Can Liver Function Be Normal in Cirrhosis?

In the progression of liver cirrhosis, the condition can be divided into two main stages: compensated and decompensated. The impact on liver function varies significantly between these stages.

Compensated Cirrhosis and Normal Liver Function

During the compensated stage of cirrhosis, a patient may still maintain normal liver function. This means that the organ is able to perform its essential tasks despite the presence of scarring. However, regular monitoring through blood tests and medical evaluations is crucial to detect any early signs of deterioration. If the cirrhosis is caused by chronic hepatitis B infection, also known as hepatitis B-related cirrhosis, it's important to closely monitor the viral load (HBV-DNA levels). Keeping the virus under control with antiviral therapy can help prevent further liver damage. In addition, patients should undergo hepatoprotective treatment and anti-fibrotic therapy to slow or halt disease progression. With proper care, complications such as portal hypertension, ascites, or even hepatocellular carcinoma can often be avoided.

Decompensated Cirrhosis and Abnormal Liver Function

Once cirrhosis progresses to the decompensated phase, liver function becomes significantly impaired. Common abnormalities include elevated bilirubin levels (jaundice), increased liver enzymes, low albumin levels, and coagulopathy. These symptoms indicate that the liver is no longer able to carry out its vital functions effectively. At this stage, aggressive supportive care is necessary, including lifestyle and dietary modifications. Patients are advised to avoid consuming hard, spicy, or overly salty foods that could potentially trigger gastrointestinal bleeding or worsen fluid retention (ascites). Regardless of the initial viral load, long-term antiviral therapy is typically required to manage the underlying cause and prevent further deterioration of liver health.