End Stage Liver Diseases

Cirrhosis is the term referred to patients suffering from a chronic liver disease. These individuals develop complications that arise due to other underlying causes and disease such as viral hepatitis and chronic alcoholism. Fibrosis is scars that develop as the result of damages caused to the liver. The progression of fibrosis creates the malfunction of the liver. There are two stages of cirrhosis, compensated and decompensated. Compensated cirrhosis refers to an individual who develops no symptoms and can continue with the condition for several years. Decompensated cirrhosis refers to the complications that develop as the consequence of progressive cirrhosis which can be life threatening and may require liver transplantation.  Individuals who develop other associated disorders such as hepatic encephalopathy, ascites or renal dysfunction and are considered to be at end-stage liver disease (ESLD).


Usually, there are no indicative symptoms of cirrhosis till the liver has developed damages. However, some of the symptoms associated with cirrhosis are fatigue, ascites (fluid in the abdomen), swelling of legs, vomiting, spiderlike blood vessels on the skin, weight loss, reduced brain function and easy bleeding.


There are several diseases and factors that can result in the damage of the liver developing cirrhosis. Some of the common causes are chronic alcohol consumption, viral hepatitis, nonalcoholic fatty liver disease (NAFLD), cystic fibrosis, inherited disorder of sugar metabolism, infections and certain medications.

Diagnosis and Treatment

Due to the lack of symptoms in early stages of cirrhosis, it is usually detected during a general checkup. The diagnosis is generally confirmed with blood tests and physical examination which can indicate enlarged or hard liver with signs of ascites. Other screening includes a blood test for liver function, kidney function and hepatitis. The liver imaging is done with MRI, CT and ultrasound scans. Liver biopsy may be required to assess the severity of the liver damage.

Treatment requires in stopping the progression of cirrhosis and treating other underlying causes and disease. Early detection of cirrhosis may assist in the treatment of the underlying causes such as alcohol dependency, medications to control hepatitis, nutritious diet for individuals with malnutrition which is common with for people with cirrhosis. Damages of the liver due to cirrhosis cannot generally be reversed but early detection means the cause can be treated and further damage limited. Treatments of other complications due to cirrhosis include medications for portal hypertension, medication to prevent the excess build of fluids in the body and treatment of hepatic encephalopathy (medication to assist in the prevention of toxin build up in the body).


The liver becomes stiff due to cirrhosis and as a result, the blood pressure builds up in the portal vein which carries blood to the liver. The blood tends to back-up in the spleen which becomes enlarged destroying the platelets. The build-up of pressure in the portal vein creates a condition called portal hypertension. Cirrhosis can result in the development of liver cancer, also known as hepatocellular carcinoma.  Some of the complications associated with cirrhosis are enlargement of the spleen, swelling of the legs and abdomen, malnutrition, jaundice, gallstones and liver failure.