Progression
A healthy liver has a large functional capacity, meaning people can live for many years with increasing liver damage without realising it.16
Cirrhosis is the term used to describe long-term liver damage or fibrosis, when accumulated scarring causes the liver tissue to harden along with the formation of nodules. Hepatic stellate cells are the main cell type producing collagen fibres, promoting fibrosis in response to liver injury or chronic inflammation.3,12,16,17
Cirrhosis is sometimes called end-stage liver disease as it is the last stage of liver disease which starts with inflammation (hepatitis), fatty deposits (steatosis) and then increasing fibrosis. However, the liver can regenerate so cirrhosis is not necessarily irreversible. Removing the underlying cause can often result in a dramatic improvement in liver function.3,16
In compensated cirrhosis, the liver is still coping and working reasonably well. Decompensated cirrhosis is when liver functions start to fail, resulting in problems such as:16,18,19
- portal hypertension
- varices (gastro-intestinal bleeding)
- ascites (fluid accumulation in the abdomen)
- hepatic encephalopathy (toxins accumulating in the blood stream cause cognitive impairment).