Cirrhosis Of The Liver In Advanced Stages: Recognizing Key Clinical Symptoms

When cirrhosis reaches its final stage, also known as decompensated cirrhosis, the body begins to show a range of noticeable symptoms. One of the most prominent areas affected is the digestive system, with patients often experiencing persistent abdominal bloating, loss of appetite, and an aversion to fatty foods. These gastrointestinal disturbances may be accompanied by recurring nausea, vomiting, and intermittent diarrhea.

Unexplained weight loss is another common symptom. While some patients may not experience a significant drop in overall weight, they often display visible muscle wasting in the limbs—this condition is medically referred to as sarcopenia. Despite increasing abdominal fluid accumulation (ascites), which may mask weight loss, many patients suffer from malnutrition due to reduced intestinal nutrient absorption and poor dietary intake.

Jaundice also becomes increasingly prevalent in late-stage liver disease. Patients may notice yellowing of the skin and whites of the eyes, along with dark, tea-colored urine. This occurs as the liver's ability to process bilirubin declines, causing levels of this pigment to rise in the bloodstream.

A persistent low-grade fever, typically below 38°C (100.4°F, is frequently observed. This mild but ongoing elevation in body temperature can last for extended periods and tends to recur even after brief improvements.

In addition to these core symptoms, several serious complications may arise. Repeated episodes of upper gastrointestinal bleeding—such as vomiting blood or passing black, tarry stools—are possible. Another major concern is hepatic encephalopathy, a condition caused by the liver's declining ability to remove toxins like ammonia from the blood, leading to confusion, altered consciousness, and even coma. As the disease progresses, patients may develop reduced urine output and potentially hepatorenal syndrome, with the risk increasing alongside disease severity.