Cirrhosis
Understanding Liver Cirrhosis
Cirrhosis is an advanced stage of scarring (fibrosis) of the liver caused by various liver diseases and conditions, such as hepatitis and chronic alcoholism.
The liver performs several important functions, including neutralizing harmful substances in the body, cleansing the blood, and producing essential nutrients.
Cirrhosis occurs in response to liver damage. Whenever the liver is injured, it tries to repair itself.
During this process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function properly.
Decompensated cirrhosis is a term used to describe the onset of certain complications resulting from changes caused by cirrhosis. Decompensated cirrhosis is life-threatening.
Liver damage caused by cirrhosis is generally irreversible.
However, if liver cirrhosis is diagnosed early and its cause is treated, further damage can be limited and, in rare cases, reversed.
Symptoms
Cirrhosis often causes no signs or symptoms until liver damage is extensive.
When signs and symptoms appear, they may include:
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Fatigue
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Prone to bleeding
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Prone to bruising
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Itchy skin
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Yellowing of the skin and eyes (jaundice)
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Fluid buildup in the abdomen (ascites)
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Loss of appetite
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Nausea
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Swelling of the legs
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Weight loss
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Confusion, drowsiness, and slurred speech (hepatic encephalopathy)
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Spider-like blood vessels on the skin; itchy skin
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Redness on the palms
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Testicular atrophy in men
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Breast Enlargement in Men
Causes
Heart
Various 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 accumulation in the liver (nonalcoholic fatty liver disease)
Other possible causes include:
• Accumulation of iron in the body (hemochromatosis)
• Cystic fibrosis
• Copper buildup in the liver (Wilson's disease)
• Malformed bile ducts (biliary atresia)
• Inherited disorders of sugar metabolism (galactosemia or glycogen storage disease)
• Genetic digestive disorder (Alagille syndrome)
• Liver disease caused by the immune system (autoimmune hepatitis)
• Damage to the bile ducts (primary biliary cirrhosis)
• Hardening and scarring of the bile ducts (primary sclerosing cholangitis)
• Infections, such as schistosomiasis
• Medications, such as methotrexate
Risk Factors for Liver Cirrhosis
You may be at risk for liver cirrhosis if you have any of the following conditions:
• Hepatitis B chronic
• Chronic hepatitis C
• Chronic excessive alcohol consumption
• Fatty liver disease (nonalcoholic steatohepatitis)
• Autoimmune liver disease (autoimmune hepatitis, primary biliary cirrhosis, or primary sclerosing cholangitis)
• Wilson's disease, hemochromatosis, and other rare inherited liver diseases
Diagnosis
People with early-stage liver cirrhosis usually have no symptoms.
Cirrhosis is often first detected through routine blood tests or physical exams.
A doctor may order one or more laboratory tests that can detect liver problems, such as cirrhosis.
Laboratory tests
01
Liver function.
Blood tests are performed to check for elevated levels of bilirubin—a byproduct of red blood cell breakdown—as well as certain enzymes that may indicate liver damage.
02
Kidney function.
Blood tests are performed to measure creatinine levels, as kidney function may decline in more advanced stages of cirrhosis (decompensated cirrhosis).
03
Hepatitis B and C tests.
A blood test is performed to check for the presence of the hepatitis virus.
04
Blood clotting.
The international normalized ratio (INR) is measured to assess the blood's ability to clot.
A doctor may order imaging tests and other tests to further diagnose cirrhosis:
05
Magnetic resonance elastography or transient elastography.
This noninvasive imaging test detects hardening or stiffness of the liver and may eliminate the need for a liver biopsy.
06
Other imaging tests.
MRI, CT scans, and ultrasounds produce images of the liver.
07
Biopsy.
A tissue sample (biopsy) is not always necessary to diagnose cirrhosis. However, doctors may use it to determine the severity, extent, and cause of liver damage.
Prevention
Reduce your risk of cirrhosis by taking care of your liver.
01
Do not drink alcohol if you have cirrhosis.
If you have liver disease but do not yet have cirrhosis, talk to your doctor about whether you should drink alcohol at all. The source page lists the limits for healthy adults as up to one drink per day for women of all ages and men over the age of 65, and up to two drinks per day for men 65 years of age or younger.
02
Consumption healthy eating habits.
Choose a plant-based diet rich in fruits and vegetables. Choose whole grains and low-fat protein sources. Reduce your intake of fatty foods and fried foods. The source page notes that caffeinated coffee may protect against liver fibrosis and liver cancer.
03
Maintain a healthy weight.
Excess body fat can damage the liver. Talk to your doctor about a weight-loss plan if you are obese or overweight.
04
Reduce your risk of hepatitis.
Sharing needles and having unprotected sex can increase the risk of hepatitis B and C. Vaccination hepatitis B available.
If you are concerned about the risk of liver cirrhosis, talk to your doctor about how to reduce that risk.
Treatment
Treatment for cirrhosis depends on the cause and the extent of liver damage. The goal of treatment is to slow the progression of liver scarring and to prevent or treat the 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 the early stages of cirrhosis, liver damage may be minimized by treating the underlying cause.
The options include:
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Treatment for alcohol dependence.
People with cirrhosis caused by alcohol abuse must stop drinking alcohol. If you have cirrhosis, it is very important to stop drinking alcohol because even small amounts of alcohol are toxic to the liver. If it is difficult to stop drinking, your doctor may recommend a treatment program for alcohol addiction.
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Weight loss.
People with cirrhosis caused by nonalcoholic fatty liver disease can improve their health by losing weight and controlling their blood sugar levels. It is important to maintain an adequate protein intake while trying to lose weight if you have cirrhosis.
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Medication to control hepatitis.
Medications can limit further damage to liver cells caused by hepatitis B or C through targeted treatment of the virus.
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Medications to treat other causes and symptoms of cirrhosis.
Medications can slow the progression of certain types of liver cirrhosis.
The doctor will work to treat any complications of cirrhosis.
In cases of advanced cirrhosis, when the liver stops functioning, a liver transplant may be the only treatment option.
Note regarding alcohol units on the source page
Tolerance to alcohol varies greatly from person to person, so know your limits and try not to exceed them. The source page lists 14 units per week for men and seven units per week for women. NOTE: One unit is equivalent to 10 ml or 8 g of pure alcohol. The number of units in a single drink depends on the drink’s size and alcohol content. For example, according to the source, a glass of wine (250 ml) contains 3 units, a standard can of beer (440 ml) contains 2 units, and a shot of hard liquor (25 ml) contains 1 unit.