Chronic liver inflammation and cirrhosis

Chronic inflammation results in death (necrosis) of liver cells and scarring (fibrosis).  Extensive scarring is known as cirrhosis, the end result of which is liver failure i.e. the liver can no longer carry out its functions.  In this situation the person is very ill and unless a liver transplant is possible, the prognosis is poor.

Fortunately the liver is a very adaptable organ and can go on doing its job very well even if a part of it is damaged.  In other words the liver is very good at compensating for damage to it.  The term compensated cirrhosis means that the liver has extensive scarring but is not failing in its vital functions.

The liver's ability to compensate for damage means that liver disease may be far advanced before the patient recognises any warning signs or symptoms.  However, some complications can occur in compensated cirrhosis.

If liver disease is progressive there comes a time when there is so much damage that the liver can no longer compensate for the damage and loss of healthy liver tissue.  It then starts failing to carry out its functions.  The term decompensated cirrhosis means that liver failure is occurring.  It is associated with certain serious problems e.g. the normal circulation of blood through the liver becomes disrupted.  Problems may include:

• development of ascites (abnormal accumulation of fluid in abdomen)
• development of encephalopathy (affects the brain, causing confusion, and drowsiness and loss of consciousness)
• bleeding from distorted vessels that drain blood from the oesophagus - the tube that carries food from the mouth to the stomach.  These distorted blood vessels are known as oesophageal varices.

Liver cancer

Primary liver cancer (cancer starting in the liver) is also known as hepatocellular carcinoma (HCC).  Some patients with cirrhosis go on to develop HCC.

Blood clotting problems

The liver produces substances such as prothrombin that are necessary for the clotting of blood, so it's not surprising that people with severe liver disease are at increased risk of heavy bleeding following any sort of trauma.

Feeling tired and weak

The liver is essential in the digestion of food, so liver failure is associated with loss of weight, tiredness and weakness.