What Is Cirrhosis of the Liver?

Your liver is remarkably forgiving — it can repair itself after many kinds of injury, often without you ever knowing anything was wrong. Cirrhosis is what happens when that repair process is pushed too far, for too long. Repeated injury leaves scar tissue instead of healthy liver, and over years the scarring can become extensive enough to distort the organ itself. The video above, "Liver Cirrhosis" (4 minutes 45 seconds), puts it plainly: cirrhosis is a late stage of scarring — fibrosis — of the liver, caused by many forms of liver disease and conditions such as hepatitis and chronic alcohol use. The questions below follow the ones patients most often ask next.

What actually changes inside the liver?

A healthy liver is soft and smooth, and blood flows through it easily. As fibrosis builds, bands of scar tissue form between areas of working liver cells, and the surviving cells group into nodules. The liver becomes firmer and lumpier, and blood has to push harder to get through it. That rising pressure in the vein that brings blood to the liver — portal hypertension — sits behind several of the later problems, including fluid collecting in the abdomen and swollen veins in the gullet. Meanwhile the liver gradually does its everyday jobs less well: making proteins and clotting factors, processing nutrients, and clearing substances the body no longer needs. If the underlying cause of injury is caught and treated early in the scarring process, further damage can often be slowed or stopped — which is exactly why finding the cause matters so much, as our article on what hepatitis is explains for one of the commonest routes in.

Would you feel it happening?

Often not, at least not early. Many people with compensated cirrhosis — where the liver is scarred but still largely keeping up — feel well, and the condition is first spotted on blood tests or a scan done for something else. When symptoms do appear, they tend to build gradually: tiredness, loss of appetite, weight loss, nausea, itchy skin, or yellowing of the eyes and skin (jaundice). Later signs can include swelling in the legs or abdomen, bruising more easily, and confusion or sleepiness if waste products that the liver normally clears begin to affect the brain. The site's "Liver Disease Stages" video walks through how those later stages can develop over years. Any confusion, vomiting blood, black stools, or rapidly increasing abdominal swelling needs urgent medical care, not a routine appointment.

How do doctors confirm it — and what happens after?

There's no single test. Doctors usually combine your history — alcohol use, viral hepatitis, fatty liver disease, medicines, other conditions — with blood tests of liver function, scans of the liver, and sometimes a scan that measures liver stiffness. Occasionally a biopsy is discussed if the picture is still unclear. Once cirrhosis is confirmed, care has two tracks running side by side. The first is treating or removing the cause where that's possible: antiviral care for viral hepatitis, stopping alcohol, or managing fatty liver disease, for example. The second is watching for and managing complications — regular monitoring, scans, and camera checks of the gullet veins in many cases — while treating fluid build-up, infection, or confusion promptly if they appear. In advanced disease where the liver can no longer sustain the body, the conversation may eventually turn to what a liver transplant involves. If you're told you have cirrhosis, the most useful questions to bring are: what caused mine, how advanced is it, and what monitoring do I need from here?

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician and researcher.

Educational only — this article is general information about cirrhosis, not medical advice and not a diagnosis. If you have liver disease or symptoms that worry you, discuss them with your own clinician or a liver specialist.

Frequently Asked Questions

Is cirrhosis the same as fibrosis?
They're stages of the same process. Fibrosis is scar tissue forming in the liver; cirrhosis is the advanced stage, where extensive scarring and nodules have changed the liver's structure and begun to affect how it works.

Can cirrhosis be reversed?
Established cirrhosis is generally considered permanent scarring, but treating the underlying cause can often stop or slow further damage, and some improvement in liver function is possible. Your specialist can explain what that means in your case.

What causes cirrhosis?
Long-standing liver injury of many kinds: chronic hepatitis B or C, heavy alcohol use over years, and fatty liver disease are among the commonest. Autoimmune and inherited conditions and some bile duct diseases can also lead to it.

How is cirrhosis diagnosed?
Usually by a combination of history, blood tests, and imaging, often including a scan that measures liver stiffness. No single test tells the whole story, and a biopsy is only sometimes needed.

Can you live with cirrhosis?
Many people live with compensated cirrhosis for years, especially when the cause is treated and complications are monitored. The outlook depends on the cause, how advanced the scarring is, and whether complications develop — a question for your own care team.