Liver Cirrhosis

Liver cirrhosis is a late-stage liver disease in which healthy liver tissue is replaced with scar tissue, preventing the liver from functioning properly. The scar tissue blocks the flow of blood through the liver and slows the liver's ability to process nutrients, hormones, drugs, and toxins. It also reduces the production of proteins and other substances made by the liver. Cirrhosis is a progressive disease that develops slowly over many years and can lead to liver failure if not properly managed.

Causes

  • Chronic alcohol abuse (alcoholic liver disease)
  • Chronic viral infections such as hepatitis B, C, and D
  • Non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH)
  • Autoimmune hepatitis
  • Inherited disorders such as hemochromatosis, Wilson's disease, and alpha-1 antitrypsin deficiency
  • Biliary diseases such as primary biliary cholangitis and primary sclerosing cholangitis
  • Prolonged exposure to certain toxins and medications
  • Cardiac cirrhosis due to chronic heart failure
  • Infections such as schistosomiasis (more common in developing countries)

Signs and Symptoms

  • Fatigue and weakness
  • Loss of appetite
  • Nausea
  • Easy bruising and bleeding
  • Jaundice (yellowing of the skin and eyes)
  • Itchy skin
  • Swelling in the legs, ankles, or abdomen (edema and ascites)
  • Spider-like blood vessels visible on the skin (spider angiomas)
  • Redness in the palms of the hands (palmar erythema)
  • Confusion, drowsiness, and slurred speech (hepatic encephalopathy)
  • Weight loss
  • Muscle cramps and pain
  • Bleeding varices (enlarged veins in the esophagus or stomach that can rupture)

Diagnosis

Physical Examination

The doctor will check for signs such as jaundice, ascites, enlarged spleen, and other physical manifestations of liver disease.

Blood Tests

Liver function tests, complete blood count, tests for viral hepatitis, autoimmune markers, and other blood tests to assess liver damage and function.

Imaging Studies

Ultrasound, CT scan, or MRI to visualize the liver and assess its size, shape, and texture, as well as to look for signs of portal hypertension or tumors.

Elastography

A non-invasive technique that measures the stiffness of the liver, which correlates with the amount of scarring (fibrosis).

Liver Biopsy

A procedure where a small sample of liver tissue is removed and examined under a microscope. This is the most definitive test for cirrhosis and can help determine the cause and extent of liver damage.

Treatment Options

Treatment of Underlying Cause

Addressing the primary cause of cirrhosis, such as abstaining from alcohol, antiviral medications for hepatitis, medications for autoimmune hepatitis, or management of other contributing conditions.

Medications for Symptoms and Complications

Various medications to manage complications of cirrhosis, including diuretics for ascites, beta-blockers to reduce portal hypertension, lactulose for hepatic encephalopathy, and antibiotics for infections.

Nutritional Support

Dietary recommendations to ensure proper nutrition while managing symptoms, often including adequate protein intake, sodium restriction, and sometimes supplements.

Liver Transplantation

For advanced cirrhosis or liver failure, a liver transplant may be the only option for long-term survival.

Home Remedies

Completely Avoid Alcohol

Regardless of the cause of cirrhosis, alcohol should be completely avoided as it can accelerate liver damage.

Follow a Liver-Friendly Diet

A balanced diet low in sodium, with moderate protein intake, and rich in fruits, vegetables, and whole grains. Avoid raw seafood and limit processed foods.

Stay Hydrated

Drink plenty of water, but follow doctor's recommendations on fluid intake, especially if you have ascites.

Regular Exercise

Gentle, regular physical activity as recommended by your healthcare provider can help maintain overall health and manage weight.

Avoid Hepatotoxic Substances

Be cautious with medications, including over-the-counter drugs like acetaminophen, and avoid exposure to chemicals that can damage the liver.

Preventive Care

  • Limit alcohol consumption or abstain completely
  • Get vaccinated against hepatitis A and B
  • Practice safe sex and don't share needles to prevent hepatitis B and C
  • Maintain a healthy weight
  • Follow a balanced, nutritious diet
  • Exercise regularly
  • Be cautious with medications and follow dosing instructions carefully
  • Avoid exposure to toxins like cleaning products and insecticides
  • Get regular check-ups, especially if you have risk factors for liver disease
  • Manage conditions like diabetes and high cholesterol that contribute to fatty liver disease

Surgical Options

Liver Transplantation

Replacing the diseased liver with a healthy one from a deceased donor or part of a liver from a living donor. This is considered for patients with end-stage liver disease or acute liver failure when other treatments aren't effective.

Learn More About This Procedure

TIPS (Transjugular Intrahepatic Portosystemic Shunt)

A procedure to create a new pathway between two blood vessels in the liver to reduce portal hypertension and its complications, such as bleeding varices or ascites that don't respond to other treatments.

Learn More About This Procedure

Paracentesis

A procedure to remove excess fluid from the abdomen (ascites) using a thin, long needle. This is typically performed for diagnostic purposes or to relieve symptoms when ascites is severe or doesn't respond to medications.

Learn More About This Procedure

Schedule a Consultation

If you're experiencing symptoms of liver cirrhosis, our expert team is here to help you find the right treatment approach for your specific needs.

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