What are the symptoms of cirrhosis?

Blood from the stomach and intestines passes through your liver, where it is filtered and processed before heading to other parts of your body. When scar tissue begins to replace healthy tissue in the liver, it is harder for blood to flow normally through the liver and for the liver to work in its usual way. Cirrhosis is a silent disease, and people who have it sometimes don’t have symptoms until there’s been a lot of injury to the liver. Injury may be occurring even if a person has few or no symptoms.

The symptoms of early liver cirrhosis (sometimes called compensated cirrhosis) include:

  • fatigue and loss of energy
  • unexplained loss of appetite and weight loss
  • nausea
  • abdominal pain
  • pinhead-sized spots on the skin from which tiny blood vessels spread out in a circle (spider angiomas)
  • redness of the palms of the hand (palmar erythema)

In some people, cirrhosis progresses over time and the liver’s ability to work normally decreases. How quickly this happens varies from person to person and depends on a few things, including the person’s general health, their gender, the cause of the cirrhosis, the stage of the disease when they were diagnosed, their diet and their alcohol intake.

In a small number of people with cirrhosis, the liver gets so damaged it can no longer work properly. (This serious type of damage is called decompensated cirrhosis.)

Symptoms of more serious cirrhosis include:

  • continuous weight loss
  • extreme fatigue
  • yellowing of the skin (jaundice) or eyes that doesn’t go away
  • itchy skin
  • dark, tea-coloured urine
  • difficulty falling asleep and/or staying asleep; sleep patterns are reversed for some people: they stay awake through the night and sleep during the day
  • frequent bacterial infections in fluid that can accumulate in the belly (spontaneous bacterial peritonitis)
  • bleeding gums or gums that get bruised easily
  • swelling or ruptured veins (varices) in the esophagus (food pipe) and stomach. (Some symptoms of this are black or bloody stools and dark vomit that looks like coffee grounds. If you notice this, you need to get medical attention right away. Bleeding varices are a very serious and potentially life-threatening medical problem.)
  • painful swelling of the legs (edema) and abdomen (ascites) due to an imbalance of fluid
  • shortness of breath, although this is not a common symptom
  • confusion, forgetfulness, personality changes, changed sleep habits or other changes in mental function (hepatic encephalopathy)

If you have cirrhosis and you notice any of these symptoms, you should mention them to your care provider as soon as possible. They might be a sign that your cirrhosis is getting worse.