What Are the Causes of Cirrhosis?

An autopsied liver showing a dense network of scar tissue, called cirrhosis. The scarring has occurred in response to chronic injury from alcohol abuse. CDC/ Dr. Edwin P. Ewing, Jr.

Cirrhosis is one of the top causes of death in the United States. As of 2005, it was number 12 on a list researched by the Centers for Disease Control and Prevention. As the liver is injured over a long period of time (from many different causes), the liver replaces damaged cells with scar tissue called "fibrosis." Extensive fibrosis is called "cirrhosis," which can lead to serious liver problems as the liver loses its ability to function.

Why Is the Liver Important?

The good news is that many types of cirrhosis are completely preventable. Here are many of the known causes of cirrhosis. Of these, the first six are the most common in developed nations, such as many European countries and North America:

  • Alcoholism
  • Chronic hepatitis B
  • Chronic hepatitis C
  • Autoimmune hepatitis
  • Nonalcoholic fatty liver disease. Also called "steatohepatitis," this is a problem tied to the obesity epidemic in many Western countries.
  • Biliary cirrhosis. The health of the liver is closely tied to its bile ducts. This means that problems with your bile ducts can cause liver disease in a number of ways. Examples of this type are sclerosing cholangitis and autoimmune cholangiopathy, a type of biliary obstruction.
  • Cardiac cirrhosis. This is a liver disease caused by right-sided congestive heart failure. It's very rare, but it's caused by a long-term increase in venous blood pressure that leads to an enlarged liver with poor circulation.
  • Inherited metabolic liver disease. There are several of this type that can lead to serious liver problems. Examples are Wilson's disease, hemochromatosis, and alpha-1 antitrypsin deficiency.
  • Unknown causes. Determining if you have liver cirrhosis is relatively straightforward. Doctors can order a biopsy, which shows the presence and degree of cirrhosis. Sometimes it's possible to determine what caused the cirrhosis; however, some people have developed cirrhosis without the usual expected causes. Doctors call this type "cryptogenic cirrhosis," which means cirrhosis from an unknown cause.

    More on Preventing Hepatitis


    Bacon, BR. Cirrhosis and Its Complications. In: AS Fauci, E Braunwald, DL Kasper, SL Hauser, DL Longo, JL Jameson, J Loscaizo (eds), Harrison’s Principles of Internal Medicine, 17e. New York, McGraw-Hill, 2008. 1971-1972