Symptoms of cirrhosis

There are usuallyfew symptoms during the early stages of cirrhosis. Noticeable problemstend to developas the liver becomes more damaged .

Inearly-stage cirrhosis, the liver is able to function properly despite being damaged. As the condition progresses, symptoms tend to develop when liver functionsare affected.

Symptoms of cirrhosiscan include:

• tiredness and weakness
• loss of appetite
• weight loss and muscle wasting
• feeling sick(nausea) and vomiting
• tenderness or pain around the liver area
• tiny red lines (blood capillaries) on the skin above waist level
• very itchy skin
• yellowing of the skin and the whites of the eyes (jaundice)
• a tendency to bleed and bruise more easily, such as frequent nosebleeds or bleeding gums
• hair loss
• fever and shivering attacks
• swelling in the legs, ankles and feetcausedbya build-up of fluid (oedema)
• swelling in your tummy (abdomen) caused bya build-up of fluid known as ascites severe casescan make you look heavily pregnant

You mayalso notice changes in your personality, problems sleeping (insomnia) , memory loss , confusion and difficulty concentrating.

This is known as encephalopathy, andoccurs when toxins affect your brain because your liver is unable to remove them from your body.

Late-stage symptoms

In the later stages of cirrhosis, you may vomit blood or have tarry, black stools.

This is because blood can't flow through the liver properly, which causes an increase in blood pressure in the vein that carries blood from the gut to the liver (portal vein).

The increase in blood pressure forces blood through smaller, fragile vessels that line your stomach and gullet (varices).

These can burst under high blood pressure, leading to internal bleeding, which is visible in vomit and yourstools.

Over time, the toxins that would normally be removed from the body by a healthy liver can cause multiple organ failure, followed by death.

When toseek medical help

You should see your GP if you have persistent signs and symptoms of cirrhosis.

Seek immediate medical help if you develop the following symptoms, particularly if you've previously been diagnosed with cirrhosis:

• fever and shivering attacks
• shortness of breath
• vomiting blood
• very dark or black tarry stools
• periods of mental confusion or drowsiness