Symptoms

Many people experience few symptoms at the onset of cirrhosis.

Early symptoms include the following:

• Fatigue and loss of energy.
• Loss of appetite and nausea.
• Spider angiomas may develop on the skin; these are pinhead-sized red spots from which tiny blood vessels radiate.

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Patients in later stages may develop the following symptoms:

• Jaundice. This is a yellowish cast to the skin and eyes, which occurs because the liver cannot process bilirubin for elimination from the body.

Jaundice is a condition produced when excess amounts of bilirubin circulating in the blood stream dissolve in the subcutaneous fat (the layer of fat just beneath the skin), causing a yellowish appearance of the skin and the whites of the eyes. With the exception of normal newborn jaundice in the first week of life, all other jaundice indicates overload or damage to the liver, or inability to move bilirubin from the liver through the biliary tract to the gut.

• The palms of the hands may be reddish and blotchy, a condition known as palmar erythema.
• Loss of body hair.
• Abnormalities in hormone-affected organs. In men with alcoholic cirrhosis, the testicles may atrophy and their breasts may become swollen, sometimes painfully.
• Ascites. A swollen belly is a sign of ascites, the most common major complication of cirrhosis, which occurs when fluid accumulates in the abdomen. Fever, abdominal pain, and tenderness when the belly is pressed indicate that the fluid is infected, but infection can occur without any symptoms.
• Fluid buildup and swelling (edema) in legs.

Symptoms of Primary Biliary Cirrhosis

People with primary biliary cirrhosis are subject to severe generalized itching and often develop small fatty yellow lumps called xanthomas on the eyelids, hands, and elbows. They may have an unpleasant condition called steatorrhea, in which the feces contain excessive fat, causing them to float and to be very foul smelling.

Click the icon to see an image of a xanthoma.