Signs and symptoms of cirrhosis

As continued scarring and damage to the liver occur, the following signs and symptoms may appear:

• Loss of appetite
• Weight loss
• Jaundice – yellow discoloration of the whites of the eyes and skin occurs because bile pigment can no longer be removed from the liver
• Itching – due to the retention of bile products in the skin
• Ascites – abdominal swelling due to an accumulation of fluid caused by the obstruction of blood flow through the liver
• Vomiting of blood – frequently occurs from swollen ruptured varices (veins that burst) in the lower end of the esophagus due to the increased pressure in these vessels caused by scar tissue formation
• Encephalopathy (impending coma) – subtle mental changes ranging from poor concentration advancing to profound confusion and coma.

Treatment for these conditions

• Ascites is treated by reducing the intake of salt and the administration of medications to improve excretion of salt and water by the kidneys (fluid tablets or diuretics). Some people are unable to take fluid tablets because of side effects. In some instances, large amounts of fluid are removed by direct catheter drainage through the abdominal wall (a ‘tap’).
• Treatment of encephalopathy includes use of specific medication such as lactulose syrup.
• Treatment of bleeding from varices (internal varicose veins) includes taking medication to reduce the likelihood of bleeding or rebleeding, ‘banding’ (the placement of rubber bands on the varices at the time of endoscopy), and occasionally, a radiological procedure called trans jugular intrahepatic Porto systemic shunt (TIPSS).

Management of Encephalopathy

When this condition develops at home it can be distressing to deal with, so if you have noticed any worrying mental changes in your family member or friend, please feel free to discuss it with a member of the transplant team. We can give you strategies to help prevent it or manage it, if it occurs.