Causes & Complications

Causes & Complications

Causes

A wide range of diseases and conditions can damage the liver and lead to cirrhosis. The most common causes are:

• Chronic alcohol abuse
• Chronic viral hepatitis (hepatitis B and C)
• Fat accumulating in the liver (nonalcoholic fatty liver disease)

Other possible causes include:

• Iron buildup in the body (hemochromatosis)
• Cystic fibrosis
• Copper accumulated in the liver (Wilson’s disease)
• Poorly formed bile ducts (biliary atresia)
• Inherited disorders of sugar metabolism (galactosemia or glycogen storage disease)
• Genetic digestive disorder (Alagille syndrome)
• Liver disease caused by your body’s immune system (autoimmune hepatitis)
• Destruction of the bile ducts (primary biliary cirrhosis)
• Hardening and scarring of the bile ducts (primary sclerosing cholangitis)
• Infection such schistosomiasis
• Medications such as methotrexate

Complications

Complications of cirrhosis can include:

• Complications related to blood flow:
  • High blood pressure in the veins that supply the liver (portal hypertension)
    Cirrhosis slows the normal flow of blood through the liver, thus increasing pressure in the vein that brings blood from the intestines and spleen to the liver.
  • Swelling in the legs and abdomen
    Portal hypertension can cause fluid to accumulate in the legs (edema) and in the abdomen (ascites). Edema and ascites also may result from the inability of the liver to make enough of certain blood proteins, such as albumin.
  • Enlargement of the spleen (splenomegaly)
    Portal hypertension can also cause changes to the spleen. Decreased white blood cells and platelets in your blood can be a sign of cirrhosis with portal hypertension.
  • Bleeding
    Portal hypertension can cause blood to be redirected to smaller veins, causing them to increase in size and become varices. Strained by the extra load, these smaller veins can burst, causing serious bleeding. Life-threatening bleeding most commonly occurs when veins in the lower esophagus (esophageal varices) or stomach (gastric varices) rupture. If the liver can’t make enough clotting factors, this also can contribute to continued bleeding. Bacterial infections are a frequent trigger for bleeding.
• Other complications:
  • Infections
    If you have cirrhosis, your body may have difficulty fighting infections. Ascites can lead to spontaneous bacterial peritonitis, a serious infection.
  • Malnutrition
    Cirrhosis may make it more difficult for your body to process nutrients, leading to weakness and weight loss.
  • Buildup of toxins in the brain (hepatic encephalopathy)
    A liver damaged by cirrhosis isn’t able to clear toxins from the blood as well as a healthy liver can. These toxins can then build up in the brain and cause mental confusion and difficulty concentrating. Hepatic encephalopathy symptoms may range from fatigue and mild impairment in cognition to unresponsiveness or coma.
  • Jaundice
    Jaundice occurs when the diseased liver doesn’t remove enough bilirubin, a blood waste product, from your blood. Jaundice causes yellowing of the skin and whites of the eyes and darkening of urine.
  • Bone disease
    Some people with cirrhosis lose bone strength and are at greater risk of fractures.
  • Increased risk of liver cancer
    A large proportion of people who develop liver cancer that forms within the liver itself have cirrhosis.
  • Acute-on-chronic liver failure
    Some people end up experiencing multi organ failure. Researchers now believe this is a distinct complication in some people who have cirrhosis, but they don’t fully understand its causes.