Cirrhosis in adults: Assessment and management ( NICE )

Cirrhosis is a pathological condition of the liver characterized by extensive fibrosis (formation of scar tissue) and the development of nodules within the liver tissue. This condition is a consequence of chronic and sustained liver injury, which disrupts the liver's normal lobular architecture. Various factors can contribute to liver injury, including viral infections (such as hepatitis B and C), exposure to toxins or harmful substances, genetic predispositions, and autoimmune processes where the body's immune system mistakenly attacks liver cells.

In response to these injurious stimuli, the liver attempts to repair itself by forming scar tissue, a process known as fibrosis. Initially, during the early stages of fibrosis, the liver may still maintain most of its essential functions. However, with continued and severe injury, fibrosis can progress, leading to the widespread replacement of healthy liver tissue with fibrotic tissue. At this advanced stage, the liver loses its ability to function properly, resulting in the clinical manifestation of cirrhosis.

Presented below is a summary of guidance by NICE on the diagnosis of cirrhosis in adults, relevant to primary care.