Cirrhosis history and symptoms

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Sudarshana Datta, MD [2]


Liver cirrhosis may present with non specific constitutional symptoms such as fever, anorexia, fatigue, nausea, vomiting, menstrual irregularities and testicular atrophy. Patients with decompensated cirrhosis may develop complications and present with jaundice, increase in abdominal girth due to ascites, pruritus, hematochezia, melena and confusion due to hepatic encephalopathy. Symptoms may also vary depending upon the underlying cause of cirrhosis. A detailed history of alcohol use, blood transfusions, history of viral hepatitis and family history of liver disease must be taken in all patients.


Social history

  • History of alcohol use:
    • Amount
    • Duration
  • History of illicit drug use
  • History of unprotected sexual intercourse

Past Medical history

Menstrual history

Family history

Medication history


  • Symptoms may vary depending on the underlying cause of cirrhosis:
  • Primary biliary cirrhosis presents with the following symptoms:
    • Fatigue out of proportion to the severity of the disease
    • Pruritis
      • May be intermittent
      • Increases in the evening
      • May present in the last trimester of pregnancy and may be mis-diagnosed as cholestasis of pregnancy


  1. Flores YN, Lang CM, Salmerón J, Bastani R (2012). "Risk factors for liver disease and associated knowledge and practices among Mexican adults in the US and Mexico". J Community Health. 37 (2): 403–11. doi:10.1007/s10900-011-9457-4. PMID 21877109.
  2. Williams EJ, Iredale JP (1998). "Liver cirrhosis". Postgrad Med J. 74 (870): 193–202. PMC 2360862. PMID 9683971.
  3. Schuppan D, Afdhal NH (2008). "Liver cirrhosis". Lancet. 371 (9615): 838–51. doi:10.1016/S0140-6736(08)60383-9. PMC 2271178. PMID 18328931.
  4. Bloom S, Kemp W, Lubel J (2015). "Portal hypertension: pathophysiology, diagnosis and management". Intern Med J. 45 (1): 16–26. doi:10.1111/imj.12590. PMID 25230084.

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