What are the first symptoms of cirrhosis of the liver?

The liver is a silent organ that usually does not hurt. However, cirrhosis of the liver, when it evolves, causes symptoms that should lead to consultation. Does she hurt her stomach? Is the belly swollen?

Cirrhosis of the liver can evolve silently or cause only mild and not very suggestive symptoms when it is in the stage of “compensated cirrhosis”. The “first” symptoms of cirrhosis appear when it progresses towards decompensation (decompensated cirrhosis). She is no longer at the beginner stage.

1. A swollen belly

In the case of cirrhosis, the liver is much more fibrous and tough. And the fact that the liver hardens can develop asciteswhich is fluid that can accumulate in the peritoneum (belly)“, explains Dr. Christophe Hézode, gastroenterologist and hepatologist. This is due to what is called a portal hypertensionthat corresponds to increased blood pressure in the portal vein, caused mainly by the hardness of the liver which slows down the crossing of the blood in the liver. “Concretely, the belly swells, with fluid inside. And that is one of the first manifestations of cirrhosis“, he continues.

2. Esophageal varices

Another manifestation of cirrhosis: varicose veins that are located not in the legs but in the esophagus (oesophageal varices). “Because the liver is hard, the blood has difficulty passing through it and therefore takes bypass routes (another path), which creates varicose veins in the esophagus. And these varicose veins can burst from time to time (ruptured esophageal varices)which can lead to gastrointestinal bleeding“, says our expert. The person vomits blood or has black stools.

Evolution of liver inflammation to cirrhosis © nmfotograf – stock.adobe.com

3. Jaundice

Since in cirrhosis there are fewer functioning liver cells, the liver functions less well. And a liver that works less well can lead to jaundice (jaundice in medical parlance)“, warns Dr Hézode. Jaundice is characterized by yellow skin, discoloration of the white of the eye in yellow or even dark urine.

4. A loss of concentration

The liver is a kind of factory that will detoxify the body of all bad substances. But when it works less well and fails to metabolize so-called neurotoxic substances (in other words, toxic to the brain), there is a risk ofhepatic encephalopathy.The person is drowsy, has trouble concentrating, is confused (act of “responding to the side” or doing inappropriate things). Encephalopathy can, in extreme cases, lead to coma“.

“Cirrhosis can be asymptomatic, when it is uncomplicated and undecompensated”

5. Sudden weight loss

Sudden weight loss and a sudden loss of appetite can be a sign of liver dysfunction such as cirrhosis.

6. Severe fatigue

And finally, like almost all liver diseases, cirrhosis causes significant fatigue. But fatigue is a symptom common to many pathologies, so it is not specifically suggestive of cirrhosis of the liver.

Does cirrhosis hurt your stomach?

The liver is a silent organ which usually doesn’t hurt. In effect, “the liver is an organ that is not innervated, has no nerve endings, responsible for the sensation of pain“, makes a point of specifying our interlocutor. Ascites can give the sensation of bloating, and can be painful during the first episodes due to distension of the skin. When the ascites is chronic or small, there is no real pain.

Can cirrhosis be asymptomatic?

Yes.Cirrhosis can be asymptomatic, when it is uncomplicated and not decompensated. The liver may simply be a little harder and larger on palpation or Fibroscan. Symptoms will come at the time of decompensation and complications“, concludes our interlocutor.

Thank you to Dr. Christophe Hézode, Medical Director Hepatology at the International Medical Affairs Department of Gilead and former Head of the Hepatology Department at Henri Mondor Hospital and Professor of Hepatology at Paris-Est Créteil University.

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