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Cirrhosis - discharge

Definition

Cirrhosis is scarring of the liver that often eventually causes poor liver function. It is the most advanced stage of chronic liver disease. You were in the hospital to treat this condition.

When You're in the Hospital

You have cirrhosis of the liver. Scar tissue forms and your liver gets smaller and harder. Most of the time, this damage cannot be undone. However, the problems it causes can be treated.

While you were in the hospital, you may have had:

• Lab tests, x-rays, and other imaging exams

• A sample of liver tissue taken (biopsy)

• Treatment with medicines

• Fluid (ascites) drained from your belly

• Tiny rubber bands tied around abnormal blood vessels in your esophagus (the tube that carries food from your mouth to your stomach) called esophageal varices

• Placement of a tube or shunt (TIPS or TIPSS) to help prevent too much fluid in your belly

• Antibiotics to treat or prevent infection in the fluid in your belly

What to Expect at Home

Your health care provider will talk with you about what to expect at home. This will depend on your symptoms and what caused your cirrhosis.

Medicines you may need to take include:

• Lactulose, neomycin, or rifaximin for confusion caused by liver problems (hepatic encephalopathy)

• Medicines to help prevent bleeding from your swallowing tube or esophagus (from enlarged veins called varices)

• Water pills, to get rid of extra fluid in your body (ascites)

• Antibiotics, for infection in your belly (bacterial peritonitis)

Self-care

Do not drink any alcohol. Your provider can help you stop drinking.

Limit salt in your diet.

• Ask your provider which foods you should avoid. Your provider or nutritionist can give you a low-salt diet.

• Learn to read labels on cans and packaged foods to avoid salt.

• Do not add salt to your foods or use it in cooking. Use herbs or spices to add flavor to your foods.

Ask your provider before taking any other medicines, vitamins, herbs, or supplements that you buy at the store. This includes acetaminophen (Tylenol), cold medicines, aspirin, ibuprofen (Advil, Motrin), naproxen (Aleve, Naprosyn), and others. In general, you can take acetaminophen in doses up to 1.5 grams a day (for example, one 500 mg pill up to 3 times a day). NSAIDs such as ibuprofen, naproxen, and similar are not recommended in cirrhosis because they can hurt the kidneys . Watch out for medicines that contain acetaminophen (also called paracetamol) in combination, such as some cold medicines).

Ask if you need vaccines to prevent hepatitis A, hepatitis B, lung or bodily infections due to specific bacteria such as pneumococcus, the flu and COVID-19.

You will need to see your provider for regular follow-up visits. Make sure you go to these visits so your condition can be checked. It is much easier to prevent problems than to treat them after they happen.

Other tips for caring for your liver are:

• Eat a healthy diet.

• Keep your weight at a healthy level. Some people with cirrhosis start to lose muscle and in these situations it is very important to keep up your protein intake . Discuss this possibility with your provider.

• Try to avoid becoming constipated.

• Get enough exercise and rest.

• Try to reduce your stress.

When to Call the Doctor

Contact your provider if you have:

• Fever above 100.5°F (38°C), or a fever that does not go away

• Belly pain

• Blood in your stool or black, tarry stools

• Blood in your vomit

• Bruising or bleeding more easily

• A buildup of fluid in your belly

• Swollen legs or ankles

• Breathing problems

• Confusion or problems staying awake

• Yellow color to your skin and the whites of your eyes (jaundice)

References

Garcia-Tsao G. Cirrhosis and its sequelae. In: Goldman L, Cooney KA, eds. Goldman-Cecil Medicine. 27th ed. Philadelphia, PA: Elsevier; 2024:chap 139.

Kamath PS, Shah VH. Overview of cirrhosis. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 11th ed. Philadelphia, PA: Elsevier; 2021:chap 74.

Review Date: 2/3/2025

Reviewed By: Jenifer K. Lehrer, MD, Gastroenterologist, Philadelphia, PA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.