Cirrhosis Of The Liver: Understanding The Decompensated Stage

Cirrhosis is categorized into two main phases: compensated and decompensated. The decompensated stage, often referred to as the advanced or end-stage of liver disease, typically overlaps with what is known as the late phase of cirrhosis. During the compensated phase, the liver still functions adequately despite the presence of scarring, largely due to its strong regenerative capacity. In fact, scientific studies have shown that up to 70%-80% of a healthy liver can be removed and it can still perform essential functions, which explains why the compensated period in cirrhosis patients can last for many years.

Decompensation occurs when the remaining healthy liver cells are no longer able to support the body's normal functioning. At this point, vital processes like the production of albumin—a protein crucial for maintaining fluid balance in the body—become impaired. When albumin levels drop too low, fluid can accumulate in the abdominal cavity, leading to a condition called ascites, which is one of the hallmark signs of decompensation.

Other serious complications may also arise during this stage, including gastrointestinal bleeding, hepatic encephalopathy (a decline in brain function due to liver damage), and increased susceptibility to infections. The appearance of these symptoms marks the transition into the decompensated phase. Managing this stage requires comprehensive medical care and lifestyle adjustments to reduce symptoms and prevent further deterioration.

The ultimate goal of treatment in cirrhosis is to prolong the compensated phase and delay the onset of decompensation. Early diagnosis and intervention play a critical role in improving long-term outcomes for patients living with liver disease. Understanding the progression of cirrhosis helps patients and caregivers make informed decisions about treatment and lifestyle changes.