What are the signs of liver cirrhosis?

From the Guidelines

Liver cirrhosis is characterized by signs such as ascites, bleeding, encephalopathy, and jaundice, which mark the transition from a compensated to a decompensated phase, significantly impacting morbidity, mortality, and quality of life. These signs are critical indicators of the disease's progression and are associated with a higher risk of complications and mortality 1.

Key Signs and Symptoms

• Ascites, which is the accumulation of fluid in the abdominal cavity
• Bleeding, often due to portal hypertension and varices
• Encephalopathy, characterized by confusion, difficulty thinking, and altered mental status
• Jaundice, which is the yellowing of the skin and eyes due to elevated bilirubin levels As the disease progresses, other complications may arise, including rebleeding, acute kidney injury, hepatopulmonary syndrome, portopulmonary hypertension, cirrhotic cardiomyopathy, and bacterial infections 1.

Importance of Early Recognition

Early recognition of these signs is crucial, as it allows for timely intervention and management of complications, potentially slowing the disease's progression and improving quality of life 1.

From the Research

Signs and Symptoms of Liver Cirrhosis

• Abdominal pain, nausea, and malaise are common nonspecific symptoms of cirrhosis 2
• More specific signs of cirrhosis include:
  • Hepatomegaly (enlarged liver) 2
  • Splenomegaly (enlarged spleen) 2
  • Jaundice (yellowing of the skin and eyes) 2
  • Ascites (fluid accumulation in the abdomen) 3, 2, 4
  • Encephalopathy (brain dysfunction) 3, 2, 4
  • Dilated abdominal wall veins 2
  • Spider nevi (small, dilated blood vessels) 2
  • Palmar erythema (redness of the palms) 2
• Other symptoms that may occur in patients with end-stage liver disease include:
  • Pain (prevalence range 30%–79%) 5
  • Breathlessness (20%–88%) 5
  • Muscle cramps (56%–68%) 5
  • Sleep disturbance (insomnia 26%–77%, daytime sleepiness 29.5%–71%) 5
  • Psychological symptoms (depression 4.5%–64%, anxiety 14%–45%) 5
  • Erectile dysfunction (53%–93%) in men 5

Complications of Liver Cirrhosis

• Variceal bleeding 3, 4
• Spontaneous bacterial peritonitis 3, 4
• Hepatocellular carcinoma 3, 4
• Hepatic encephalopathy 3, 4
• Ascites 3, 4

Diagnosis and Management of Liver Cirrhosis

• Diagnosis is typically made with a combination of laboratory tests, imaging studies, and liver biopsy 6, 3, 4
• Management includes treatment of the underlying cause, prevention of complications, and liver transplantation in some cases 6, 3, 4