Will cirrhosis continue to progress if there are no symptoms?

Written by Wu Hai Wu
Gastroenterology
Updated on April 28, 2025
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Cirrhosis may not have symptoms, yet it can still progress. There are various causes of cirrhosis, such as viral hepatitis, alcoholic hepatitis, autoimmune hepatitis, drug-induced hepatitis, and fatty liver disease, among others. If the underlying causes are not removed, cirrhosis can continue to progress even without symptoms. For example, in chronic hepatitis B, if no effective antiviral treatment is administered, the patient may progress to decompensated cirrhosis in the absence of symptoms, which in severe cases, can lead to the development of liver cancer. Therefore, once cirrhosis is diagnosed, it is crucial to actively identify the cause and adopt different treatments according to the specific cause, such as abstaining from alcohol if the cirrhosis is alcohol-related.

Other Voices

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Written by Si Li Li
Gastroenterology
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What are the gastrointestinal symptoms of cirrhosis?

In the early stages of cirrhosis, many patients do not exhibit any symptoms, but some may experience fatigue, nausea, vomiting, poor appetite, and indigestion. Some patients might also suffer from portal hypertensive gastropathy due to cirrhosis, leading to symptoms such as pain and bloating in the upper abdomen, acid reflux, and belching. If the disease progresses to the decompensated stage of cirrhosis, portal hypertension can cause varices in the esophagus and stomach, which may lead to severe upper gastrointestinal bleeding if hard food is consumed. Symptoms can include vomiting dark red blood or fresh blood, dizziness, fatigue, and cold sweats. In such cases, it is advised to seek immediate medical attention for emergency treatment.

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Written by Huang Ya Juan
Gastroenterology
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Early symptoms of cirrhosis

Liver cirrhosis is generally divided into compensated and decompensated stages: The compensated stage is actually an early stage of liver cirrhosis. During this stage, most patients do not show symptoms, or they may experience some mild symptoms such as abdominal discomfort, fatigue, loss of appetite, abdominal bloating, indigestion, diarrhea, etc. Decompensated stage: Early stages often present with fatigue and weakness, and later stages can include weight loss, loss of appetite, aversion to oily foods, abdominal bloating, diarrhea, fever, etc.; The liver is the only site of albumin synthesis, and during cirrhosis, reduced serum albumin can cause edema and ascites; the liver synthesizes most clotting factors, and cirrhosis can lead to coagulation disorders, clinically manifesting as gum bleeding, skin bruising, and nosebleeds; During cirrhosis, there can also be metabolic disorders of bilirubin and bile acids, leading to jaundice; Cirrhosis can also cause hormonal metabolic abnormalities, especially in patients with alcoholic cirrhosis, who may exhibit many characteristics of male dysfunction, including impotence, erectile dysfunction, testicular atrophy, loss of body hair and muscle mass, feminization, etc. Female patients may experience cessation or reduction of menstruation, excessive menstruation, infertility, etc.; Both male and female patients can develop osteoporosis, leading to spontaneous fractures.

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Written by Huang Gang
Gastroenterology
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What should I do about 7 episodes of gastrointestinal bleeding due to cirrhosis?

There are manifestations of cirrhosis, and it is accompanied by upper gastrointestinal bleeding, which occurs frequently. At this time, a gastroscopy should be conducted, in combination with an ultrasound examination of the liver, to determine whether portal hypertension is causing the bleeding. If the condition is serious, surgical treatment, such as disconnection or shunting, may be needed to relieve the pressure on the portal vein and mitigate the bleeding. Alternatively, vascular ligation can also be performed under gastroscopy to ligate the ruptured vessels, which can also stop the bleeding. Otherwise, long-term repeated heavy bleeding can easily lead to hemorrhagic anemia, and in severe cases, it can cause hemorrhagic shock, posing a life-threatening risk.

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Written by Wu Hai Wu
Gastroenterology
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Do people with cirrhosis and their family members need to use separate bowls and chopsticks when eating?

Patients with cirrhosis and their family members do not necessarily have to use separate bowls and chopsticks when eating. The causes of cirrhosis include infectious and non-infectious cirrhosis. Among infectious cirrhosis, some are transmitted through blood and others through fecal-oral transmission. Only diseases transmitted via the fecal-oral route require separate bowls and chopsticks, such as hepatitis A and hepatitis E. These types require separation from family members during meals. However, hepatitis B, or some non-infectious types such as alcoholic hepatitis, do not require the use of separate eating utensils.

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Written by Zhang Jian Kang
Infectious Disease
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Can you have intercourse after hepatic cirrhosis caused by hepatitis B?

Liver cirrhosis caused by hepatitis B, if not treated with standard antiviral therapy, is very likely to test positive for the hepatitis B virus. HBV-DNA is a good indicator of the hepatitis B virus; if HBV-DNA tests positive, then it is contagious. The main transmission routes of hepatitis B include mother-to-child transmission, blood and body fluid transmission, and sexual transmission between spouses, though this route carries a relatively lower risk. Why is this the case? Firstly, the spouse may already have hepatitis B surface antibodies, which are protective antibodies providing immunity against hepatitis B. Secondly, when adults are infected with hepatitis B, most can acutely clear the virus, preventing the chronic manifestation of the disease.