What Is Decompensated Cirrhosis?

Cirrhosis is a late stage of liver disease characterized by scarring of the liver and significant impairment of liver function. It is typically classified into two stages: compensated and decompensated cirrhosis.

Decompensated cirrhosis occurs when the liver can no longer maintain normal function, leading to serious complications. These complications may include ascites (fluid buildup in the abdomen) due to low albumin levels, gastrointestinal bleeding caused by portal hypertension, an enlarged spleen (splenomegaly), and overactivity of the spleen (hypersplenism). At this stage, blood tests often reveal elevated bilirubin levels, reduced albumin, decreased fibrinogen, and prolonged prothrombin time—indicating impaired liver synthetic function and increased risk of bleeding.

In contrast, compensated cirrhosis refers to a stage where the liver still functions adequately despite the presence of scarring. During this phase, patients may not experience noticeable symptoms because the liver has a strong ability to compensate for damaged tissue. Even with as little as 30% functional liver tissue remaining, the body may still operate normally without showing signs of liver failure.

Understanding the difference between these two stages is crucial for managing liver disease effectively and preventing progression to more severe forms of liver dysfunction. Early detection and treatment during the compensated phase can help delay or even prevent decompensation.