Introduction
Reviewed By Doctor
Dr. Sapna Kangotra
Dr. Meenu Kaushik
Dr. Megha Rathi
Dr. Nishant Bhardwaj
Dr. Ayush
Cirrhosis
Cirrhosis is a disorder in which the liver gets badly damaged over time, typically as a result of long-term injury. The liver’s function is to cleanse the body, manufacture essential proteins, and aid in digesting. However, when the liver is continually harmed, scar tissue forms, and the liver can eventually harden and become lumpy. This can impair the liver’s function and result in major health problems such as liver failure or cancer. However, with the proper therapy, you can halt or even reverse the harm. It is never too late to change for the better.
Stages of Cirrhosis
Stages of Cirrhosis: Compensated vs. Decompensated
Compensated Cirrhosis
Initially, many patients with cirrhosis do not feel unwell. This is referred to as compensated cirrhosis. Even when the liver is scarred, it still contains enough healthy tissue to carry out its essential activities. You may not have apparent symptoms, but when the liver stiffens and hardens, blood flow begins to restrict, causing early signs such as:
- Fatigue
- Poor appetite
- Weight and muscle loss
- Mood swings or depression
- Itching
- Lack of sexual urge
Decompensated Cirrhosis
As cirrhosis progresses, it might move to a more serious stage known as decompensated cirrhosis. This indicates that the liver can no longer withstand the damage, and serious consequences arise. Some of the significant difficulties that may arise include:
- Portal Hypertension: When blood can’t flow properly through the liver, pressure builds up in the veins, leading to swollen veins (varices) in the stomach or esophagus. These can burst and cause dangerous bleeding.
- Ascites: Fluid can build up in your abdomen or chest, causing swelling or shortness of breath.
- Enlarged Spleen: The spleen may become larger, leading to a drop in platelet count, which makes you bruise easily and takes longer to stop bleeding.
- Hepatic Encephalopathy: The liver can’t clear toxins from the blood, leading to confusion, forgetfulness, and difficulty concentrating. In severe cases, this can cause a coma.
- Jaundice: As the liver struggles to process bilirubin, it builds up in the body, causing yellowing of the skin and eyes.
- Liver Cancer: Cirrhosis significantly increases the risk of developing liver cancer, though liver cancer can also develop without cirrhosis. Regular screening is important for early detection.
Causes of Cirrhosis
Cirrhosis is usually the result of long-term liver damage, and several things can cause that damage:
- Heavy alcohol use is a common cause.
- Chronic viral infections like hepatitis B or C can lead to cirrhosis.
- Metabolic issues, such as obesity, diabetes, and poor diet, are also risk factors.
- Autoimmune diseases, where the immune system attacks the liver, like autoimmune hepatitis or primary biliary cholangitis.
- Genetic disorders, like hemochromatosis or Wilson’s disease, can also increase the risk of cirrhosis.
- Exposure to toxins, including certain medications and environmental pollutants, can damage the liver.
- Heart disease that leads to liver congestion can also cause cirrhosis.
In babies, biliary atresia, a condition where the bile ducts are absent or damaged, is a common cause of cirrhosis.
Diagnosis of Cirrhosis
If your doctor suspects cirrhosis, they’ll likely perform several tests:
- Blood Tests: These tests can show whether your liver enzymes are elevated, indicating liver damage. A full blood count may also show if your platelet count is low.
- Imaging: Your doctor may use an ultrasound, CT scan, or MRI to check the liver’s structure and look for any lumps that could indicate cancer.
- Transient Elastography: This test measures how stiff your liver is, which can indicate the level of scarring.
- Liver Biopsy: In some cases, your doctor may take a small sample of liver tissue to examine under a microscope. This test is the most accurate way to confirm cirrhosis but is not always needed.
Treatment of Cirrhosis
There’s no cure for cirrhosis, but treatment can help manage the condition and prevent it from getting worse.
- Addressing the Cause:
- If alcohol is the cause, stopping drinking is crucial to prevent further liver damage and give the liver a chance to heal.
- If viral hepatitis caused cirrhosis, antiviral medications can treat the infection, and sometimes cure it, especially with hepatitis C.
- For other underlying conditions, like metabolic issues, managing those through lifestyle changes or medications is important.
- Lifestyle Changes:
- Regular check-ups, including liver ultrasounds and blood tests, are essential to monitor liver health and detect liver cancer early.
- Getting vaccinated for hepatitis A and B, as well as the flu and other infections, is also recommended.
- Avoiding alcohol and quitting smoking are critical for protecting the liver.
- A healthy diet is important. Cutting down on salt can help if you have fluid retention, and eating enough protein is important to prevent muscle loss.
- Medications:
- Diuretics may be prescribed to reduce swelling caused by fluid retention.
- Other medications can help control complications like hepatic encephalopathy or internal bleeding.
- Treating Complications:
- If liver cancer is detected, early treatment can improve survival rates.
- For bleeding varices, an endoscopy may be used to stop the bleeding. In some cases, a liver transplant may be needed.
- Managing Muscle Cramps:
- Many people with cirrhosis experience muscle cramps, which can be quite painful. Supplements like magnesium, zinc, or taurine, along with a balanced diet, can help reduce the frequency and severity of cramps.
FAQs
Can cirrhosis be reversed?
In some cases, cirrhosis can be partially reversed if the underlying cause is treated, but the liver’s scar tissue can’t be undone. Early intervention can prevent further damage.
How do I know if I have cirrhosis?
If you have risk factors like chronic alcohol use or a history of hepatitis, it’s important to talk to your doctor. Symptoms might not show up until the cirrhosis is advanced.
What happens if cirrhosis goes untreated?
If left untreated, cirrhosis can lead to liver failure, serious complications like internal bleeding, and even liver cancer.
Can a liver transplant cure cirrhosis?
A liver transplant can improve the quality of life for those with severe cirrhosis, but it doesn’t cure the condition. The underlying cause must also be managed.
Is there a cure for cirrhosis?
Unfortunately, there’s no cure, but cirrhosis can be managed with the right treatment, lifestyle changes, and regular monitoring.
Conclusion
Cirrhosis is a serious condition, but with the right approach, you can manage it effectively. Working closely with your healthcare team, making necessary lifestyle changes, and keeping up with regular check-ups can help slow down the disease, manage symptoms, and prevent complications. Making those changes early can improve your quality of life and even reduce the risk of serious health issues in the future.
References
- Australian Institute of Health and Welfare (AIHW)
- American Cancer Society
- World Health Organization (WHO) Guidelines on Liver Cancer
- National Cancer Institute
Reviews By Doctor
Dr. Sapna Kangotra
Dr. Meenu Kaushik
Dr. Megha Rathi
Dr. Nishant Bhardwaj