During the initial phase of cirrhosis, the patient experiences few symptoms. These include vague physical effects: fatigue, dry mouth, jaundice, enlargement or tenderness of the upper right abdomen and itchiness all over the body. If a test of liver function delivers abnormal results, a biopsy should be taken. The stage of cirrhosis the patient has reached will be determined by the biopsy results. In stage one, abnormal tissue and inflammation have developed in the liver. This is mainly confined to the area around the portal areas which house branches of the bile duct, portal vein and hepatic artery.
As liver disease progresses to the second stage, the areas of abnormal tissue begin to form into stiff bands of connective tissue, a condition known as fibrosis. These and the inflammation have spread to include both the portal areas and the surrounding periportal regions.
Stage three is marked by the merging of areas of fibrosis. This bridging enlarges the affected regions. This can lead to a degradation of the functioning of the liver, seen often as a reduced ability to digest fats and to absorb fat-soluble vitamins.
Stage four is final cirrhosis of the liver. Patients in this stage can recover from a liver transplant, but without one, the life expectancy is less than 10 years for those who progress to a symptomatic stage of cirrhosis.