Cirrhosis

Who is the leaflet for?

Patients diagnosed with cirrhosis.

What is its aim?

To provide an overview of cirrhosis and links to more detailed resources.

What is cirrhosis?

Liver cirrhosis is a condition in which the liver is severely scarred. Common causes of cirrhosis are alcohol, fat deposition (usually associated with obesity and diabetes), hepatitis C, autoimmune liver diseases (autoimmune hepatitis, primary biliary cholangitis and primary sclerosing cholangitis), hepatitis B and inherited conditions (haemochromatosis, Wilson’s Disease and alpha-1 antitrypsin deficiency).

How common is cirrhosis?

It is estimated that more than 60,000 people have cirrhosis in the UK.

What symptoms does cirrhosis cause?

Cirrhosis does not usually cause symptoms until it is advanced. Initially it may cause various blood test abnormalities. When more severe, symptoms can include tiredness, fluid accumulation, weight loss, bruising, yellow jaundice, generalised itch, bleeding and confusion. Please seek medical attention if you develop any of these problems. Cirrhosis is also associated with liver cancer (between 1 in 100 and 1 in 20 risk per year).

How is cirrhosis diagnosed?

Cirrhosis is diagnosed with a combination of blood tests, radiology investigations (e.g ultrasound and CT scanning) and liver biopsy. The exact investigation is individually dependent.

How is cirrhosis treated?

The most important treatment of cirrhosis is removing or treating the underlying cause. It is recommended that all patients with cirrhosis, regardless of the cause, avoid alcohol as it may increase the risk of developing complications. Patients who develop cirrhosis from hepatitis B or C should be considered for treatment of these viruses. Other treatments include careful weight loss if obese, venesection to clear iron and some other disease specific medications. Otherwise, treatment is aimed at early identification of and dealing with complications.

Cirrhosis monitoring involves endoscopies to assess for varicose veins in the gullet, ultrasound scans every six months to assess for liver cancer, bone scanning to detect osteoporosis and regular blood test monitoring to pick up early signs of liver failure. Treatment of any of these complications will be discussed should they occur. Ultimately, if liver failure develops despite addressing the underlying cause, consideration of liver transplantation may become necessary. In patients where transplantation is not feasible hospital and community palliative care teams can play a valuable role in helping patients and their families.

Vaccination schedules

All patients with cirrhosis should receive vaccination against:

• SARS-CoV-2 (COVID-19) when offered
• Influenza every year
• Pneumonia (Pneumococcus - PPV 23)
• Hepatitis A and hepatitis B as required depending on blood test results

The reason for immunisation against these viruses is that they can be life threatening for patients with cirrhosis. Vaccination should be arranged through your general practice.

Further information and useful contacts

• British Liver Trust (British Liver Trust (opens in a new tab))
• Patient (opens in a new tab)