What is cirrhosis? Symptoms, causes, diagnosis, treatment and prevention

Many liver diseases can lead to this advanced stage of liver damage. Cirrhosis is a condition in which healthy liver tissue is replaced by scar tissue. Over time, scar tissue inhibits blood flow to the liver and hinders the liver’s ability to process nutrients, hormones, and medications.

Cirrhosis is always linked to other liver diseases and often develops from chronic hepatitis, alcohol-related liver disease, or non-alcoholic fatty liver disease. If cirrhosis is left untreated, the liver will not be able to function well and severe liver failure may result.

Scarring, or fibrosis, of the liver occurs when it is exposed to toxic substances. Substances such as alcohol or other drugs or inflammation, which can be caused by any liver disease. There are actually four different stages of scarring: F1 (minimal scar), F2 (significant scar), F3 (severe fibrosis) and F4 (advanced scar). Cirrhosis is stage 4, or the last stage of liver scarring.

The main causes of cirrhosis

Among the many possible causes of cirrhosis are the following:

– Chronic viral hepatitis B, C, or D.

Hepatitis C is the main cause of cirrhosis. It causes swelling of the liver, which can eventually lead to cirrhosis. About 1 in 4 people with hepatitis C develop cirrhosis. Although less common, hepatitis B and D can also cause cirrhosis.

– Excessive consumption of alcohol

Alcohol is toxic to the liver, and excessive consumption can lead to inflammation of the liver and changes in the liver cells themselves. This leads to swelling and ultimately cirrhosis.

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– Non-alcoholic hepatic steatohepatitis (NASH)

Fat buildup in the liver that is not alcohol-related is called non-alcoholic fatty liver disease. If this disease worsens, it can lead to non-alcoholic steatohepatitis, that is, inflammation appears in the liver along with fat.

– Common bile duct disease

These diseases restrict or even prevent bile from flowing into the small intestine, which can cause liver swelling and lead to cirrhosis.

– Family history

Certain genetic conditions can increase the risk of developing cirrhosis. Wilson’s disease, hemochromatosis, glycogen storage diseases, alpha-1-antitrypsin deficiency, and autoimmune hepatitis are all genetic conditions that can cause cirrhosis.

Signs and symptoms of cirrhosis

If the scarring is at an early stage, there may be no symptoms of cirrhosis. You may have cirrhosis with normal liver function. It is only when the liver becomes decompensated, or stops doing its job, that you develop symptoms. Many people learn they have cirrhosis because of a CT scan for another medical condition.

Over time, cirrhosis can begin to cause symptoms, which may include the following:

Loss of appetite


Weight loss or sudden weight gain

itchy skin

A brownish or orange color to the urine

Blood in stool


How is cirrhosis diagnosed?

Preliminary tests for cirrhosis include a complete medical examination, a review of the person’s medical history and lifestyle, and blood tests. Liver function tests can measure the levels of certain enzymes and proteins in the blood. If the levels are not within the normal range, it may indicate that the liver is not working properly.

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The final diagnosis of cirrhosis is a biopsy to determine the amount of scarring. A biopsy involves removing a small piece of tissue from the liver to examine under a microscope. A biopsy is quite invasive and carries its own risk of potential adverse effects. This is why there are now a number of non-invasive ways to assess the amount of scarring.

Treatment and medication options for cirrhosis

If autoimmune hepatitis is the root cause of the liver damage, treatment would be to treat the hepatitis. For alcohol-related liver disease, the treatment would be to avoid alcohol first. Metabolic risk factors, such as overweight or diabetes, will also be addressed. For hemochromatosis, the treatment would be to reduce the systemic level of iron overload. The overall goal of therapy is to arrest disease progression and prevent liver failure.

Life expectancy with cirrhosis

Life expectancy depends on the severity of the disease. If cirrhosis is identified and treated early and its progression arrested, it may have little impact on mortality. For stage 4 cirrhosis, the final stage of scarring, the one-year survival rate is 44%.

Complications of cirrhosis

Hypertension is a complication of cirrhosis that can have negative effects on the whole body. It occurs when a buildup of scar tissue blocks the flow of blood through the liver. This leads to abnormally high blood pressure in the portal vein, the large vein that carries blood from the intestine to the liver. This in turn causes a buildup of fluid in the abdomen (called ascites), bleeding from the veins in the esophagus or stomach, and an enlarged spleen.

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Other complications of cirrhosis include:

– Jaundice, a yellow discoloration of the skin and whites of the eyes

– Easy bruises

– Edema, or fluid retention and swelling of the legs

– Hepatic encephalopathy. A buildup of toxins in the brain that causes confusion and, in advanced stages, coma

– Renal failure

– Problems related to conditions affecting several organs and not the liver, such as heart failure

– Liver cancer (Most people who develop liver cancer have cirrhosis.)

Tips for living better with cirrhosis

Changing your lifestyle based on the type of liver disease you have is the first and most important step in managing cirrhosis.

Here are some other healthy habits that can help prevent further liver damage:

– Follow a nutritious diet and practice portion control.

– Avoid alcohol.

– Exercise regularly.

– Limit your salt intake.

– Avoid raw crustaceans and molluscs.

– Talk to your doctor about your medications and vaccinations.

– Adopt safer sex practices.

– Do not share needles, razors or toothbrushes.

– Use clean needles for tattoos or piercings.


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