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Dr. Ravichand C. Siddachari, Thursday, November 7, 2019


Cirrhosis is a serious condition where normal liver tissue is replaced by scar tissue (fibrosis). It tends to progress slowly and often does not cause symptoms in its early stages.


There are many causes of 'scarring' of the liver (cirrhosis). The most common causes are heavy alcohol drinking and infection with the hepatitis C virus.

  • Alcoholic Cirrhosis: Your liver cells break down alcohol but too much alcohol can damage the liver cells. As a rule, the heavier you’re drinking, the more your risk of developing cirrhosis.
  • Hepatitis C and Cirrhosis: Persistent (chronic) infection with the hepatitis C virus causes long-term inflammation in the liver. This can eventually lead to liver 'scarring' and cirrhosis.

Less common causes include:

  • Chronic infection with the hepatitis B virus. Worldwide, this is the most common cause of cirrhosis
  • Autoimmune hepatitis where the immune system attacks the liver
  • Non-alcoholic steatohepatitis (NASH) which causes fat to build up in the liver. This can lead to scarring and cirrhosis. Being overweight/obese increases your risk of developing NASH.
  • Severe reactions to certain medicines
  • Severe heart failure, which can cause back pressure of blood and congestion in the liver

Some rare inherited diseases, which can cause damage to liver cells. For example:

  • Haemochromatosis: This is a condition, which causes an abnormal build-up of iron in the liver and other parts of the body.
  • Wilson's Disease: This is a condition, which causes an abnormal build-up of copper in the liver and other parts of the body.


In the early stages of the condition, often there are no symptoms. The symptoms that may develop include:

  • Tiredness and weakness
  • The fluid which leaks from the bloodstream and builds up in the legs (oedema) and tummy (abdomen) - called ascites
  • Loss of appetite, feeling sick (nausea) and being sick (vomiting)
  • Weight loss (although you may put on weight if you retain a lot of fluid)
  • A tendency to bleed and bruise more easily
  • Yellowing of the skin or the whites of the eyes (jaundice) due to a build-up of bilirubin
  • Itch due to a build-up of toxins
  • Mental health changes which can develop in severe cases as toxins build up in the bloodstream and affect the brain.


A doctor may suspect, from your symptoms and a physical examination, that you have 'scarring' of the liver (cirrhosis).

Blood tests may show abnormal liver function. See separate leaflet called Liver Function Tests for more details. An ultrasound scan (or a CT scan or MRI scan) may show that you have a damaged liver. To confirm the diagnosis, a small sample (biopsy) of the liver may be taken to be looked at under the microscope.

If the underlying cause of the cirrhosis is not clear, further tests may be done to clarify the cause.


'Scarring' of the liver (cirrhosis) tends to get progressively worse if the underlying cause persists, and is not treated. In general, once the damage is done the scarring is not able to reverse. Therefore, the aim of treatment is, if possible, to prevent further liver scarring or to slow the progression of the scarring process. Treatments that may be advised include the following.

  • Not drinking alcohol if alcohol is the cause
  • Interferon and other medication may be used to treat viral hepatitis.
  • Steroid medicines or other immunosuppressant medicines may be used to treat autoimmune diseases causing liver damage.
  • Regular removal of a pint or so of blood can remove excess iron which occurs in haemochromatosis.
  • In severe cases, where the scarring is extensive and the liver can barely function, then a liver transplant may be the only option.


KIMS has been at the forefront of ground-breaking advances in the detection and treatment of liver diseases. We provide personalized care for all types of acute and chronic liver diseases including liver cirrhosis. Our liver disease specialists comprehensively evaluate patients, providing expert diagnosis and treatment plans that will help arrest or reverse their disease.



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