Liver damage can range from:

  • little to mild damage
  • mild to moderate damage (fibrosis)
  • moderate to severe damage (fibrosis to compensated cirrhosis)
  • severe damage to liver failure (decompensated cirrhosis)

Tests performed can determine the grade or stage of liver damage from fibrosis to cirrhosis and help monitor the patients liver function. Patients need to be monitored with regular tests and exams by a liver disease specialist (Hepatologist or Gastroenterologist) in order to be proactive with their care and symptoms.

Some patients can live for years with low to mild damage and no symptoms before the liver becomes severely damaged by cirrhosis in which liver function is compromised.

The Mayo Clinic states:

“Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. The liver carries out several necessary functions, including detoxifying harmful substances in your body, cleaning your blood and making vital nutrients.

Cirrhosis occurs in response to damage to your liver. Each time your liver is injured, it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function.”

There are two general categories of cirrhosis which describe the level of liver function and damage; compensated and decompensated.

Compensated Cirrhosis

Compensated cirrhosis means the liver is scarred but still able to perform most its basic functions at some level. The stage or grade of scarring depends on how well the liver is able to function. If the cause for damage is not eliminated, like having the Hepatitis C virus, or drinking alcohol, drug use, etc… liver damage will continue to progress and the patient will begin to experience more severe break down in liver function.

With compensated cirrhosis, the pressure in the portal vein is not too high and the liver still has enough healthy cells to perform its function.

Symptoms of Compensated Cirrhosis

Patients can live for years without being aware of liver damage with little to no symptoms. Not all patients experience these symptoms but common symptoms of compensated cirrhosis are:

  • itching
  • fatigue
  • loss of appetite
  • stomach upset
  • weight loss
  • bruising
  • swelling/retaining fluid in legs or abdominal area
  • confusion (brain fog)
  • Loss of muscle mass

Liver disease patients with compensated or decompensated cirrhosis are also more at risk for liver cancer. There may be no signs of liver cancer until the cancer has grown very large and causes pain. Regular ultrasound tests are recommended to monitor the liver. Early detection can save lives.

Decompensated Cirrhosis

Liver damage and severe scarring can progress to the point where the liver can no longer function properly and the patient will begin to experience more severe symptoms. Liver function will continue to decrease with the patient being more at risk for more severe complications like internal bleeding, liver cancer and liver failure and the need for liver transplant.

Symptoms of Decompensated Cirrhosis

  • Internal bleeding from large blood vessels in the esophagus (varices)
  • Fluid buildup in the abdomen (ascites)
  • Swelling in legs
  • Hepatic Encephalopathy with confusion, slurred speech, disoriented or brain fog
  • Yellowing of eyes and skin (jaundice)
  • Severe fatigue
  • Loss of appetite
  • Continued weight loss or muscle mass
  • Nausea
  • Redness in the palms of hands
  • Bruising

You can help take care of your liver and reduce your risk of cirrhosis

  • See your liver specialist regularly for tests and exams to monitor your liver condition.
  • Do not drink alcohol if you have liver disease or cirrhosis. Alcohol damages liver cells and can accelerate liver damage.
  • Do not smoke or be exposed to harmful chemicals or drugs.
  • Eat a healthy diet. Choose a plant-based diet that’s full of fruits and vegetables. Select whole grains and lean sources of protein. Reduce the amount of fatty and fried foods you eat. Caffeinated coffee may protect against fibrosis and liver cancer.
  • Maintain a healthy weight.An excess amount of body fat can damage your liver. Talk to your doctor about a weight-loss plan if you are obese or overweight.
  • Reduce your risk of hepatitis.Sharing needles and having unprotected sex can increase your risk of hepatitis B and C. Ask your doctor about hepatitis A & B vaccinations. There is no vaccination for Hep C.

This entry was originally published on Life Beyond Hepatitis C, and is reprinted with permission.