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Liver cirrhosis symptoms

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In the first phase of liver cirrhosis, the patient does not show any manifestations of the disease, but there are some physical examination data that may suggest the presence of liver disease. This phase is known as compensated cirrhosis.

Compensated cirrhosis symptoms

The presence of dilated skin capillaries, known as "spider veins", on the face or upper part of the trunk,

Palmar erythema, that is, redness of the hands.

Presence of abundant veins at the abdominal level.

When the disease progresses, the normal shape of the liver changes and increases the blood vessel pressure within this organ, known as portal hypertension. This phase is called decompensated cirrhosis.

Decompensated cirrhosis symptoms

Ascites: fluid in the abdominal cavity. This can be accompanied by fluid in the legs or oedema.

Jaundice: the patient has a yellowish colouration, due to increased bilirubin in the body, as a result of liver malfunction.

Hepatic encephalopathy: consists of alterations in behaviour and level of consciousness caused by toxic substances in the brain, which are not metabolised in the liver.

Digestive bleeding from varicose veins, which can occur either with the presence of vomiting blood or black faeces (melenas).

Portal Hypertension

Portal hypertension is increased blood pressure in the portal vein. The portal vein is a large blood vessel that carries blood from the intestines to the liver.

Due to cirrhosis, scarring and fibrous tissue are produced within the liver, obstructing blood flow within that organ. This makes the pressure in the blood vessels passing through the liver, such as the portal vein, increase.

Increased pressure within the portal vein is transmitted backward to other veins in the digestive tract and the spleen. As a consequence, abnormally large veins appear in the area of the stomach and oesophagus (oesophageal and gastric varices). These blood vessels swell with blood, making them bleed easily, so one of the main complications of portal hypertension is bleeding. The bleeding from these veins can be serious and even fatal.

Substantiated information by:

Adrià Juanola Mayos

Elisa Pose Mendez

Isabel Graupera Garcia-Milà Hepatologist Senior Specialist Hepatology Service

Martina Perez Guasch

Pere Ginès Gibert Hepatologist Hepatology Service

Published: 5 January 2023
Updated: 5 January 2023

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