Liver Cirrhosis and the Clinical Manifestations of Impaired Liver Function

In the decompensated stage of liver cirrhosis, patients often experience significant damage to liver tissue, leading to two major categories of clinical symptoms: impaired liver function and portal hypertension. The manifestations of reduced liver function are particularly noticeable and can be summarized as follows:

Digestive and Nutrient Absorption Issues
Patients may suffer from a loss of appetite, nausea, aversion to food, abdominal bloating, and diarrhea after consuming fatty meals. These symptoms arise due to the liver's diminished capacity to produce bile, which is essential for fat digestion.

Poor Nutritional Status and General Weakness
Weight loss, fatigue, lack of energy, and poor overall health are common. In severe cases, patients may become so weak that they are bedridden for extended periods.

Jaundice and Skin Changes
Yellowing of the skin and whites of the eyes (jaundice), along with darkened urine, occurs when the liver fails to process bilirubin effectively.

Bleeding Tendencies and Anemia
Easy bruising, nosebleeds, gum bleeding, and gastrointestinal hemorrhages are frequent due to decreased production of clotting factors. This often leads to anemia, further contributing to fatigue and weakness.

Hormonal Imbalances and Related Symptoms
The liver plays a key role in hormone metabolism, and its dysfunction can lead to hormonal imbalances. Men may experience reduced libido, hair loss, and gynecomastia, while women may encounter menstrual irregularities, amenorrhea, or infertility. Visible signs such as spider angiomas, palmar erythema (liver palms), and a characteristic "liver face" appearance with pallor and a tired look are also common.

These symptoms highlight the wide-ranging effects of liver dysfunction in cirrhosis and underscore the importance of early detection and management.