Cirrhosis is the scarring of the liver that happens because of chronic liver disease. Scar tissue blocks blood and bile flow through the liver and keeps it from working as it should.
As the largest internal organ in the body, the liver performs many vital tasks. For example, it gets rid of or neutralizes toxins, such as poisons, germs, and bacteria, in the blood and controls infection. The liver makes proteins that regulate blood clotting. It also produces bile that helps your body absorb the fats and fat-soluble vitamins it needs to stay healthy.
You cannot undo the damage from cirrhosis, but it progresses slowly. So early treatment can help prevent more damage. As liver function gets worse, you may experience fatigue, weight loss, swelling in your legs and abdomen, and jaundice. If the disease is severe enough, it can be fatal.
For cirrhosis to develop long-term, continuous damage to the liver needs to occur. When healthy liver tissue is destroyed and replaced by scar tissue the condition becomes serious, as it can start blocking the flow of blood through the liver.
Cirrhosis is a progressive disease, developing slowly over many years, until eventually it can stop liver function (liver failure).
The liver carries out several essential functions, including the detoxification of harmful substances in the body. It also purifies the blood and manufactures vital nutrients.
What causes Cirrhosis?
The most common causes of cirrhosis in the United States are long-term viral hepatitis C infection and chronic alcohol abuse.
Heavy, regular, long-term drinkers are much more likely to develop cirrhosis, compared to other healthy people. It is a myth that only alcoholics are at risk – regular and heavy social drinking is also linked to a higher probability of developing cirrhosis.
Typically, longer-term alcohol-related illness or death affect older people who drink more than 14 units a week and consider themselves to be “social drinkers”.
Other causes of cirrhosis include:
Hepatitis B: Hepatitis B can cause liver inflammation and damage that can lead to cirrhosis.
Hepatitis D: This type of hepatitis can also cause cirrhosis. It’s often seen in people who already have hepatitis B.
Inflammation caused by autoimmune disease: Autoimmune hepatitis may have a genetic cause. According to the American Liver Foundation, about 70 percent of people with autoimmune hepatitis are women.
Damage to the bile ducts, which function to drain bile: One example of such a condition is primary biliary cirrhosis.
Disorders that affect the body’s ability to handle iron and copper: Two examples are hemochromatosis and Wilson’s disease.
Medications: Medications including prescription and over-the-counter drugs like acetaminophen, some antibiotics, and some antidepressants, can lead to cirrhosis.
What are the symptoms of Cirrhosis?
The symptoms of cirrhosis of the liver vary with the stage of the illness. In the beginning stages, there may not be any symptoms. As the disease worsens, symptoms may include:
- Loss of appetite
- Lack of energy (fatigue), which may be debilitating
- Weight loss or sudden weight gain
- Yellowing of skin or the whites of eyes (jaundice)
- Itchy skin
- Fluid retention (edema) and swelling in the ankles, legs, and abdomen (often an early sign)
- A brownish or orange tint to the urine
- Light colored stools
- Confusion, disorientation, personality changes
- Blood in the stool
How can Cirrhosis be prevented?
These are some of the ways Cirrhosis can be prevented:
- If you drink, know your limits and do not exceed them. Keep in mind, though, that alcohol tolerance can vary greatly from one person to the next.
- Doctors often advise people to set a daily limit of one or two drinks and to avoid drinking every day.
- Avoid uncooked shellfish.
- Never mix alcohol and drugs. Some medications, including acetaminophen, react with alcohol and can damage the liver.
- Avoid exposure to industrial chemicals, which can enter the bloodstream and cause liver damage.
- Maintain a healthy, balanced diet.
How Is Cirrhosis Diagnosed?
Cirrhosis is diagnosed through several methods:
Physical exam: During a physical exam, your doctor can observe changes in how your liver feels or how large it is (a cirrhotic liver is bumpy and irregular instead of smooth).
Blood tests. If your doctor suspects cirrhosis, you will be given blood tests to find out if liver disease is present.
Other tests: In some cases, other tests that take pictures of the liver are performed, such as a computerized tomography (CT scan), ultrasound, or another specialized procedure called a radioisotope liver/spleen scan.
Biopsy: Your doctor may decide to confirm the diagnosis by taking a sample of tissue (biopsy) from the liver.
Surgery: In some cases, cirrhosis is diagnosed during surgery when the doctor is able to see the entire liver. The liver also can be inspected through a laparoscope, a viewing device that is inserted through a tiny incision in the abdomen.
How is Cirrhosis treated?
First of all, Cirrhosis cannot be cured. So any treatment given by doctors or hospitals, will aim to manage the symptoms and prevent further complications in the liver.
The medications that are needed to treat Cirrhosis depend on the cause of the disease. For example, if you have viral hepatitis, you may be prescribed anti-viral medications. If you have autoimmune hepatitis, you may be given steroid medication (corticosteroids) or medication to suppress your immune system (immunosuppressants).
There are some other actions which can be taken to prevent further damage of the liver:
Stopping Alcohol Consumption: In the case of Cirrhosis caused by alcohol intake, it is mandatory to stop drinking. Any amount of alcohol is toxic to the liver.
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 other causes and symptoms of cirrhosis: Medications may slow the progression of certain types of liver cirrhosis. For example, for people with primary biliary cirrhosis (now known as primary biliary cholangitis) that is diagnosed early, medication may significantly delay progression to cirrhosis.