What are the possible complications
of Budd-Chiari syndrome?
The information on this page is for:
- Adults with Budd-Chiari syndome or suspected Budd-Chiari syndrome
- Family, friends, carers, and healthcare professionals.
Information about Budd-Chiari syndrome in children.
These are some of the main complications that can come with Budd-Chiari syndrome if it is not treated.
You may never develop these complications. But it is a good idea to be aware of them, even if you do not have them at the moment. These complications can develop very quickly. Knowing about them in advance will mean that you know what to look out for.
This page will give you basic information. It also has links for more detailed information. So you can choose how much information is right for you.
Our tip: Bookmark this page so that you can find it again easily if you develop a complication.
On this page:
Ascites
Ascites is one of the main complications of Budd-Chiari syndrome. The build-up of blood in the liver forces other liquid out into the belly (abdomen). The build-up of fluid in the belly is called ascites.
It can be very uncomfortable. It also pushes on your other organs and can make it hard for you to eat or breathe.
Ascites fluid can be drained in hospital. But it usually builds back up and must be drained again. There are medicines that can sometimes slow down the build-up of ascites fluid.
If you have ascites, you may need to make some changes to your diet:
- Reduce the amount of salt to help slow down the build-up of ascites fluid.
- Increase the energy in your food to ensure you get enough.
You will also need to increase the amount of some of the nutrients in your food.
If you are struggling with eating because of ascites, it is important to talk to your medical team. Ask if you can be referred to a registered NHS dietitian. The dietitian can help you to make sure you are getting enough energy and nutrients.
Portal hypertension
Budd-Chiari syndrome lowers blood flow, raising pressure in a major vein in your liver. This is called portal hypertension. It can lead to an increase in pressure in blood vessels outside your liver.
Portal hypertension is involved in the development of other complications of cirrhosis. Including varices and ascites. Over time, it can also cause problems in other parts of your body, such as your kidneys.
Varices and variceal bleeding
Varices are tiny veins in your digestive system. They swell up due to higher pressure. These veins can sometimes leak or burst, causing serious bleeding. This is called a variceal bleed.
Varices can be treated to stop the bleeding. If you have Budd-Chiari syndrome, ask your medical team about the risk of varices. They may suggest regular checks to look for them.
Fibrosis and cirrhosis
Budd-Chiari syndrome causes damage to the liver cells. Your liver is very good at repairing damage, but it can only take so much. Over time, the damage can lead to scarring of the liver. This is called fibrosis.
If the damage continues, this can lead to serious permanent liver damage.
Hepatic encephalopathy (HE)
A build-up of toxins in your brain causes hepatic encephalopathy. One of your liver’s jobs is to remove toxins from your body. So, if your liver is not working properly, it cannot do this.
Hepatic encephalopathy can cause memory problems, confusion, and sleepiness. Sometimes, hepatic encephalopathy can seem to change someone’s personality.
It is often close family or friends who notice these symptoms first. So it is a good idea to share this information with them in advance.
The condition can come and go. So you can have good days and bad days. This can be unpredictable.
There are some things that can help with hepatic encephalopathy. Including a medicine called lactulose.
Liver cancer
About 1 in 10 cases of Budd-Chiari syndrome are linked to cancer. Often this is a type of liver cancer called hepatocellular carcinoma (HCC). This can cause Budd-Chiari syndrome by pushing on or growing into the veins.
Budd-Chiari syndrome can also increase the risk of developing hepatocellular carcinoma.
What is the risk of liver cancer if I have Budd-Chiari syndrome?
Researchers followed up people with Budd-Chiari syndrome for 5 years. They found that:
- 4 in 100 developed hepatocellular carcinoma.
- 96 in 100 did not develop hepatocellular carcinoma.
It is important to talk to your medical team about your personal risk. It is easier to treat hepatocellular carcinoma if it is found early. So you may need to have regular monitoring. This can be more complicated in Budd-Chiari than in some other liver conditions. Your specialist medical team will be able to help you decide on the best plan for you.
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This content was last reviewed: March 2026
Our expert reviewers:
We would like to thank everyone who helped with creating and reviewing this page. Including Prof. John F Dillon, Professor of Hepatology and Gastroenterology, School of Medicine, University of Dundee. And all our patient reviewers.
Find out how we make our patient information.
Everyone’s experience of liver disease will be different. Always talk to your specialist medical team for personal advice.
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