What are the first symptoms of cirrhosis?

The liver is a silent organ that usually does not hurt. However, cirrhosis, when it develops, causes symptoms that should lead to consultation. Does she have a stomach ache? Is the stomach swollen?

Liver cirrhosis can develop silently or cause only mild and not very suggestive symptoms when it is in the stage of “compensated cirrhosis”. The “first” symptoms of cirrhosis occur when it progresses towards decompensation (decompensated cirrhosis). She is no longer at the beginner stage.

1. A swollen belly

In the case of cirrhosis, the liver is much more fibrous and tough. And it can develop that the liver hardens asciteswhich is fluid that can accumulate in the peritoneum (stomach)“, explains Dr. Christophe Hézode, gastroenterologist and hepatologist. This is due to what you call a portal hypertensioncorresponding to increased blood pressure in the portal vein, mainly caused by the hardness of the liver, which slows down the crossing of the blood in the liver. “Specifically, the stomach swells, with fluid inside. And it is one of the first manifestations of cirrhosis“, he continues.

2. Esophageal varices

Another manifestation of cirrhosis: varicose veins that are not located in the legs, but in the esophagus (esophageal varices). “Because the liver is hard, blood has difficulty passing through it and therefore takes bypass routes (another route), creating varicose veins in the esophagus. And these varicose veins can burst from time to time (ruptured esophageal varices)which can lead to gastrointestinal bleeding“, says our expert. The person vomits blood or has black stools.

Development of liver inflammation to cirrhosis
Development of liver inflammation to cirrhosis © nmfotograf – stock.adobe.com

3. Jaundice

Since there are fewer functioning liver cells in cirrhosis, the liver functions more poorly. And a liver that is not working well can lead to jaundice (jaundice in medical parlance)“, warns Dr. Hézode. Jaundice is characterized by yellow skin, discoloration of the white of the eye in yellow or even dark urine.

4. A loss of concentration

The liver is a kind of factory that will detoxify the body of all bad substances. But when it works less well and fails to convert so-called neurotoxic substances (i.e. poisonous to the brain), there is a risk ofhepatic encephalopathy.The person is drowsy, has trouble concentrating, is confused (act of “reacting to the side” or doing inappropriate things). In extreme cases, encephalopathy can lead to coma“.

“Cirrhosis can be asymptomatic when it is uncomplicated and uncompensated”

5. Sudden weight loss

Sudden weight loss and a sudden loss of appetite can be signs of liver dysfunction such as cirrhosis of the liver.

6. Severe fatigue

And finally, like almost all liver diseases, cirrhosis causes significant fatigue. But fatigue is a symptom common to many pathologies, so it does not specifically indicate liver cirrhosis.

Does cirrhosis hurt the stomach?

The liver is a silent organ which usually does not hurt. Take effect, “the liver is an organ that is not innervated, has no nerve endings, responsible for the sensation of pain“, makes a point of specifying our interlocutor. Ascites can give a sense of bloating, and may be painful during the first episodes due to distension of the skin. When ascites is chronic or small, there is no real pain.

Can cirrhosis be asymptomatic?

Yes.Cirrhosis can be asymptomatic when it is uncomplicated and not decompensated. The liver may simply be a little harder and larger on palpation or Fibroscan. Symptoms will come at the time of decompensation and complications“, concludes our interlocutor.

Thanks to Dr. Christophe Hézode, medical director of hepatology at the International Medical Affairs Department of Gilead and former head of the hepatology department at Henri Mondor Hospital and professor of hepatology at Paris-Est Créteil University.

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