The Most Effective Way to Assess Liver Cirrhosis with or without Ascites

Liver cirrhosis is a widespread chronic liver disease that progresses over time. It typically results from long-term damage caused by one or more factors, such as viral hepatitis, alcohol consumption, or non-alcoholic fatty liver disease. In many cases, particularly in Asia, viral hepatitis is the leading cause of cirrhosis.

When evaluating the progression of cirrhosis and determining whether ascites has developed, color Doppler ultrasound is considered the most effective diagnostic tool. This imaging technique allows physicians to examine blood flow and detect abnormalities in liver structure, including fluid accumulation in the abdominal cavity.

At the histological level, cirrhosis involves extensive hepatocyte necrosis, nodular regeneration of surviving liver cells, and fibrous tissue proliferation. These changes disrupt the normal liver lobule architecture, replacing it with regenerative nodules and fibrous septa—eventually causing the liver to harden and lose function.

In the early stages, patients may not exhibit noticeable symptoms due to the liver's strong compensatory capacity. However, as the disease advances, signs such as impaired liver function and portal hypertension become more evident. Patients often experience complications like hepatic encephalopathy, upper gastrointestinal bleeding, secondary infections, splenomegaly, and the development of ascites, which is a key indicator of decompensated cirrhosis.

Moreover, advanced cirrhosis increases the risk of hepatocellular carcinoma, making regular monitoring essential. Early diagnosis and proper management can significantly improve patient outcomes and quality of life. Therefore, incorporating routine ultrasound screening into the care plan for individuals with chronic liver disease is highly recommended.