The Typical Symptoms of Liver Function Decompensation in Cirrhosis Patients

During the decompensation phase of cirrhosis, patients often experience severe liver damage, leading to two major categories of symptoms: impaired liver function and portal hypertension. One of the most prominent signs of this stage is the development of ascites, which affects more than 75% of patients and is a primary reason for seeking medical care.

Portal hypertension can lead to several visible complications, including fluid accumulation in the abdomen (ascites), the opening of portosystemic collateral circulation, and an enlarged spleen accompanied by hypersplenism. These manifestations are key indicators of disease progression and require close medical monitoring.

In terms of liver dysfunction, patients may suffer from digestive issues such as poor appetite, nausea, early satiety, bloating, and diarrhea after consuming fatty foods. Malnutrition, weight loss, fatigue, and general weakness are also common. Some patients become so debilitated that they remain bedridden for extended periods.

Jaundice—characterized by yellowing of the skin and eyes—and darkened urine are frequent signs due to reduced bilirubin processing. Easy bruising, nosebleeds, gum bleeding, and gastrointestinal hemorrhages may occur as the liver's ability to produce clotting factors declines.

Hormonal imbalances are another critical aspect of decompensated cirrhosis. Men may experience reduced libido, testicular atrophy, hair loss, and gynecomastia, while women may develop menstrual irregularities, amenorrhea, or infertility. Physical signs like palmar erythema (liver palms) and spider angiomas (spider moles) are also commonly observed, along with a characteristic facial appearance known as the "hepatic face," marked by sallow skin and a tired expression.

These symptoms collectively indicate significant liver deterioration and highlight the importance of timely medical intervention and supportive care during the decompensation phase of cirrhosis.