Cirrhosis is a disease characterized by destruction of healthy liver tissue. Scar tissue replaces once healthy tissue with tough fibrous nodules. Cirrhosis often begins with no symptoms as the body often compensates for the early damage, a condition referred to as compensated cirrhosis. Later in the disease, symptoms arise due to extensive damage to the liver's function. De-compensated cirrhosis marks end stage cirrhosis, and exhibits various symptoms.
Weakness and Altered Mental State
Weakness and fatigue often afflict the person with end stage cirrhosis. The Merck Manuals Online Medical Library explains that causes include malnutrition, anemia and hepatic encephalopathy. Hepatic encephalopathy describes a condition where the damaged liver becomes unable to rid the body of toxins. These toxins build in the blood and brain, and cause behavioral changes, inability to concentrate, drowsiness, confusion, coma and eventually death.
Abdominal Discomfort
Abdominal discomfort commonly affects those with end stage cirrhosis, and manifests in many different ways. "Medical Surgical Nursing" states that the abdomen often swells due to fluid accumulation in the abdominal cavity. This condition is known as ascites, and causes bloating, pain, tightness and shortness of breath. Other common symptoms include nausea, vomiting, indigestion, diarrhea, loss of appetite and weight loss.
Bleeding
Patients with end stage cirrhosis are more susceptible to bleeding. The liver metabolizes vitamin K which is responsible for clotting blood. Without the necessary vitamin K, the blood thins and causes a high risk of bleeding. In addition, blood from a narrowing or blocked vein in the liver can engorge in the veins of the stomach, esophagus and intestines, increasing the risk of rupturing and bleeding. The American Academy of Family Physicians reports that 10 to 30 percent of cirrhosis patients develop bleeding in the esophagus.
Other Symptoms
End stage cirrhosis may also increase the risk of infection due to the liver's inability to rid the body of bacteria and other substances. Jaundice, or yellowing of the skin and the white of the eye, may occur, and The Merck Manuals Online Medical Library also lists swelling, itching and pale-colored stools as symptoms commonly exhibited in end stage cirrhosis.
References
- "Medical Surgical Nursing"; Ignatavicius, D. MSN, Workman, L. Ph.D..; 2002
- American Academy of Family Physicians: Cirrhosis and Chronic Liver Failure Part II
- Merck Manuals Online Medical Library: Cirrhosis
- American Academy of Family Physicians: Cirrhosis and Chronic Liver Failure Part I
