Charlotte, NC
Bibhusan Basnet, MD
Saloni Shrestha, MBBS
Liver Cirrhosis is a chronic and progressive condition that affects the liver, leading to scarring and permanent damage. Cirrhosis develops when the liver is repeatedly injured, resulting in inflammation and scar tissue formation that gradually replaces healthy liver tissue. As the scar tissue accumulates, it can obstruct the liver’s blood supply, impair its ability to function properly, or even result in liver failure.
Cirrhosis is a progressive condition that often presents with few or no symptoms until the liver has been significantly damaged. However, as the disease progresses, certain signs and symptoms may manifest, indicating the presence of cirrhosis. Here are the common symptoms associated with cirrhosis.
Liver Cirrhosis can be classified into two main types: compensated and decompensated. These classifications reflect the degree of liver damage and the liver’s ability to function.
In compensated cirrhosis, the liver can still perform its functions, although it may be impaired to some extent due to the presence of scar tissue. The body compensates for the damaged liver by adjusting and adapting to maintain normal bodily functions. At this stage, individuals may not exhibit significant symptoms or may experience mild symptoms that do not interfere with daily life. However, it is important to note that even in compensated cirrhosis, the liver is still scarred and requires ongoing management and monitoring.
Decompensated cirrhosis occurs when the liver has been severely damaged and can no longer function adequately. The liver’s ability to perform vital tasks, such as detoxifying the blood, producing proteins, and processing nutrients, is significantly impaired at this stage. Decompensated cirrhosis is often accompanied by various complications and symptoms, and it can have a profound impact on a person’s health and quality of life. Individuals with decompensated cirrhosis require more intensive medical management and may need interventions such as liver transplantation.
Several factors contribute to the development of liver cirrhosis. While alcohol addiction is a well-known cause, numerous other underlying causes exist. These include:
Diagnosing liver cirrhosis involves a combination of methods, including evaluating symptoms, medical history, physical examination, laboratory tests, and imaging studies.
The doctor will begin by asking about your symptoms, medical history, alcohol consumption, and exposure to risk factors for liver disease. They will also perform a physical examination to assess signs of liver damage, such as jaundice, fluid accumulation in the abdomen (ascites), or an enlarged liver.
Blood tests are crucial in diagnosing liver cirrhosis. They help assess liver function, identify potential causes of cirrhosis, and evaluate the severity of liver damage. Common blood tests include:
Various imaging techniques are used to visualize the liver and assess its structure and function depending on the need and availability. These may include:
In some cases, a liver biopsy may be performed to confirm the diagnosis and assess the severity of cirrhosis. During this procedure, a small sample of liver tissue is obtained using a needle, which is then analyzed under a microscope. A liver biopsy can provide information about the extent of liver damage, inflammation, and fibrosis or scarring. It is important to note that liver biopsy is an invasive procedure with potential risks, and it may not be necessary for all cases of cirrhosis. The decision to perform a liver biopsy is made on an individual basis, considering the patient’s specific circumstances and the need for additional information to guide treatment.
Liver cirrhosis can lead to various complications as the liver function progressively deteriorates. These complications can significantly impact a person’s health and quality of life. Some common complications of liver cirrhosis include:
The treatment of cirrhosis aims to address the underlying cause, prevent further liver damage, manage symptoms, identify and treat liver cancer, and, if possible, delay or avoid the need for a liver transplant and improve the quality of life. Here are some common approaches in the management of cirrhosis:
If cirrhosis is caused by a specific condition such as viral hepatitis or autoimmune liver disease, treatment will focus on managing and controlling the underlying cause. This may involve antiviral medications for viral hepatitis, immunosuppressive drugs for autoimmune liver diseases, or lifestyle modifications for conditions like nonalcoholic fatty liver disease (NAFLD).
Medications may be prescribed to manage symptoms and complications of cirrhosis. Some commonly used medications include:
A balanced and nutritious diet is essential for individuals with cirrhosis. A dietitian may guide appropriate dietary choices to manage symptoms, prevent malnutrition, and support liver health. This may involve limiting sodium (salt) intake, increasing protein intake, and ensuring sufficient calorie consumption.
It is important for individuals with liver cirrhosis to receive recommended vaccinations. Vaccinations recommended for patients with liver cirrhosis include hepatitis A and B vaccines to protect against viral infections, influenza vaccines to prevent flu-related complications, and pneumococcal vaccines to reduce the risk of bacterial infections. Other vaccinations, such as Tdap and shingles, may also be considered based on individual circumstances.
Certain lifestyle adjustments can help prevent further liver damage and improve overall well-being if diagnosed with cirrhosis. These may include:
In cases of severe variceal bleeding, endoscopic treatments such as band ligation or sclerotherapy may be performed to stop the bleeding. Medications like octreotide may also reduce blood flow to the varices.
TIPS is a procedure that creates a shunt between the portal vein and hepatic vein, reducing portal hypertension. It can help manage complications such as ascites and variceal bleeding that do not respond to medication or endoscopic treatment.
A liver transplant may be considered for individuals with advanced cirrhosis and liver failure. A liver transplant involves replacing the diseased liver with a healthy liver from a deceased or living donor. This is a major surgical procedure, and post-transplant immunosuppressive medications are required to prevent rejection of the new liver.
If you suspect you have cirrhosis or have been diagnosed with it, it is important to follow up with your doctor regularly. Depending on the severity of your condition, your doctor may recommend specific lifestyle adjustments to prevent further liver damage.
Do not hesitate to seek medical attention if you have the following:
Common misconceptions about cirrhosis include:
Cirrhosis is a serious condition characterized by liver scarring and damage. It can be caused by various factors, not just heavy drinking, and is associated with significant complications. While it cannot be fully reversed, early detection and proper management can slow its progression, alleviate symptoms, and prevent further liver damage. Treatment addresses the underlying cause, manages complications, and promotes a healthy lifestyle. Regular medical monitoring and proactive communication with healthcare professionals are vital for individuals with cirrhosis to optimize their health and well-being.
