Liver Cirrhosis

What is liver cirrhosis?

Liver cirrhosis occurs when a long-term medical condition causes the liver to form scar tissue. This scar tissue replaces the normal, healthy liver, and causes the liver to become less effective. This causes problems with blood flow through the liver and interferes with the liver's other functions. There are many possible causes of liver cirrhosis, but the most common causes are hepatitis, fatty liver disease, and long-term, heavy alcohol use. Diagnosis may involve multiple tests to investigate the remaining ability of the liver and the cause of the damage. Treatment involves managing the underlying cause and preventing further damage to the liver. It is important to reduce or stop drinking alcohol, and to keep to a low-protein diet. There is no cure for liver cirrhosis, but good management can slow down the scarring process and stop the condition from progressing.

Risks

The liver has many functions, and acts to break down (metabolize) many substances that we eat and drink (alcohol and some medications, for example), produces substances for digestion (bile), stores sugar for future use, and produces proteins to help with other bodily functions, such as blood clotting. The most common causes of liver cirrhosis are long-term, heavy alcohol use and long-term viral hepatitis B or C. Other causes include inflammation caused by autoimmune diseases (where the immune system mistakenly attacks the liver or the bile ducts), or the excessive storage of iron (hemochromatosis) or fat (fatty liver disease) in the liver. Some medications can also cause this condition. This condition is common. Liver cirrhosis most commonly affects older adults, and people with other medical conditions. Obesity is also a risk factor.

Symptoms

The typical symptoms include tiredness, itchy skin, tremor, a loss of appetite, weight and muscle loss, yellowing of the skin and eyes (jaundice), small spider-shaped blood vessels on the skin, and swelling of the legs and abdomen. As the condition progresses, people may become confused, forgetful and drowsy. The symptoms of liver cirrhosis occur when the liver is scarred and not able to let blood flow freely through or perform the functions that it should. For this reason, symptoms usually only occur in the later stages of cirrhosis.

Diagnosis

The diagnosis is made by a doctor assessing symptoms, doing a physical examination and doing a blood test to investigate the liver function and possible underlying causes, such as the hepatitis virus, or signs of inflammation in the body. In many cases, an ultrasound or CT scan of the liver is also necessary. In some cases, a small sample of the liver (a biopsy) may be taken to investigate the underlying cause.

Treatment

The treatment depends on the causes of liver cirrhosis and the stage of the liver damage at the time of diagnosis. Common measures include reducing alcohol intake, taking lactulose and eating a low protein diet. If there is an underlying cause, it should be treated or managed. Other procedures may be needed to investigate or treat the complications. The last resort in cases of total liver failure is liver transplantation.

Prevention

Reducing alcohol intake can help to prevent many cases of liver cirrhosis. Preventing hepatitis B or C infections can also help to prevent this condition. Maintaining a healthy weight is also helpful.

Other names for liver cirrhosis

  • Liver scarring