As the liver is repeatedly injured, normal liver tissue is replaced by scar tissue (fibrosis). When scarring becomes widespread and nodules form, the liver becomes cirrhotic. Early (compensated) cirrhosis may have few symptoms. Decompensated cirrhosis can lead to jaundice, ascites, confusion (hepatic encephalopathy), internal bleeding from varices, and an increased risk of liver cancer and death.
Symptoms are often subtle at first (fatigue, easy bruising) and may progress to more obvious signs like fluid retention, jaundice, confusion, or gastrointestinal bleeding.
Call the office if you have known liver disease and notice new or worsening swelling, confusion, jaundice, abdominal pain, or changes in your usual symptoms, or if you have questions about surveillance or transplant evaluation.
Seek emergency care for vomiting blood, black/tarry stools, severe shortness of breath, sudden confusion, severe abdominal pain, high fever, or if you feel extremely weak or faint—these can be life-threatening complications.
Evaluation includes identifying the underlying cause (viral hepatitis, alcohol, fatty liver, autoimmune, etc.), assessing the degree of scarring with imaging and blood-based scores, and screening for complications such as varices and liver cancer.
Management focuses on treating the cause, preventing and treating complications, and assessing timing for liver transplantation. Lifestyle choices (no alcohol, vaccinations, careful medication use) are critical to protect remaining liver function.
If your insurance requires a referral or prior authorization, our billing office will make every effort to obtain it before services are rendered. If you choose to proceed without required authorization, insurance may deny coverage. If you are a Medicare patient, you may be asked to sign an Advanced Beneficiary Notice (ABN) acknowledging financial responsibility if insurance does not pay. If you are enrolled in a commercial insurance plan you will be asked to sign a non-covered services form.