Liver Cirrhosis -- Symptoms, Stages & Treatment

You are not alone

Liver cirrhosis is one of the leading causes of death in India. But it is manageable -- especially when caught early.

1 in 5

All cirrhosis-related deaths worldwide occur in India -- more than any other country.

Lancet GBD Study 2019

112M

People worldwide are currently living with compensated (early-stage) liver cirrhosis.

PMC / Lancet Gastroenterology

2 yrs

Median survival after cirrhosis becomes decompensated -- without treatment or transplant.

PMC / Compensated Cirrhosis Review

What exactly is liver cirrhosis?

The liver is remarkable at healing itself. But repeated injury -- from alcohol, a virus, or fat -- eventually overwhelms it. Instead of regenerating properly, it forms scar tissue. Over time, that scar tissue takes over.

Healthy Liver

Normal function, no damage

Inflammation

Liver tries to repair repeated injury

Fibrosis

Scar tissue begins forming

Cirrhosis

Extensive scarring; function impaired

Common causes in India

Alcohol

Responsible for 30-70% of cirrhosis cases across India

Hepatitis B

Most common overall cause of liver cancer and cirrhosis nationally

Fatty Liver (NASH)

9-32% of Indians have NAFLD; NASH can progress to cirrhosis over years

Hepatitis C

Major cause -- increasingly curable with modern direct-acting antivirals

Two stages: what they mean for you

Compensated (Early)

Liver is scarred but still functioning. Often no symptoms. Median survival: 10-12 years. Treatment at this stage can prevent progression.

Decompensated (Advanced)

Liver can no longer maintain basic functions. Ascites, jaundice, confusion appear. Median survival: 2 years without transplant.

5-12% of compensated patients progress to decompensation each year. Source: PMC / Lancet Gastroenterology

Recognise the signs

Cirrhosis is often silent in its early stages. By the time symptoms appear, significant damage may already exist -- which is why high-risk individuals should be screened regularly.

Early / General Symptoms

Persistent fatigue and weakness

Loss of appetite and nausea

Unexplained weight loss

Spider angiomas (spider veins on skin)

Mild discomfort in the upper right abdomen

Warning Signs -- Seek Specialist Care Urgently

Swollen abdomen (ascites -- fluid accumulation)

Yellowing of skin and whites of eyes (jaundice)

Confusion, forgetfulness, or personality change

Vomiting blood or passing black tarry stools

Persistent swelling in the legs

Treatment Plan

What treatment looks like at each stage

Treatment is tailored to the stage of cirrhosis and its underlying cause. The earlier treatment begins, the more options are available and the better the outcomes.

Stage 01

Compensated Cirrhosis

Liver is scarred but still functioning

Treat the underlying cause (antivirals for hepatitis, complete alcohol abstinence)
Diet and exercise -- reduce fatty foods, no alcohol
Medications to control complications (diuretics for mild fluid retention)
Ultrasound every 6 months -- screen for liver cancer
Blood tests every 3-6 months to track liver function

Stage 02

Decompensated Cirrhosis

Complications have developed

Hospitalisation to manage acute complications
Paracentesis (drainage) for tense ascites
Endoscopic banding or injection for variceal bleeding
Lactulose and rifaximin for hepatic encephalopathy
Antibiotics for spontaneous bacterial peritonitis
Begin transplant evaluation -- MELD score calculated

Stage 03

Liver Transplant

When the liver can no longer sustain life

Living donor transplant -- fastest path, no waiting list
Deceased donor listing through SOTTO registry (Punjab)
Pre-transplant nutritional optimisation
Surgery followed by lifelong immunosuppression
Return to full normal life for most patients within 3-6 months

This treatment overview is for general information only and has not yet been formally reviewed for this publication. Your care plan will be determined by Dr. Sahota after a personal evaluation. Do not make treatment decisions based on this page alone.

Liver Cirrhosis