Symptoms may develop gradually, or there may be no symptoms.

When symptoms do occur, they can include:

• Abdominal indigestion or pain
• Confusion or problems thinking
• Impotence, loss of interest in sex, and breast development (gynecomastia) in men
• Nausea and vomiting
• Nosebleeds or bleeding gums
• Pale or clay-colored stools
• Small, red spider-like blood vessels on the skin
• Swelling or fluid buildup of the legs (edema) and in the abdomen (ascites)
• Vomiting blood or blood in stools
• Weakness
• Weight loss
• Yellow color in the skin, mucus membranes, or eyes (jaundice)

During a physical examination the health care provider may find:

• An enlarged liver or spleen
• Excess breast tissue
• Expanded (distended) abdomen, as a result of too much fluid
• Reddened palms
• Red spider-like blood vessels on the skin
• Smaller (contracted) fingers
• Small testicles in men
• Widened (dilated) veins in the abdomen wall
• Yellow eyes or skin (jaundice)

Tests can reveal liver problems including:

• Anemia (detected on a CBC)
• Clotting problems
• Liver function problems (detected on liver function tests)
• Low serum albumin

The following tests may be used to evaluate the liver:

• Magnetic resonance imaging (MRI) of the abdomen
• Computed tomography (CT) of the abdomen
• Ultrasound of the abdomen

A liver biopsy confirms cirrhosis.

Some patients will be screened for liver cancer every six months. Your doctor will use a blood test to check for levels of alpha fetoprotein and will do an imaging test (ultrasound, MRI, or CT scan).