Bloating, Loss of Appetite, and Fatigue – These Could Be Signs of Liver Cirrhosis

Bloating, fatigue, and a reduced appetite may seem like common symptoms, but they could be warning signs of a more serious condition such as liver cirrhosis. In this case report, we follow the journey of a 49-year-old female patient who experienced these symptoms for nearly 20 days before seeking medical attention. She also reported occasional nausea and dry heaving. Upon diagnosis, she was found to have decompensated cirrhosis with significant ascites. After undergoing paracentesis and liver transplant surgery, her condition improved significantly.

She was treated at The First Hospital of China Medical University in March 2022. Her treatment plan included surgical procedures, oral medication (cyclosporine soft capsules), and intravenous infusions of glucose, potassium chloride, and human albumin. After a three-week hospital stay and one month of post-operative follow-up, her symptoms had largely disappeared, and she showed no signs of immune rejection while maintaining good overall recovery.

Initial Consultation and Symptoms

The patient presented with persistent upper abdominal bloating, fatigue, and loss of appetite. Despite trying over-the-counter medications aimed at improving gastric motility, she experienced minimal relief. She had a history of hypertension and megaloblastic anemia but no prior history of hepatitis or tuberculosis. Abdominal CT scans revealed severe ascites and a shrunken liver, leading to a preliminary diagnosis of cirrhosis.

Diagnostic Findings and Treatment Approach

Blood tests confirmed elevated bilirubin levels, low albumin, abnormal clotting function, and moderately raised liver enzymes. Combined with clinical findings such as splenomegaly and ascites, the diagnosis was confirmed as decompensated liver cirrhosis. Paracentesis was performed to drain excess abdominal fluid, and intravenous therapy was initiated to support liver function and maintain electrolyte balance.

Given the severity of her condition, liver transplantation was recommended as the most effective long-term solution. Following a successful transplant and a three-week recovery period, the patient was discharged with a prescription for cyclosporine to prevent organ rejection.

Post-Operative Recovery and Follow-Up

After paracentesis, the patient experienced immediate relief from bloating and fatigue. Post-transplant evaluations showed normal liver function and no signs of rejection. During her hospital stay, ascites did not reoccur, and she regained much of her strength. She was advised to monitor for any recurrence of symptoms or signs of rejection, such as fever, jaundice, or diarrhea, and to seek prompt medical care if needed.

Key Recommendations for Long-Term Recovery

Following discharge, patients should prioritize rest, maintain a regular sleep schedule, and avoid excessive physical strain or late nights. Proper wound care is essential to prevent infection, including keeping the surgical site clean and dry. A light, easily digestible diet is encouraged, avoiding high-sodium, high-fat, or spicy foods. Adherence to prescribed medication schedules is crucial—patients must not alter dosages or discontinue treatment without medical supervision.

Early Detection Is Critical

Liver cirrhosis often progresses silently, with early symptoms like fatigue, bloating, and poor appetite going unnoticed. As seen in this case, timely intervention can significantly improve outcomes. Delayed diagnosis can lead to life-threatening complications such as severe ascites, bleeding, or hepatic failure. Therefore, it's vital to take early symptoms seriously and seek prompt medical evaluation. Early treatment not only improves prognosis but also reduces both the complexity and cost of care.