Cirrhosis is a liver disease caused by scarring of the liver over a long period of time (months to years).
The liver is a very important part of the body.
Scarring of the liver causes permanent damage and makes it hard for the liver to do its job.
In the US, cirrhosis most often results from alcohol abuse. Many other things can cause it as well, such as hepatitis, inherited diseases, long-term exposure to toxic chemicals, some medicines, and intestinal bypass surgery.
The changes in the liver that lead to cirrhosis are gradual. At first liver cells are injured. If the cause of the injury continues (for example, illness or alcohol abuse), the liver cells start to die. After a while the dying liver cells are replaced with scar tissue. This scar tissue cannot do the work the liver needs to do. The poisons the liver normally clears from the body start to build up in the blood and make you sick.
The symptoms of early liver damage depend on what is causing it. At first there may not be any symptoms, or the symptoms may be very mild. Symptoms may include:
Both a medical history and physical exam are very important in the diagnosis of cirrhosis. The medical history helps your healthcare provider learn what may be causing the liver damage. The physical exam helps your provider know how much the liver is damaged.
Blood tests give information on how well the liver is working. They also may help find the cause of the cirrhosis; for example, hepatitis B infection.
You will have an ultrasound or CT scan to make pictures of the liver and give information about its size and condition.
You may need to have a liver biopsy to see how much the liver is damaged and to confirm the diagnosis. When you have this test you usually don’t have to stay in a hospital overnight. Your skin will be numbed and then a needle will be put through your skin and into your liver. The needle is used to get a small piece of the liver for tests.
Liver damage from cirrhosis is permanent, but treatment can stop or delay more damage. Treatment can also help prevent some complications.
The first important step is to remove what is causing the damage, if possible. For example, you must stop drinking any alcohol. If you have infectious hepatitis, the infection may be treated with medicine. If an intestinal bypass for obesity is the cause, the intestine needs to be reconnected to allow normal digestion.
In all cases, no matter what is causing the liver damage, you must eat a healthy diet. The body needs all recommended nutrients to keep the tissues healthy. You may need vitamin supplements and may have to change your diet. Your healthcare provider or dietitian can tell you what your diet needs are, depending on how much your liver is damaged. As you get better, your diet may be adjusted until it is the same as the diet recommended for someone without liver disease.
Cirrhosis can cause problems in other parts of the body and these will need to be treated. For example, fluid may build up in your belly. Or you may have bleeding from the esophagus (the tube that connects your throat to your stomach), causing bloody vomit, or bleeding in the stomach, causing bloody or tarlike bowel movements. Medicine can help control the buildup of fluid in the belly. Surgery may be needed to treat bleeding in the stomach and esophagus.
A liver transplant is a possible treatment for a failing liver, but whether you are a candidate for this surgery depends on a number of factors, such as your overall health and whether you have stopped drinking. Also, there are many more people who need a liver transplant than there are liver donors, so the wait for an available liver to transplant may be long.
If the liver keeps getting injured, the cirrhosis will get worse and more liver cells will stop working. This can kill you.
If it’s possible to stop the damage to your liver, the problem may not get worse and the remaining unscarred cells will keep do the important work of the liver.