125077.
https://pubmed.ncbi.nlm.nih.gov/25125077/
Hagström H, Kechagias S, & Ekstedt M. (2022). Risk for hepatic and extra-hepatic outcomes in .... Journal of internal medicine, 34118091.
Q.
What does stage 4 cirrhosis mean in terms of liver failure?
A.
Stage 4 cirrhosis means the liver is very damaged and not working well, which can lead to serious health problems and a higher risk of death. See below to understand more.
References:
Wedd J, Bambha KM, Stotts M, Laskey H, Colmenero J, Gralla J, & Biggins SW. (2014). Stage of cirrhosis predicts the risk of liver-related death in .... Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 24916539.
https://pubmed.ncbi.nlm.nih.gov/24916539/
Axley P, Mudumbi S, Sarker S, Kuo YF, & Singal AK. (2018). Patients with stage 3 compared to stage 4 liver fibrosis .... PloS one, 29746540.
https://pubmed.ncbi.nlm.nih.gov/29746540/
Goodman ZD. (2007). Grading and staging systems for inflammation and fibrosis .... Journal of hepatology, 17692984.
Q.
What is the life expectancy for someone in stage 4 cirrhosis?
A.
Life expectancy for someone with stage 4 cirrhosis can be quite limited, often measured in months to a few years, depending on complications and overall health. See below to understand more.
References:
de Franchis R, & Dell'Era A. (2007). Non-invasive diagnosis of cirrhosis and the natural history .... Best practice & research. Clinical gastroenterology, 17223493.
https://pubmed.ncbi.nlm.nih.gov/17223493/
Wedd J, Bambha KM, Stotts M, Laskey H, Colmenero J, Gralla J, & Biggins SW. (2014). Stage of cirrhosis predicts the risk of liver-related death in .... Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 24916539.
https://pubmed.ncbi.nlm.nih.gov/24916539/
Zipprich A, Garcia-Tsao G, Rogowski S, Fleig WE, Seufferlein T, & Dollinger MM. (2012). Prognostic indicators of survival in patients with .... Liver international : official journal of the International Association for the Study of the Liver, 22679906.
Q.
What medications are safest for someone with cirrhosis?
A.
In people with cirrhosis, medication choices need to be made carefully to avoid liver damage. Many common drugs need dose adjustments or should be avoided entirely. See below to understand more.
References:
Weersink RA, Burger DM, Hayward KL, Taxis K, Drenth JPH, & Borgsteede SD. (2020). Safe use of medication in patients with cirrhosis. Expert opinion on drug metabolism & toxicology, 31810397.
https://pubmed.ncbi.nlm.nih.gov/31810397/
Amarapurkar DN. (2011). Prescribing medications in patients with decompensated .... International journal of hepatology, 21994861.
https://pubmed.ncbi.nlm.nih.gov/21994861/
Westphal JF, & Brogard JM. (1997). Drug administration in chronic liver disease. Drug safety, 9258630.
Q.
What other health problems can cirrhosis lead to?
A.
Cirrhosis can lead to many health problems like fluid buildup in the belly, confusion, and bleeding easily. It can also cause problems with the kidneys and make you more likely to get infections. See below to understand more.
References:
Premkumar M, & Anand AC. (2022). Overview of Complications in Cirrhosis. Journal of clinical and experimental hepatology, 35814522.
https://pubmed.ncbi.nlm.nih.gov/35814522/
Reincke M, Thimme R, & Schultheiß M. (2023). [Complications of liver cirrhosis]. Deutsche medizinische Wochenschrift (1946), 37820648.
https://pubmed.ncbi.nlm.nih.gov/37820648/
Nusrat S, Khan MS, Fazili J, & Madhoun MF. (2014). Cirrhosis and its complications: evidence based treatment. World journal of gastroenterology, 24833875.
Q.
What symptoms should I expect in stage 4 cirrhosis on a daily basis?
A.
In stage 4 cirrhosis, you may experience tiredness, confusion, swelling, and trouble eating. It’s important to manage these symptoms with your healthcare provider. See below to understand more.
References:
Foster C, Baki J, Nikirk S, Williams S, Parikh ND, & Tapper EB. (2020). Comprehensive Health-State Utilities in Contemporary .... Hepatology communications, 32490321.
https://pubmed.ncbi.nlm.nih.gov/32490321/
Tapper EB, Baki J, Parikh ND, & Lok AS. (2019). Frailty, Psychoactive Medications, and Cognitive .... Hepatology (Baltimore, Md.), 30382584.
https://pubmed.ncbi.nlm.nih.gov/30382584/
Faccioli J, Nardelli S, Gioia S, Riggio O, & Ridola L. (2022). Nutrition Assessment and Management in Patients with .... Journal of clinical medicine, 35628968.
Q.
What foods are bad for the liver?
A.
A diet high in sugar (especially fructose), saturated and trans fats, refined carbohydrates, and excessive alcohol is harmful to the liver.
References:
Berná G, Romero-Gomez M. The role of nutrition in non-alcoholic fatty liver disease: Pathophysiology and management. Liver Int. 2020 Feb;40 Suppl 1:102-108. doi: 10.1111/liv.14360. PMID: 32077594.
Salehi-Sahlabadi A, Sadat S, Beigrezaei S, Pourmasomi M, Feizi A, Ghiasvand R, Hadi A, Clark CCT, Miraghajani M. Dietary patterns and risk of non-alcoholic fatty liver disease. BMC Gastroenterol. 2021 Jan 28;21(1):41. doi: 10.1186/s12876-021-01612-z. PMID: 33509112; PMCID: PMC7844966.
Zelber-Sagi S, Salomone F, Mlynarsky L. The Mediterranean dietary pattern as the diet of choice for non-alcoholic fatty liver disease: Evidence and plausible mechanisms. Liver Int. 2017 Jul;37(7):936-949. doi: 10.1111/liv.13435. Epub 2017 Jun 1. PMID: 28371239.
Q.
What foods are good for the liver?
A.
Foods that are good for your body are the same ones that are good for your liver. These include whole-foods that are high in fiber and unprocessed.
References:
Montemayor S, García S, Monserrat-Mesquida M, Tur JA, Bouzas C. Dietary Patterns, Foods, and Nutrients to Ameliorate Non-Alcoholic Fatty Liver Disease: A Scoping Review. Nutrients. 2023 Sep 14;15(18):3987. doi: 10.3390/nu15183987. PMID: 37764771; PMCID: PMC10534915.
George ES, Forsyth A, Itsiopoulos C, Nicoll AJ, Ryan M, Sood S, Roberts SK, Tierney AC. Practical Dietary Recommendations for the Prevention and Management of Nonalcoholic Fatty Liver Disease in Adults. Adv Nutr. 2018 Jan 1;9(1):30-40. doi: 10.1093/advances/nmx007. PMID: 29438460; PMCID: PMC6333937.
Berná G, Romero-Gomez M. The role of nutrition in non-alcoholic fatty liver disease: Pathophysiology and management. Liver Int. 2020 Feb;40 Suppl 1:102-108. doi: 10.1111/liv.14360. PMID: 32077594.
Q.
What is the life expectancy for stage 3 and stage 4 cirrhosis?
A.
The life expectancy for individuals with cirrhosis varies significantly between stages 3 and 4. Generally, patients with stage 3 cirrhosis have a better prognosis than those with stage 4 cirrhosis, as the latter is associated with more severe liver damage and complications.
References:
Kumar R, Kumar S, Prakash SS. Compensated liver cirrhosis: Natural course and disease-modifying strategies. World J Methodol. 2023 Sep 20;13(4):179-193. doi: 10.5662/wjm.v13.i4.179. PMID: 37771878; PMCID: PMC10523240.
Axley P, Mudumbi S, Sarker S, Kuo YF, Singal AK. Patients with stage 3 compared to stage 4 liver fibrosis have lower frequency of and longer time to liver disease complications. PLoS One. 2018 May 10;13(5):e0197117. doi: 10.1371/journal.pone.0197117. Erratum in: PLoS One. 2018 Aug 2;13(8):e0199402. doi: 10.1371/journal.pone.0199402. PMID: 29746540; PMCID: PMC5944985.
Mallik M, Singhai A, Khadanga S, Ingle V. The Significant Morbidity and Mortality Indicators in Patients of Cirrhosis. Cureus. 2022 Jan 14;14(1):e21226. doi: 10.7759/cureus.21226. PMID: 35174029; PMCID: PMC8841014.
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Link to full study:
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Tapper EB, Parikh ND (Year). Diagnosis and Management of Cirrhosis and Its Complications: A Review. JAMA.
https://pubmed.ncbi.nlm.nih.gov/37159031/Smith A, Baumgartner K, Bositis C (Year). Cirrhosis: Diagnosis and Management. American family physician.
https://pubmed.ncbi.nlm.nih.gov/31845776/Schuppan D, Afdhal NH (Year). Liver cirrhosis. Lancet (London, England).
https://pubmed.ncbi.nlm.nih.gov/18328931/