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Liver Cirrhosis

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What is Liver Cirrhosis?

Liver cirrhosis is a chronic liver disease, in which scar tissues develop on the liver surface and prevent normal functioning. It disrupts blood flow and slows the ability of the liver to process nutrients, hormones, and toxins.

Cirrhosis can be life-threatening because of irreversible scarring. The symptoms can be none to very mild in an early stage. But as the disease progresses over time, there is an accumulation of fibrous scar tissue that replaces the healthy liver tissue. Regenerative nodules may also form as the liver tries to heal itself.

Cirrhosis can be seen in the advanced stages of Non-alcoholic fatty liver disease and various other conditions which lead to liver damage. Mostly the scarring caused by Cirrhosis cannot be reversed, but proper treatment can help keep it under check. Hepatitis B & C, long-term alcohol abuse, excess of toxic substances like copper or iron in the liver, etc. can be other causes apart from NAFLD.

Symptoms & Signs of Liver Cirrhosis

A lot of times symptoms are not visible until cirrhosis has progressed. The symptoms become visible because the scarring reaches a point where the liver fails to function normally. Limiting its ability to:

  • Purify blood
  • Produce clotting proteins
  • Absorption of fats and fat-soluble vitamins
  • Toxin breakdown

Some of the symptoms include:

  • Confusion, forgetfulness, difficulty in thinking
  • Bruising or bleeding easily
  • Itchy skin
  • Darker colored urine
  • Abdominal swelling
  • Swelling in legs
  • Decreased appetite
  • Fatigue
  • Weight loss
  • Mild pain on the upper right side of your abdomen
  • Nausea, vomiting
  • Enlarged or swollen veins
  • Gynaecomastia (Larger breasts in males)
  • Shrinkage in testicles
  • Jaundice (yellowing of the eyes and skin)
  • Ascites (an abnormal collection of fluid in the tummy)

The course of treatment to be taken is determined by how badly the liver is injured. Most important goal is to preserve the healthy tissue that is left.

Stages of Cirrhosis of the Liver

Depending on how well the liver is functioning, there are two stages the symptoms of Cirrhosis fall into: compensated and decompensated cirrhosis. The course of treatment depends on the stage a person is in.

  • Compensated Cirrhosis: there are no noticeable signs of liver disease and no major abnormality in the blood tests. There can be a few features of chronic liver disease in radiological investigations and liver Biopsies.
  • Decompensated Cirrhosis: The symptoms and signs of chronic liver disease are very noticeable, with worsening of blood investigations with obvious features of CLD and worsening in radiological tests and biopsy (not routinely recommended). The chances of at least one life-threatening complication are higher in decompensated patients and need immediate medical attention. Survival in such patients with decompensated cirrhosis reduce significantly.
Diagnosis of Liver Cirrhosis

Your doctor will ask you to undergo various tests and physical examinations looking at your past medical history. You may have tests such as:

  • Blood tests: It include certain blood investigation to see clotting status of blood as well as liver functions to determine the functioning status of the liver. Complete blood count for anemia.
  • Liver Biopsy (If required): To find out the type of liver disease, small samples are taken from your liver with a needle and accessed under a microscope.

You might have to undergo various imaging tests as advised by your doctor. Namely:

  • Abdominal ultrasound
  • Elastography / FibroScan
  • Abdominal computed tomography (CT) scan / Magnetic resonance imaging (MRI)

If the diagnostic tests suggest that you have been suffering from Liver Cirrhosis your doctor may suggest a treatment plan with various options to slow down the progression of scar tissue buildup and prevention/treatment of any other health issue. Cirrhosis is a progressive disease, so the liver damage can sometimes reverse or improve if whatever is triggering it is gone.

Treatment of Liver Cirrhosis

Treatment depends upon the stage of cirrhosis, it’s mainly medical in the compensated stage. There is no permanent cure for chronic liver disease as damage to the liver is irreversible. Most of the treatment is based on the removal of offending agents, precautions to slow down the damage, and prevention and treatment of complications. Such patients are advised to stop drinking alcohol, and offending medications and are suggested to take a balanced, healthy, low-fat diet.

Lifestyle modifications: Changing your lifestyle can not cure cirrhosis completely, but can definitely stop it from getting worse. Dietary changes must be made, including cutting back on calories and avoiding fast food, soda, and big meals. You need to prefer to drink lot of liquids if doctors allows, including enough fruits and vegetables in your diet, avoiding drinking too much alcohol, and engaging in daily exercise. Following the doctor’s recommendations for eating wholesome foods and boosting physical activity is crucial.

Diuretics: To be taken in consultation with doctors. It boosts urine production, which further aids in eliminating any excess water and salt content.

Ammonia Reducer: To be taken in consultation with doctors. It aids in lowering the body’s ammonia levels and stabilizes its effects.

Beta Blocker: To be taken in consultation with doctors. Beta blockers can help reduce the pressure on the eyes when used as eye drops. It even helps in bringing down the patient’s heart rate and blood pressure.

Antibiotics and Antiviral Drugs: To be taken in consultation with doctors if patient has Hepatitis B or Hepatitis C.

But if Cirrhosis has reached a point where treatment is not enough, the patient has to go through a transplant.

Prevention of Liver Cirrhosis
  • Do not abuse alcohol. Limit drinking to 2 drinks for men or 1 drink for women. No drinking of alcohol in presence of any liver disease.
  • Eating a well-balanced, healthy, low-fat diet
  • Maintain body weight
  • Regular exercise
  • Avoid high-risk behaviors (IV drug abuse and multiple sex partners), that can lead to infection with hepatitis
  • Get vaccinations for Hepatitis B & C

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