Doc Fio

Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.

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The liver carries out several necessary functions, including detoxifying harmful substances in your body, cleaning your blood and making vital nutrients.

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Cirrhosis occurs in response to damage to your liver. Each time your liver is injured, it tries to repair itself.

In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function.

Decompensated cirrhosis is the term used to describe the development of specific complications resulting from the changes brought on by cirrhosis. Decompensated cirrhosis is life-threatening.

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The liver damage done by cirrhosis generally can't be undone.

But if liver cirrhosis is diagnosed early and the cause is treated, further damage can be limited and, rarely, reversed.

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Symptoms

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Cirrhosis often has no signs or symptoms until liver damage is extensive.

When signs and symptoms do occur, they may include:

• Fatigue

• Bleeding easily

• Bruising easily

• Itchy skin

• Yellow discoloration in the skin and eyes (jaundice)

• Fluid accumulation in your abdomen (ascites)

• Loss of appetite

• Nausea

• Swelling in your legs

• Weight loss

• Confusion, drowsiness and slurred speech (hepatic encephalopathy)

• Spiderlike blood vessels on your skin

• Redness in the palms of the hands

• Testicular atrophy in men

• Breast enlargement in ment

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Causes

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The liver

A wide range of diseases and conditions can damage the liver and lead to cirrhosis. The most common causes are:

• Chronic alcohol abuse

• Chronic viral hepatitis (hepatitis B and C)

• Fat accumulating in the liver (nonalcoholic fatty liver disease)

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Other possible causes include:

• Iron buildup in the body (hemochromatosis)

• Cystic fibrosis

• Copper accumulated in the liver (Wilson's disease)

• Poorly formed bile ducts (biliary atresia)

• Inherited disorders of sugar metabolism (galactosemia or glycogen storage disease)

• Genetic digestive disorder (Alagille syndrome)

• Liver disease caused by your body's immune system (autoimmune hepatitis)

• Destruction of the bile ducts (primary biliary cirrhosis)

• Hardening and scarring of the bile ducts (primary sclerosing cholangitis)

• Infection such schistosomiasis

• Medications such as methotrexate

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Risk factors for liver cirrhosis

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You may be at risk of liver cirrhosis if you have one of the following conditions:

• Chronic hepatitis B

• Chronic hepatitis C

• Chronic excessive alcohol intake

• Fatty liver disease (non-alcoholic steatohepatitis)

• Autoimmune liver disease (autoimmune hepatitis, primary biliary cirrhosis or primary sclerosing cholangitis)

• Wilson disease, hemochromatosis and other rare inherited liver diseases.

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Diagnosis

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People with early-stage cirrhosis of the liver usually don't have symptoms.

Often, cirrhosis is first detected through a routine blood test or checkup.

Your doctor may order one or more laboratory tests that may suggest a problem with your liver, such as cirrhosis.

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Laboratory tests:

• Liver function. Your blood is checked for excess bilirubin, which is a product of red blood cells breaking down, as well as for certain enzymes that may indicate liver damage.

• Kidney function. Your blood is checked for creatinine as kidney function may decline in later stages of cirrhosis (decompensated cirrhosis).

• Tests for hepatitis B and C. Your blood is checked for the hepatitis viruses.

• Clotting. Your international normalized ratio (INR) is checked for your blood's ability to clot

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Your doctor may order imaging and other tests to further diagnose cirrhosis:

• Magnetic resonance elastography or transient elastography. These noninvasive imaging tests detect hardening or stiffening of the liver and may eliminate the need for a liver biopsy.

• Other imaging tests. MRI, CT and ultrasound create images of the liver.

• Biopsy. A tissue sample (biopsy) is not necessarily needed to diagnose cirrhosis. However, your doctor may use it to identify the severity, extent and cause of liver damage.

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Prevention

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Reduce your risk of cirrhosis by taking care of your liver

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• Do not drink alcohol if you have cirrhosis. If you have liver disease but do not have cirrhosis, talk to your doctor about whether you may drink alcohol at all. For healthy adults, that means up to one drink a day for women of all ages and men over age 65, and up to two drinks a day for men age 65 and younger.

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• Eat a healthy diet. Choose a plant-based diet that's full of fruits and vegetables. Select whole grains and lean sources of protein. Reduce the amount of fatty and fried foods you eat. Caffeinated coffee may protect against fibrosis and liver cancer.

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• Maintain a healthy weight. An excess amount of body fat can damage your liver. Talk to your doctor about a weight-loss plan if you are obese or overweight.

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• Reduce your risk of hepatitis. Sharing needles and having unprotected sex can increase your risk of hepatitis B and C. Hepatitis B vaccination is available.

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If you're concerned about your risk of liver cirrhosis, talk to your doctor about ways you can reduce your risk.

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Treatment

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Treatment for cirrhosis depends on the cause and extent of your liver damage. The goals of treatment are to slow the progression of scar tissue in the liver and to prevent or treat symptoms and complications of cirrhosis. You may need to be hospitalized if you have severe liver damage.

Treatment for the underlying cause of cirrhosis

In early cirrhosis, it may be possible to minimize damage to the liver by treating the underlying cause.

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The options include:

• Treatment for alcohol dependency. People with cirrhosis caused by alcohol abuse should stop drinking. If you have cirrhosis, it is essential to stop drinking since any amount of alcohol is toxic to the liver. If stopping alcohol use is difficult, your doctor may recommend a treatment program for alcohol addiction.

• Weight loss. People with cirrhosis caused by nonalcoholic fatty liver disease may become healthier if they lose weight and control their blood sugar levels. It is important to maintain adequate protein intake while attempting weight loss in the setting of cirrhosis.

• Medications to control hepatitis. Medications may limit further damage to liver cells caused by hepatitis B or C through specific treatment of these viruses.

• Medications to control other causes and symptoms of cirrhosis. Medications may slow the progression of certain types of liver cirrhosis. 

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Your doctor will work to treat any complications of cirrhosis.

In advanced cases of cirrhosis, when the liver ceases to function, a liver transplant may be the only treatment option.

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The tolerance for alcohol varies greatly from person to person, so know your limits and do not exceed them as much as possible. For men, it’s 14 units a week and in women, seven units a week. NOTE: One unit equals 10ml or 8g of pure alcohol. The number of units in a drink is based on the size of the drink as well as its alcohol strength. For e.g. a glass (250ml) of wine has 3 units, a standard can (440ml) of beer has 2 units and a shot (25ml) of spirits carries 1 unit.

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