What happens to the liver in each of the four stages of cirrhosis?

Reviewed by Yoshinori Abe, MD

Internal Medicine

Cirrhosis is a chronic liver disease that progresses through four stages, beginning with mild scarring (fibrosis) and advancing to severe scarring, loss of liver function, and life-threatening complications such as portal hypertension, ascites, and liver failure. Early detection is critical, as earlier stages may be manageable or reversible, while later stages often require advanced treatment or transplant.

Because symptoms of liver disease can be subtle, overlap with other conditions, or appear only after significant damage has occurred, it's important not to guess. Take a free, instant, online symptom check to better understand what your body may be telling you and get clear guidance on your next steps.

Reviewed for medical accuracy: 07/20/2026

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Explanation

Cirrhosis is a condition where the liver becomes scarred and damaged over time. It progresses through four stages:

Compensated Cirrhosis: In this early stage, the liver has some scarring, but it can still perform its functions. People may not have any symptoms.
Compensated Cirrhosis with Varices: The liver is more scarred, and blood flow through the liver is reduced, causing veins in the stomach or esophagus to swell (called varices). Symptoms might still be mild or absent.
Decompensated Cirrhosis: The liver is severely scarred and cannot function properly. Symptoms like jaundice (yellowing of the skin), fluid buildup in the belly, and confusion can occur. This stage requires medical attention.
Late Decompensated Cirrhosis: This is the most severe stage, with significant liver damage. Complications are more frequent and serious, such as liver failure, which can be life-threatening.

If you're experiencing any concerning symptoms related to liver health, you can use a free symptom checker to better understand what might be happening. Cirrhosis is a serious condition that needs medical care to manage symptoms and prevent further damage.

(References)

de Franchis R, & Dell'Era A. (2007). Non-invasive diagnosis of cirrhosis and the natural history .... Best practice & research. Clinical gastroenterology, 17223493.
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.
Ginès P, Krag A, Abraldes JG, Solà E, Fabrellas N, & Kamath PS. (2021). Liver cirrhosis. Lancet (London, England), 34543610.

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