There are often no symptoms and signs of cirrhosis for many years, since the pathological processes take a long time to affect liver structure and function. Initial symptoms are non-specific such as malaise, fatigue, poor appetite, generalised weakness and weight loss. On abdominal examination a firm enlarged liver may be felt. Weight loss due to decreased food intake and malabsorption of fats and vitamins leads to signs of malnutrition.
In diseases where bile secretion is affected causing cirrhosis e.g. primary biliary cirrhosis, jaundice and itching occur. Other features of long standing liver disease include palmar erythema (red palms), xanthelasmata (fatty yellow deposits in the skin), muscle wasting, white nails, spider naevi (small irregular skin lesions made up of distended blood vessels), hair loss, gynaecomastia (enlarged breast tissue in males), testicular atrophy etc. The spleen may be enlarged.
Late complications include ascites, abnormal bleeding from the gastro intestinal tract, liver failure, kidney failure, hepatic encephalopathy and liver cancer.
Cirrhosis is diagnosed and monitored by blood tests, liver scans and liver biopsy (taking a small piece of liver tissue for examination under the microscope).