Fibrosis vs Cirrhosis: What’s The Difference?


Fibrosis vs cirrhosis, what is the difference between these two diseases? One thing they both have in common is that they affect the liver. Fibrosis is a condition that happens when the liver tissue becomes scarred limiting its function. Liver scarring occurs in stages and the first or early stage is known as fibrosis. When this scarring is in the late stages, it is defined as cirrhosis. A healthy liver has to regenerate ability, meaning it can regenerate its parts or function but in the case of both diseases, the liver has been inflamed causing an excessive buildup of scar tissues. This hinders it from carrying out its self-repair and other functions.

Fibrosis scarred tissue can limit or block the flow of blood in the liver which may lead to the killing or starvation of healthy cells in the liver thus creating more scarred tissue, cirrhosis. The damage of fibrosis can be reversed by administering certain medications, changing one’s life lifestyle, and clearing infections. Cirrhosis, on the other hand, is irreversible, it can only be managed to slow down its progression and relieve symptoms. Untreated fibrosis will eventually lead to cirrhosis or more severe liver issues. As we go on we will be comparing the stages of both diseases, their causes, and symptoms.

Stages Of Fibrosis vs Cirrhosis

A person who is suspected to have liver fibrosis will need to carry out several tests for a proper diagnosis to be given. The first step that will usually be done is a liver biopsy, where the sample liver tissue is extracted using a needle.

A pathologist will examine this sample using a microscope, to evaluate the type and extent of damage done. It is usually difficult to determine what stage of fibrosis the person has but there are different methods or scales used in determining this. These scales include Ishak, Batts-Ludwig, and Metavir scales.

This scoring system considers fibrosis effect on the liver portal veins, which is the vein that supplies the liver blood from the body’s intestines.

The scoring system for Metavir rates fibrosis progression as follows;

  • Zero activity, A0
  • Mild activity, A1
  • Moderate activity, A2
  • Severe activity, A3

The system also determines the fibrosis level;

  • Fibrosis absent, F0
  • Absence of septa in portal fibrosis, F1
  • Infrequent septa in portal fibrosis, F2
  • Multiple septa with no cirrhosis, F3
  • Cirrhosis, F4

Here we see that Cirrhosis is the final progression or of fibrosis or liver scarring. It occurs when fibrosis is unnoticed or left untreated. A3F3 is the most advanced fibrosis type a person can have before they develop cirrhosis.

The other scale system works in a similar manner.

Symptoms of Fibrosis and Cirrhosis

There are hardly any visible symptoms of fibrosis so most times people are unaware that their liver is getting sick. Meanwhile, liver health is deteriorating steadily, its overall function is getting affected. The liver is unable to purify blood properly, it can’t clear infections and store up energy. Its regenerating power is limited and there is a restricted flow of blood within it.

Unfortunately, obvious symptoms begin to appear when fibrosis has progressed into cirrhosis. These symptoms vary but the most common early cirrhosis indicators include:

Loss of appetiteMild pain or discomfort in the right abdomen (upper part)
Unexplained fatigueEasy bleeding and bruising
Vomiting and nauseaFluid retention
Weight lossHeightened medication sensitivity
JaundiceDark urine
 AscitesCognitive function problems
Itchy skin


There is always an underlying cause of fibrosis, so an effective treatment will have to address this cause. If what caused fibrosis is successfully treated then there will no progression into cirrhosis.

In the U.S, liver fibrosis is mostly caused by chronic alcoholism, Viral hepatitis B or C, liver disease (nonalcoholic fatty), nonalcoholic steatohepatitis.

The last two causes mostly develop in people that are overweight, prediabetic or diabetic individuals, have increased cholesterol and fat within their bloodstream.

Other common possible liver fibrosis cause includes hemochromatosis (excess iron), Wilson’s disease (copper accumulation), obstruction of bile ducts, chronic stage of heart failure and autoimmune hepatitis.

There is some specific medication that can cause liver fibrosis such as chlorpromazine, amiodarone, tolbutamide, isoniazid, oxyphenisatin, methyldopa, and methotrexate.

When the root cause has been identified then the doctor will recommend a specific treatment which may include;

  • Limiting or stopping alcohol consumption. The patient may be referred to some support system to make this long term.
  • Administering antiviral medications to treat chronic stages of viral hepatitis
  • Treating nonalcoholic steatohepatitis and fatty liver condition with a balanced diet. Working towards losing about seven percent of the gained weight in a year, regulating fat, sugar and cholesterol level.
  • Using medications to extract heavy metals like copper and iron
  • Removing or dissolving obstructions in the bile ducts
  • Cutting away any medication that is associated with fibrosis
  • Using medications to reduce the immune system activity

While we wait for scientists to come up with medications that will directly treat or reverse fibrosis damage, medical practitioners all over the world are using this method to treat their patients. There is ongoing research on antifibrotic drugs, hopefully, it is a successful one.

There are also natural remedies that help to reduce fibrosis and they include;

  • Moderate coffee consumption
  • Staying hydrated
  • Using milk thistle as it contains an increased amount of antioxidant silymarin (people on medications for hepatitis C are not advised to use this)
  • Those with NASH should drink vitamin E

Fibrosis vs cirrhosis, which has better treatment or management methods? Both of these actually do require some additional treatment form which will be administered per case. In the situation whereby the damage is too bad, particularly in liver cirrhosis, the doctor would recommend a liver transplant in order to save the patient’s life.

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