Cirrhosis is advanced scarring of the liver. It develops slowly, over years of ongoing liver injury, and many people feel well until it is advanced. Two things matter most once cirrhosis is found: treating its cause, and checking regularly for liver cancer so that it can be found early.
Common causes
- Fatty liver (MASLD), now a leading cause. See fatty liver.
- Chronic hepatitis B or hepatitis C
- Alcohol
- Less common causes, such as autoimmune and inherited liver diseases
How it is assessed
- Blood tests of liver function, blood count and clotting
- A FibroScan to measure liver stiffness, and an ultrasound scan
- A gastroscopy to look for enlarged veins (varices) in the food pipe or stomach, which can bleed
Liver cancer surveillance
People with cirrhosis have a higher risk of liver cancer (hepatocellular carcinoma). International guidelines recommend an ultrasound every six months, often with an AFP blood test. The aim is to find a cancer while it is small, when surgery, ablation or a transplant can still cure it. Surveillance is also advised for some people with hepatitis B who do not have cirrhosis.
Keeping to the six-monthly schedule matters. Most liver cancers found through regular surveillance are found at an earlier stage than those found because of symptoms.
Looking after a cirrhotic liver
- Treat the cause: antiviral medicine for hepatitis B or C, weight loss and diabetes control for fatty liver, and stopping alcohol completely
- Vaccination against hepatitis A and B if not immune, and yearly influenza vaccination
- Avoid anti-inflammatory painkillers (NSAIDs) such as ibuprofen; paracetamol in normal doses is usually safer. Check before taking herbal or traditional remedies.
- Regular reviews, even when you feel well
Warning signs
See a doctor promptly for swelling of the abdomen or legs, yellowing of the eyes, confusion or drowsiness, fever with abdominal pain, or black stools.
General information only. Reviewed by Dr Chia Chung King, 2026-11-07. Book a consultation.