2016-06-16 14:36:25 UTC

Cirrhosis 103: Causes

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Cirrhosis has many causes. It can come from certain illnesses or disorders, direct harm to the liver cells, indirect harm by inflammation, or swelling, or a block in the bile ducts, which drain the liver cells of bile.

Common Causes of Direct Liver Harm

  • Long-term alcohol abuse.
  • Chronic viral hepatitis (types B, C and D).
  • Nonalcoholic fatty liver disease (NAFLD).
  • Autoimmune hepatitis.
  • Obesity.
  • Inherited (passed down through family) illnesses, such as alpha-1-antitrypsin deficiency, among others.


As the rate of obesity rises, liver disease that may lead to cirrhosis, such as nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH), may become more widespread. These health problems look like alcoholic liver disease, but they happen in people who drink little to no alcohol. 

  • Patients with NAFLD have fatty livers without inflammation or damage, which may not show any symptoms. 
  • NASH involves the buildup of fat in the liver cells, as well as inflammation of the liver, which can kill the liver cells and lead to cirrhosis.

Inherited Illnesses

Two inherited illnesses result in the abnormal storage of metals in the liver, leading to tissue damage and cirrhosis.

Wilson’s disease

  • Patients store too much copper in the liver, brain, kidneys and corneas of the eyes.
  • This is a rare health issue most often seen in children or young adults, not older patients.


  • Too much iron is taken in by the body, and the extra iron is deposited in the liver and other organs, such as the pancreas, skin, intestinal lining, heart and endocrine glands.


Common Causes of Indirect Harm by Way of Bile Duct Damage


The bile ducts carry bile formed in the liver to the intestines, where the bile helps the body digest fat.

  • Primary biliary cirrhosis: the liver’s microscopic bile ducts are slowly destroyed.
  • Primary sclerosing cholangitis: bile ducts inside and outside the liver become swollen and scarred.
  • Biliary atresia: injury and loss of the bile ducts that are used for draining bile from the liver; found in newborn infants.

Rarely, medications may cause chronic liver disease and cirrhosis. Talk to your doctor about which ones may pose a risk.

There are many causes of cirrhosis that are less often seen, such as veno-occlusive disease, sarcoidosis (granulomatous liver disease), heart failure and chronic infections, like schistosomiasis and others.

If the cause of cirrhosis is still not clear after a full set of testing, it is termed “cryptogenic cirrhosis.” As many as 10 percent of patients with cirrhosis fall into this grouping.


© AGA, September 2017

©AGA, July 2016

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