The Centers for Disease Control and Prevention reports an estimated 3.2 million Americans are living with chronic hepatitis C infection. While the disease varies in severity from person to person, the American Gastroenterological Association states 20 percent to 30 percent of people with chronic hepatitis C develop cirrhosis of the liver. Prior to the development of cirrhosis, most people with hepatitis C have few if any symptoms. However, the development of cirrhosis typically ushers in a variety of symptoms, which tend to progress over time.
Abdominal and Tissue Swelling
Hepatitis C-induced cirrhosis can cause fluid accumulation in the abdomen, a condition known as ascites. In addition, a severely damaged liver often cannot make sufficient blood proteins. Low blood protein levels cause fluid leakage into the tissues with associated swelling. The feet and legs are commonly affected.
Male Sexual Changes
Severe hepatitis C-related liver damage can affect male sex hormone balance. Possible symptoms of such an imbalance include breast enlargement, shrinkage of the testicles, decreased interest in sexual activity and impotence.
Female Sexual Changes
Women with extensive hepatitis C-related liver damage also experience sex hormone imbalances. Possible symptoms include decreased menstrual frequency, absence of menstruation and decreased interest in sexual activity.
Vomiting Blood
Advanced cirrhosis typically causes increased pressure in the veins throughout the abdomen. Because veins are structurally unequipped to tolerate high pressure, they may balloon outward. These ballooned areas are called varices; they are prone to rupture. Vomiting large quantities of fresh blood often indicates the rupture of esophageal or stomach varices. This situation is a medical emergency. If you experience these symptoms call 911 to get help.
Abnormally Colored Stools
Cirrhosis can lead to black- or clay-colored stools. Intestinal bleeding from varices or due to liver-related clotting abnormalities causes black stools. Abnormalities in liver production of bile and its flow into the intestine can cause pale, clay-colored stools.
Nausea and Decreased Appetite
Nausea and decreased appetite are common symptoms of extensive hepatitis C-related liver damage. Unintentional weight loss often accompanies these symptoms. Loss of muscle mass can cause the extremities and face to appear thin and wasted.
Itching and Jaundice
When chronic hepatitis C infection extensively damages the liver, chemicals called bilirubin and bile salts build up in the blood and accumulate in the skin. Their skin presence can cause intense itching. In addition, bilirubin stains the skin a yellowish color. This yellow cast to the skin is called jaundice.
Easy Bruising and Bleeding
The liver produces of a group of proteins called clotting factors, which work together to form clots that stop bleeding. When the liver is severely damaged by chronic hepatitis C infection, it may be unable to make sufficient quantities of the clotting factors. In addition, blood platelet levels may be low with severe liver disease. The platelets work with the clotting factors to form clots. The combination of decreased clotting factors and a low platelet level often cause easy bruising and bleeding.
References
- Centers for Disease Control and Prevention: Hepatitis C Information for Health Professionals
- National Institute of Diabetes and Digestive and Kidney Diseases: Cirrhosis
- National Institute of Diabetes and Digestive and Kidney Diseases: Cirrhosis Symptoms
- American Gastroenterological Association: Symptoms of Cirrhosis
- American Gastroenterological Association: Complications of Hepatitis C
