Cirrhosis

Overview

Cirrhosis is a serious liver condition caused by several types of liver disease, including hepatitis and chronic alcoholism. Cirrhosis involves severe scarring (fibrosis) of the liver. Scarring is caused over time by repeated cycles of damage and repair to the liver. Liver damage caused by cirrhosis cannot be reversed, though further damage can be minimized with proper treatment.

Cirrhosis causes

Causes of cirrhosis include:

• Alagille syndrome (genetic digestive condition)
• Alpha-1 antitrypsin (AAT) deficiency
• Autoimmune hepatitis
• Biliary atresia (poorly formed bile ducts)
• Brucellosis (infectious disease caused by improperly prepared meat or dairy products)
• Certain medications, such as methotrexate or isoniazid
• Chronic alcohol abuse
• Cystic fibrosis
• Hemochromatosis (excess iron in the body)
• Hepatitis B, C or D
• Non-alcoholic fatty liver disease (fat accumulating in the liver)
• Primary biliary cirrhosis (destruction of bile ducts)
• Primary sclerosing cholangitis (scarring of bile ducts)
• Sugar metabolism disorders, including galactosemia or glycogen storage disease
• Syphilis
• Wilson’s disease (excess copper in the liver)

Cirrhosis risk factors

Factors that put you at an increased risk for developing cirrhosis include:

• Being overweight or obese
• Drinking too much alcohol
• Having a viral hepatitis infection

Cirrhosis symptoms

Many people with cirrhosis don’t experience any signs and symptoms until the disease has progressed. Signs and symptoms of cirrhosis may include:

• Breast enlargement (in men)
• Bruising or bleeding easily
• Confusion
• Decreased or lost appetite
• Drowsiness
• Edema (swelling in the legs, feet or ankles)
• Fatigue
• Fluid buildup in the abdomen
• Itchy skin
• Jaundice (yellowing of the skin and eyes)
• Loss of menstrual period
• Nausea
• Redness on the palms of your hands
• Slurred speech
• Spiderlike blood vessels on the skin
• Unintentional weight loss

Cirrhosis diagnosis

Your specialist will use one or more of the following diagnostic tools to diagnose cirrhosis:

Blood tests

Your specialist will obtain a sample of your blood for close analysis in the lab. Excess amounts of bilirubin (substance made during the breakdown of red blood cells) can indicate that your liver isn’t working properly. Certain enzymes can be present in your blood that can point to liver damage. If your blood contains too much creatinine (waste product that your kidneys normally filter out of your blood), your kidneys may not be working properly.

Imaging tests

Your specialist may recommend you undergo imaging tests – such as magnetic resonance elastography (MRE), magnetic resonance imaging (MRI), computed tomography (CT) scan or ultrasound – to locate areas of hardening in your liver.

Liver biopsy

In this test, your specialist removes a small tissue sample (biopsy) from your liver for careful analysis in the lab. Analysis of the tissue sample can reveal the severity, extent and cause of your liver damage.

Cirrhosis treatment

Your specialist may recommend one or more of the following treatment options for cirrhosis:

• Liver transplant - if your cirrhosis is advanced and other treatments would not be effective, your specialist may recommend you undergo a liver transplant. Your liver will be removed, and a donor liver will be put in its place.
• Reducing fluid in your body - you may need to eat a low-sodium (salt) diet and take medication (diuretic) to reduce excess fluid in your body.
• Treating infection - if you have a current infection, your specialist will prescribe antibiotic medication to clear up the infection. You may need to receive vaccinations for influenza (flu), pneumonia and hepatitis, to further reduce your future risk of infection.
• Treating the underlying cause - your liver specialist will recommend treating the underlying cause of your cirrhosis. If you are dependent on alcohol, you should seek a treatment program to help you quit drinking. If you are overweight, you should lose weight. If you have a hepatitis infection, your specialist will prescribe medications to control the infection and minimize further damage to your liver.

When should I seek care?

If you experience any of these symptoms, start by voicing your concerns and symptoms to your primary care provider. From there, your doctor may suggest seeing a liver specialist for more specialized treatment.