There are very few symptoms of cirrhosis during the early stages of the condition. It's often picked up during tests for an unrelated illness.
You should visit your GP as soon as possible if you have any of the following symptoms:
- fever and shivering
- shortness of breath
- vomiting blood
- very dark or black, tar-like stools (faeces)
- periods of confusion or drowsiness
Read more about the symptoms of cirrhosis.
If your GP suspects that you have cirrhosis, they will take your medical history and carry out a physical examination to look for signs of chronic liver disease. If suspected, you'll be referred for a number of tests to confirm the diagnosis.
Tests
You may have any of the tests that are described below.
- A blood test to measure your liver function and the amount of liver damage. The test may measure the levels of the liver enzymes alanine transaminase (ALT) and aspartate aminotransferase (AST) in your blood (these will be raised if you have hepatitis). The blood test may also be used to identify other causes of liver disease, such as viral hepatitis and too much iron or copper in your blood.
- Imaging tests – an ultrasound scan, computerised tomography (CT) scan or a magnetic resonance imaging (MRI) scan may be carried out on your liver. The scans can produce detailed images of your liver and highlight any scarring. Some scans may also measure the stiffness of the liver, which is a good indication of whether your liver is scarred.
- Liver biopsy – a fine needle is inserted into your body (usually between your ribs). A small sample of liver cells is taken and sent to a laboratory to be examined under a microscope. The biopsy is usually carried out under local anaesthetic, as a day case or with an overnight stay in hospital. The outcome of the biopsy will confirm a diagnosis of cirrhosis and may provide more information about the cause.
- Endoscopy – an endoscope is a thin, long, flexible tube with a light and a video camera at one end. It will be passed down your oesophagus (food pipe) and into your stomach. Images of your oesophagus and stomach will be transmitted to an external screen. The doctor will be looking for varices (swollen vessels), which are a sign of cirrhosis.
Grading
There are several different systems for grading cirrhosis according to how serious it is. One system is the Child-Pugh score which, based on your examination and laboratory tests, grades cirrhosis from A (relatively mild) to C (severe).
