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This leads to the formation of regenerative hepatic nodules encased in dense fibrous tissue, containing significantly higher levels of extracellular matrix proteins, particularly collagen types I, III, and IV, which hinder portal blood flow and elevate portal pressure, ultimately culminating in clinically significant portal hypertension in later disease stages ( In this comprehensive and evidence-driven review, the objective is to scrutinize the repercussions, diagnosis, and management of these often overlooked yet prevalent and challenging-to-treat symptoms encountered in cirrhosis (Figure 1)