When the liver develops cirrhosis it still continues to function for many years. The patient has compensated cirrhosis. After many years of cirrhosis patients develop liver failure. The cirrhosis is then decompensated.

Ascites is the most common form of liver failure. Fluid accumulates in the abdominal cavity that can become infected, called SBP (spontaneous bacterial peritonitis). Ascites is treated with sodium restriction in the diet and diuretics. Lasix (furosemide) and aldactone (spironolactone) are commonly used diuretics. If the ascites is not controlled adequately the fluid can be removed by inserting a needle into the abdominal cavity. This procedure is called a large volume paracentesis.

Jaundice is yellow discoloration of the skin and eyes. When this is seen in a patient with HCV cirrhosis is usually indicates the need for a liver transplant. The yellow pigment in the blood is called bilirubin.

Portal hypertension is a complication of cirrhosis where the pressure in the portal vein is increased. This causes the spleen to enlarge and large veins in the esophagus to form called varices. Esophageal varices can rupture and bleed. Esophageal band ligation can prevent this bleeding or treat it once it occurs.

Hepatic encephalopathy is a complication of cirrhosis. The liver cleans the blood of ammonia and other brain toxins. When the liver fails these toxins accumulate causing sleepiness, memory loss and confusion. This can be treated with lactulose and Xifaxin.