Complications

Complications of cirrhosis can include:

• High blood pressure in the veins that supply the liver (portal hypertension). Cirrhosis slows the normal flow of blood through the liver, thus increasing pressure in the vein that brings blood to the liver from the intestines and spleen.
• Swelling in the legs and abdomen. The increased pressure in the portal vein can cause fluid to accumulate in the legs (edema) and in the abdomen (ascites). Edema and ascites also may result from the inability of the liver to make enough of certain blood proteins, such as albumin.
• Enlargement of the spleen (splenomegaly). Portal hypertension can also cause changes to and swelling of the spleen, and trapping of white blood cells and platelets. Decreased white blood cells and platelets in your blood can be the first sign of cirrhosis.
• Bleeding. Portal hypertension can cause blood to be redirected to smaller veins. Strained by the extra pressure, these smaller veins can burst, causing serious bleeding. Portal hypertension may cause enlarged veins (varices) in the esophagus (esophageal varices) or the stomach (gastric varices) and lead to life-threatening bleeding. If the liver can't make enough clotting factors, this also can contribute to continued bleeding.
• Infections. If you have cirrhosis, your body may have difficulty fighting infections. Ascites can lead to bacterial peritonitis, a serious infection.
• Malnutrition. Cirrhosis may make it more difficult for your body to process nutrients, leading to weakness and weight loss.
• Buildup of toxins in the brain (hepatic encephalopathy). A liver damaged by cirrhosis isn't able to clear toxins from the blood as well as a healthy liver can. These toxins can then build up in the brain and cause mental confusion and difficulty concentrating. With time, hepatic encephalopathy can progress to unresponsiveness or coma.
• Jaundice. Jaundice occurs when the diseased liver doesn't remove enough bilirubin, a blood waste product, from your blood. Jaundice causes yellowing of the skin and whites of the eyes and darkening of urine.
• Bone disease. Some people with cirrhosis lose bone strength and are at greater risk of fractures.
• Increased risk of liver cancer. A large proportion of people who develop liver cancer have pre-existing cirrhosis.
• Acute-on-chronic cirrhosis. Some people end up experiencing multiorgan failure. Researchers now believe this is a distinct complication in some people who have cirrhosis, but they don't fully understand its causes.