Cirrhosis is a condition in which a liver stops functioning normally because its healthy tissue has been replaced by scar tissue. It’s caused by chronic injury, either from liver disease, infection, or drug and alcohol abuse.
- Cirrhosis is the result of progressive scarring (fibrosis) caused by liver damage, which makes it difficult for the liver to function. It can take years to become life-threatening.
- Common causes include chronic alcoholism, viral hepatitis, fatty liver disease, cystic fibrosis, and infections like syphilis.
- While the damage from cirrhosis cannot be reversed, it can be managed if caught early enough. If the damage is too extensive, the only treatment is liver transplantation.
Cirrhosis is the result of long-term damage to the liver. This means a variety of diseases and conditions can lead to it. The following are some of the most common causes of cirrhosis:
- Alpha-1 Antitrypsin Deficiency: This causes a mutated form of a protein to build up in the liver, which damages it.
- Autoimmune Hepatitis: This is a rare condition that causes the body to attack its own liver.
- Blocked Bile Ducts: This may be caused by primary biliary cirrhosis or primary sclerosing cholangitis.
- Chronic Alcoholism: Alcoholism is defined as five or more drinks a day for at least five of the past month.
- Chronic Viral Hepatitis Infection: This includes a hepatitis B, C, or D infection lasting over several decades.
- Cystic Fibrosis: This is a genetic condition that causes mucus to build up throughout the body, including the liver.
- Hemochromatosis: This causes excess iron to build up in the digestive tract.
- Nonalcoholic Fatty Liver Disease: This condition is most often caused by obesity.
- Wilson’s Disease: This rare genetic condition causes copper to build up in the liver.
Cirrhosis can develop over many years without showing any signs or symptoms. It’s only when the liver has significant scarring that symptoms will begin to show. The following are some of the most common:
- Absent periods (women)
- Bleeding or bruising easily
- Enlarged breasts (men)
- Fluid in the abdomen (ascites)
- Forgetfulness or mental confusion
- Jaundice (yellowing of skin and eyes)
- Lack of appetite
- Nausea and vomiting
- Swollen legs
- Vomiting blood
- Weight loss
Because signs and symptoms of cirrhosis do not develop until the liver has become significantly impaired, the only way to detect this condition early is through a blood test. This test measures a variety of substances that help determine whether the liver is working correctly. These include:
- Antibodies: High levels of these may be evidence of autoimmune hepatitis.
- Bilirubin: Bilirubin is a waste product that is processed by the liver. If bilirubin levels are high, it may be a sign that something is wrong with the liver.
- Liver Enzymes: High levels of certain enzymes, such as alkaline phosphatase, may indicate liver damage.
- Proteins: Albumin and globulin are two proteins made by the liver. Low levels may mean the liver is not functioning correctly.
- Viruses: The presence of hepatitis could indicate cirrhosis.
The following are some other common ways to diagnose cirrhosis:
- Imaging Tests: These will allow doctors to form an image of the liver so that they can better detect signs of cirrhosis. They may include a computerized tomography (CT) scan, an ultrasound, and magnetic resonance imaging (MRI).
- Liver Biopsy: This is a surgical procedure that removes a tiny portion of liver tissue so that doctors can examine it under a microscope to determine what is wrong.
Cirrhosis cannot be reversed with treatment. In fact, the only treatment that can cure cirrhosis is a liver transplantation. However, treating the underlying cause of cirrhosis can slow or even stop additional liver damage. This can help prevent liver failure later on.
Treating Underlying Causes
Those with early-stage cirrhosis can especially benefit from stopping its underlying cause. This may involve the following treatment options:
- Alcohol Dependency Treatment: Anyone who has cirrhosis caused by excessive alcohol use should try to stop drinking immediately and get help if they cannot.
- Medications: If the cirrhosis is caused by Wilson’s disease, primary biliary cirrhosis, or other treatable conditions, medications can help prevent further damage.
- Viral Hepatitis Treatment: If the cirrhosis is caused by viral hepatitis, medications can help control the infection and prevent further damage.
- Weight Loss: If the cirrhosis is caused by nonalcoholic fatty liver disease, losing weight and controlling blood sugar is recommended.
Treating Complications and Symptoms
It’s also possible to address any ongoing complications or symptoms caused by cirrhosis. This may include the following:
- Bleeding: Blood pressure medications can usually help control excessive bleeding. In severe cases, a shunt may be surgically implanted to reduce blood pressure in the liver.
- Excess Fluid: This can be controlled through a low-sodium diet and medications. If fluid buildup is severe, it may need to be drained.
- Infections: Antibiotics and vaccinations can help prevent and control infections.
- Inflammation: Steroids can help reduce liver inflammation.
- Liver Cancer: Regular examinations will help monitor for any signs of liver cancer, which can be a complication of cirrhosis.
When cirrhosis is severe enough to cause liver failure, a liver transplantation may be necessary. This procedure involves removing the entire diseased liver and replacing it with a healthy donor liver. Potential candidates will need to go through an extensive evaluation process to determine if they are mentally and physically ready for this procedure.
Learn more about liver transplantations.
Since cirrhosis cannot be reversed, successfully managing this condition depends on removing its cause. This may mean losing weight, quitting alcohol and/or drugs, or taking medication. The better a patient is able to do this, the better their long-term prognosis will be.
The severity of liver damage also affects a patient’s outlook. To determine this, doctors may use the Child-Pugh classification. This assigns a score to five different factors:
- Albumin: Measurement of an essential protein made by the liver.
- Ascites: Fluid build up in the abdomen.
- Bilirubin: A measurement of how effectively the liver excretes bile.
- Hepatic Encephalopathy: Impaired brain function when the liver does not filter toxins from blood.
- Prothrombin Time (INR): A measurement of the liver's ability to make blood clotting factors.
There are three classes of Child-Pugh scores. The one-year survival rates for each are:
- Class A: 100 percent
- Class B: 80 percent
- Class C: 45 percent
If liver damage is severe, a liver transplantation may be necessary. In this case, a MELD score is used to determine the patient’s priority on the liver transplant waiting list.
Our center has extensive experience diagnosing cirrhosis and helping patients successfully manage its symptoms. This includes classes and support groups for those who want to quit alcohol or drugs.
Call us at (877) LIVER MD/ (877) 548-3763 or use our online form to schedule an appointment.