What are the 4 Stages and Symptoms of Cirrhosis

What are the 4 Stages and Symptoms of Cirrhosis

symptoms stage cirrhosis hepatitis

Take center stage and help your liver heal

If you are like me, you did not know diddley squat about the stages of cirrhosis when you were diagnosed. I understood what End Stage meant. The End is pretty easy to figure out. But how in the heck did I get to the end, or stage 4, or End Stage or whatever they called it? What happened before, during and after? If you have even read one of my blogs, you know that I have questions. There is no stopping until I get some answers.

Cirrhosis is basically talked about in 4 stages. There are many different ways that a doctor can assess what stage you are in. You will have blood tests, maybe an MRI, a FibroSURE scan, liver biopsy or perhaps other procedures performed. Your doctor does all of these tests in an attempt to see the liver itself and to see how your body is function in relationship to the liver. I have come to believe that the whole body is run by the liver. Which is true in a way. The liver performs tasks that are amazing! The part that makes me the happiest is that it is the only organ that actually tries to heal itself.

I think of it this way: When you cut your finger, the skin knits itself together to close up the wound. This knitting is what causes scars. Like the ones on your knees and elbows. Each scar represents a story of a bike wreck, a scrape from the sidewalk, or a cut from a tree branch. You can probably remember how you got every scar.

Your bones also tell a story about any breaks that you have had. Calcium and other minerals leave deposits as they repair the damaged bone. They can be seen on X Ray years later.

Your liver tells the story of your life also. If it has been bombarded by the Hepatitis C Virus, overloaded by fatty liver disease, or attacked by your own immune system, it shows up as scars. Drugs and alcohol also put a heavy burden on the liver and damages cells. The scars show up on the various tests that give an actual picture. They also show up in your blood work and in your other organs. Your liver enzymes are raised as they race to fix the damaged cells.

Scarring in the liver is called fibrosis. That is because when the liver is healing itself, it forms collagen bands. Remember how your skin and bones heal? Same thing, different material. In a nutshell, collagen grows and connects and wraps itself around the liver. It also wraps around the portal vein and smaller veins too. Your poor liver does not consider what the scarring will eventually do, it just tries to heal itself.

Stage 1 of Cirrhosis is when your liver is actively inflamed and trying to heal.

What your liver is going through: Basically the liver is destroying itself in its attempt to heal. It begins to show signs of swelling. Some connective tissue may be found the portal vein area. That is also where your main arteries supply blood and where the bile ducts are. There is not a lot of connective tissue at this stage of Cirrhosis. Very little damage has been done, but your liver is definitely feeling some pain from the Hepatitis C Virus or from whatever is attacking it.

stages liver cirrhosis hep c

You can help heal the owy on your liver!

What you are going through: This stage usually has no symptoms. You do not even have a clue that something is wrong. IDK how many times I have wished that Hepatitis C testing were done routinely. But, no use crying over spilled milk. sigh

Stage 2  shows the inflammation, but not a lot of damage.

What the liver is going through: There is a red alert going off in your body telling the liver to work harder. The liver begins to start putting out collagen to try and stop the swelling. It is still working really well. Most of the liver is healthy and normal, and the fibrous bands are mainly around the portal vein area. Your other organs are probably not even affected yet.

What you are going through: At this time, you may have slightly higher liver enzymes in your blood work. I know that mine elevated about 12 years ago and then went back down. It should have been a red flag. Most of us do NOT have any symptoms at this point.

Stage 3 is where the damage is really showing up more.

What the liver is going through: The fibrous bands send out runners that are trying to grab onto or connect with who knows what trying to heal. You may hear the term “bridging” used. I picture it just like a bridge made of white collagen fibers bound up trying to help. The problem is that it does NOT help. The connections are not useful. They can wrap around the arteries and veins. Then the blood supply begins to be shut down. The arteries are pinched off in a way. The liver feels the pressure. It’s job is to filter the blood. What? No blood coming through? Major problems occur and begin to affect other organs. Again, any healthy piece of liver that is left will keep doing it’s job. It compensates for the mess that is being made.

What you are going through: By this time you are feeling it. You may have itchy skin or eczema, hair loss, mental confusion, high and low blood sugar swings, food coma after heavy protein meal, and some swelling.

Stage 4 is considered the last stage.

What the liver is going through: By the time this happens, scar tissue of fibrous bands have zig zagged all through the portal vein system. Even the healthier portions of the liver cannot compensate very well any more. The spleen, gall bladder, and gastrointestinal tract are all feeling the impact. Your liver has passed it’s pain onto the rest of your body. You may hear the term decompensation.

What you are going through: This is where it begins to fall apart for you. You many have mental confusion, brain fog, or hepatitic encephalopathy, yellowing of the eyes and skin called jaundice, reverse sleep pattern, swelling from fluid build-up called ascites, portal hypertension creating varices, and other symptoms. 

stage cirrhosis hepatitis symptomsEnd Stage Liver Disease deserves it’s own blog. And it shall have one eventually. We know what it means. The liver is no longer able to carry out the functions that you need to keep going. You are going through a very hard time mentally, physically, and emotionally. I had that label the minute I was diagnosed with Hepatitis C.

End Stage does not have to mean the end of your life. Saying those words to you is the whole purpose of why I blog. At one time, liver fibrosis reversal was not considered possible. At one time they thought the earth was flat.

Let’s hang in there together as best friends. I am out to prove that there is life with Stage 4 Cirrhosis. You can’t get rid of me that easy. Stick with me. Practice lifestyle and diet changes. We’re going to figure this thing out together. xoxo Karen:)

For more links to Cirrhosis and Hepatitis C articles click here. 

Do you really believe that the liver can heal itself? Are you willing to make changes so that it can?

 

pics via nlm.nih.gov, livedesignonline.com, weightlossdetective.com

 

20 thoughts on “What are the 4 Stages and Symptoms of Cirrhosis

  1. Hi Karen,

    Yes, I believe that our body can heal itself by changing our diet. First off, I didn’t know what cirrhosis mean til I read your blog. Thank God that I have immune vaccination against all sorts of Hepatitis. Being a CNA and RT (respiratory therapy) student then, I had to get all my immunizations done before I could work in a hospital. Anyway, thank you for sharing this informative article.

    My question, how did you get healed from cirrhosis? What kind of diet did you have?

    Angela

    1. Angela,
      I still have end stage cirrhosis. The damage is permanent, but there is hope for reversing some of the fibrosis. What was considered a death sentence is now an invitation to life.

      I have written a lot on a liver loving diet and am try to compile and publish my recipes that helped rid me of the “expiration date” stamped on my foot. lol.

      I too was a CNA and heading toward nursing school. Back then, there were no universal precautions. Hep c was called Non Hep A or B.

      Thanks for your compliment. Truly. Your story of chasing your dreams and learning how to run a website has helped me so much. It has inspired me to keep this little site going.

      Keep up the work! Although our sites are different, I need yours to fuel mine. xoxoxo Karen:)

      1. Debbie,

        When I wrote that, it was at the beginning of understanding how my own body worked. Writing and researching have helped me to figure out so many things. Like how to help my body heal and support my liver.

        I think it was painful too. Reading about the earlier stages and wishing there had been more attention paid to warning signs made me angry! But I let go of that too and accept it for what it is now. I like to promote this one again from time to time to be a guide for the newly diagnosed. Our knowledge is what gives us power when we talk to our doctors. It helps us make informed decisions regarding what tests should be done too!

        You’ve blessed me with your sweet words. I hope your week is awesome!
        xo Karen:)

  2. Angela, I just wanted to point out that your statement “Thank God that I have immune vaccination against all sorts of Hepatitis” leads me to think that you believe that you were immunized against Hepatitis C.

    There is no such thing; there is no vaccination for HCV.

    Don

    1. Don,

      I’m glad you caught this! You are absolutely right. There is currently NO vaccine against Hepatitis C. I hope someday there will be. That is one of the reasons that even those of us who clear the virus still have to be cautious regarding reinfection. My doctor told me that with the new safety measures in place regarding blood testing for transfusions, it has become much more rare to get.

      Thanks so much for your comment and correction!
      Karen:)

  3. My recent diagnosis of Myelofibrosis was devastating. Seeing you & reading your words are exactly what I needed. Thank you Karen!

    1. Tia,

      I read about Myelofibrosis after your post. I got your message about your doctor’s conservative treatment. You are so blessed to be able to have an allied health team you can trust. You said it, it doesn’t matter what illness we are facing, the emotions are the same. We have to grieve some losses and then decide how we will cope.

      Your positive outlook is what will see you through. It’s a day by day process, isn’t it? I’m always here for you, so let me know if you need anything.

      xoxo Karen:)

  4. Hello Karen,

    I just happened upon your blog and I am so glad I did. It helps so much to read your posts and to know that I am not alone. I also went through banding, thankfully only once and have had check ups and so far no additional banding is needed. I too am on a beta-blocker. It’s very scary to realize that cirrhosis is a condition I am going to live with, but I realize that the key word is LIVE. I plan to visit your blog often now that I have found it. Thank you Karen, it truly does feel like I found a new friend.

    1. Chrissy,

      I love it that you’re reading around on the blog. Writing about illness is such a solitary thing. Me in my living room. (except right now my computer is down and I’m doing this at school before the bell rings.. lol) It is ALL about connecting with each other. It feels like our body has betrayed us. But with love and care, good nutrition and support, we are doing it. I ate a lot of onions on a burrito last night and had heartburn this morning. That seems like a small thing until you’ve had a banding. I take an acid blocker to help my stomach stay healthy.
      No recent bandings for YOU!! That means the beta blockers are doing their job. What once seemed so scary is now a little less frightening to us. Congratulations on a good bill of health for the varices. I could just hug you right now!
      xoxo I’ll be watching to hear from you soon.
      Karen:)

  5. Hi Karen,

    I just ran across this site, and wanted to share. It was more like, I needed to share. I don’t even remember when I was first told I had Non A Non B Hepatitis. I have rarely had health insurance, so I think I was told after donating blood. No one told me that I needed to seek treatment so I just thought the worst of it would be that I could not donate blood anymore. Over the years, off and on, if I was hospitalized or had blood work done, someone might mention that I had hepatitis. I vaguely remember at one point someone told me it was now called Hepatitis C. Again, not 1 person ever told me that I should seek treatment. I finally got on a sliding scale payment program in San Antonio called Care Link, and started to see doctors. My PCP would do bloodwork when I went for an appointment with the flu or something, but other than that no tests were ordered and no regular blood work was done. He told me he was keeping an eye on my numbers for the time being. Still, I was not told by him it could lead to something more serious and treatment was never mentioned. They no longer have my medical records from that time because of lack of space to store them. They were destroyed after 5 years, without notifying anyone they were going to do this. Fast forward to November 2, 2011 exactly 2 years after my mother died. I am at the minor emergency clinic for what I don’t remember, and the doctor I saw casually tells me that I have Cirrhosis. So I went home and started reading because that was all he said. I have now been to 2 Hepatologists through that sliding scale program. My first visit I was told that I could stop taking my vitamins and no treatment was discussed. That first doctor was in a hurry and kept trying to walk out of the room. She did order the test where they go down your throat and look around. They found I had portal hypertension and stage one varices at that time. I had a follow up visit with a wonderful new PCP who started me on Propranolol and Lactulose. That made my Hepatologist mad. On follow up visits with my hepatologists, they kept telling me I could stop taking the Propranolol. When they finally said I was ready to start treatment, I told them I wanted to start treatment there with them with FDA approved drugs, I was told they were sending me to the Texas Liver Institute for a drug study with non FDA approved drugs. There was no study for Hep C and Cirrhosis combined for a while. When I finally started screening for a study for Cirrhosis, the EKG showed I have a heart condition called LBBB. So there went the study. I argued my way back to the Hepatologist to get the FDA approved treatment which includes Interferon. They won’t treat me due to the LBBB. I was told wait for new drugs to get approved. In the meantime, my liver has gone from swollen and enlarged to shrunken and wrinkled. I finally got insurance through obama care, and will see a new hepatologist the 21st of this month at the Texas Transplant Institute Liver Clinic. I don’t need a transplant yet, but can still be seen there. I have no family support to speak of. My daughter recently came on board, but has trouble helping me deal with it so most of it I deal with on my own. I feel thrown away. I can’t hold any more health info in my brain. I think my Prozac and maybe Propranolol contributed to the heart issues, which make me dizzy and always exhausted along with the bad liver. I tell God my life is in His hands. Thank you for letting me share.

    Karen P.

    1. Karen,

      First of all – I love your name.. it means “Pure” and I want to assure you that you are NOT a throw away. It sometimes feels like it when our voice is not heard or respected. Your daughter will have to slowly come to understand your diagnosis. It is so hard on our kids. That is where we learn to trust God for our future. He is faithful.

      I have heard of your heart condition, but did not know that it would be made worse with propanolol. You are in a pickle! I know for a fact that it makes us groggy. I take mine just before bed. The one I use called Nadolol is time released so I do not have to take it during the day. That really helped. I don’t know if you are on a morning dose, but that can really put you back to the bed for the day.

      I have heard good things about the Texas Liver Institute. I had to go through a transplant hospital to treat also. At least now you have a couple of things going your way. You are being seen by a good team of transplant docs who can help you if your liver fails. You can treat and get rid of the virus so your liver will get a break. You have a chance to get insurance which will make good medical care easier to keep!

      All of these things, along with your daughter being in the picture can add up to a hope for a good future! Stick with the Lactulose too! You have come a long way with a lot of hard mountains to climb. I have a feeling that you will get over this one too dear friend.

      Thank you so much for sharing your story. You are NOT alone. I think this will encourage many others to hang in there and hope that they will finally get the break they need too!
      Love,
      xo Karen:) Stay in touch.

  6. I have a fatty liver that I’ve been working on, losing weight is the main thing but that takes time. My liver enzyme was elevated so my doctor wanted to take a biopsy to see if my liver had any cirrhosis. He gave me three months to get my enzyme down before we started taking drastic measures (I don’t drink and I’m not horribly overweight). I started taking another milk thistle product and it did good, I could feel the pain in my side reducing and I felt more energetic.
    Remus recently posted…What does SGPT/ALT Blood Test Value mean?My Profile

    1. Fatty liver diet is pretty tough to get going. You’re right, it takes some time, but will be so worth the effort. I wonder your doctor means by drastic measures. Some consider the needle guided biopsy an invasive procedure. I know that use other methods also. The GOOD news is that you were able to reduce your pain. Don’t you absolutely love it when you get a little control over your illness?

      Not drinking and keeping your weight down is awesome! You’ve won a huge part of the battle already. Milk thistle is has been endorsed by some M.D.’s and others totally disapprove of it. As long as your doctor is aware, I am happy to hear that you are getting great results! I tried the milk thistle product too and wrote about it on this blog.

      All my best to you on your health journey. I’m glad you stopped by to visit! I stopped by your site but was unable to leave a comment. Can you tell me why? I’d love to chat more.
      Thanks, xo Karen:)

  7. my story is different which confuses me. I woke up with a pain in my stomach-the pain radiated to my right side and up my back. It was severe and I had trouble breathing. I was diagnosed with pancreatis. A gastronologist came in and said it was my liver. When I got home I had edema in my lower extremeties & my stomach area began to swell. They took out 3 gallons of fluid and said it contained fluid that proved it was cirrhosis. I was not a drinker and am considered thin. I also do not have heapitis. My doctor told me not to eat hot dogs (which I never do) and watch my sait intake. That’s it. I am scared and do not know what to do. I have pain on my right side and it is strong. Help

    1. Hi there. Your message raises some anger in me. I gotta calm down here. When I was first diagnosed, it felt like I was not getting any information either. But honestly? For you to have ascites (fluid build up) and swelling in belly, legs, and feet there is definitely liver disease happening. You deserve to at least know the cause of it. For example it could be autoimmune, fatty liver disease, or other things besides hepatitis or alcohol and drug use.

      You also should have some other tests like an endoscopy where they look in your stomach. Did they perform a CT scan? These diagnostic tools can help a doctor to know how to treat you. I’m assuming they gave you some diuretics, right?

      I will say that the advice is basically the same no matter what caused it: Low sodium, plant protein as much as possible etc. Now I am calming down. Really, this is why I started the blog. I was just like you and didn’t know what to do next. My doctor’s did perform a lot of tests and kept a close eye on me. I hope that your doctor is doing a close follow up also. Do you have family or friends who can help you know which steps to take next? Maybe another doctor?

      Listen kiddo, it is scary. My liver has hurt all week since I had a procedure done. Pain sucks… and it plays tricks on your mind. Please try and take deep breaths and relax. Send your liver some loving thoughts and good food. I’m sending loving thoughts right now.
      xoxo Karen:)

      1. Thank you for your responce. I am not a medical person and am looking for answers. I now am eating foods around the outside and not the middle of the grocery store. After reading so much on the internet I wonder what stage of cirrohsis I am. Some bloggers claim the liver will heal itself. Since changing my diet the pain is not as bad.
        thanks again Henry

        1. Henry,

          You’re shopping the same way I do! It’s really different for us now! The liver definitely can heal itself. It’s the healing that causes the fibrosis. Many people who get rid of initial cause of liver damage such as HCV, drinking, or drugs or use drugs to reduce inflammation from other liver disease do really well.

          I say that because if you are only stage 2 ish, you can live decades with the diet and lifestyle you describe. My hope is that you will do just that!

          THanks for stopping by, xo Karen:)

  8. Karen you’re the angel that many of us look too ! Having end stage cirrhosis and facing my next steps now ) starting sept 2nd I start all my tests . I have remained quiet . I took my daughter on a small vacation! The 1st one since clearing my virous 12 weeks ago ! I don’t have the heart to tell her what’s ahead now .. I’ve decided to wait and see what all my options w) be after Sept 2nd, but Karen I am 4ever gratful for all that you write . So many complications we have from all the virous caused . I just want to tell you ) your name is brought up often ) so people like me miles away think about you often . I watched all your videos during my tx ! I follow your posts as my he allows on top of work ) and being sick ! I have you in my prayers . You amaze me at all you can do . Your knowledge . I have lost my teeth on too so so many complications ‘ My stroke caused many issues . My list is long . What’s important is that we all stand as 1) and get well . The education you’re putting out is so important . Thank you . can’t concentrate long enough to do all that I used too in my community with hcv ! So I look up to you . I know you need to look up to us now though . Not enough words can say how much you’re loved and thought of. I will be holding your hand ) please hold mine too ) as our new liver journeys have started! But we will win this battle , I’ve had that horrible stomach and pain since 6pm or so ! After waking up at 9pm or so I got up . Still awake now ) but thanks to all that you do Karen my mind is calm and eyes are heavy . I hope you awake pain free! If I sound confused today ) I know you understand . I hope that you’re smiling today beautiful and that rainbow touches you .. You deserve the dream ! I love you Karen ❤️❤️❤️

    1. Dear Ann,

      When I first read your comment, I thought maybe you didn’t want it posted. Many readers like to remain anonymous. You and I share so many common friends, that I feel you are ok with me responding on the website here. I truly had no idea you were going through the listing process. You are right, it is so easy to get brain foggy and forgetful.
      It’s scary stuff sweet girl. But it is also a new beginning for us in many ways. We will focus our attention on training for the transplant. Like a laser beam, we will set our eyes on being in the best possible shape. Then we can begin to heal and move toward the bright future!
      I will be writing about the process of getting listed and also about the surgery itself and the lifelong committment to caring for a grafted organ. We will be learning about this together dear one. I’m so sorry that you have to endure it, but you are not alone.
      It means so much to me that you were my bestie during treatment. I was holding your hand then and will continue to hold your hand through whatever comes up next.
      You are not so far from me. You should let me know when you are near Tulsa again. We can hook up and hug and chat! I mean that!
      Much much love and I”m going to bed too. Pain was less today. Yes, healing always comes. I love you too Ann!xoxo Karen:)

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