Cirrhosis is an alteration of the liver’s normal architecture, which takes place as a result of different liver diseases. One of the most common causes of cirrhosis is alcohol, which acts as a toxic substance and causes alcoholic liver disease. However, the number one cause of cirrhosis is hepatitis C, with over 26% of cases in the United States.

Cirrhosis is sometimes asymptomatic, and patients with symptoms can display a very mild or decompensated liver disease. The natural course of cirrhosis usually includes portal hypertension, which then turns into ascites of varying intensities, and one of the worst consequences is hepatic encephalopathy. In this article, we’re going through the symptoms of each one of these stages.

Portal hypertension signs and symptoms

1. Gastrointestinal bleeding

It is often the case that cirrhosis and portal hypertension cause a stagnant blood flow in certain veins, especially in esophageal veins. They become enlarged and create varices, and these are very susceptible to breaking. Thus, the first symptom in many patients with portal hypertension is vomiting red blood due to a rupture of the varicose veins in the esophagus. It can also cause blood in the stools or tarry and black stools.

This symptom is made worse in patients with alterations in platelet levels. The liver also contributes to coagulation factors, and a liver with cirrhosis does not have the same function as a healthy organ. Thus, the coagulation time is prolonged, and the gastrointestinal system as a whole becomes more susceptible to bleeding.