Cirrhosis
What is cirrhosis?
Cirrhosis refers to a slowly progressing disease in which healthy liver tissue has been replaced by scar tissue. This is the result of chronic (long-term) hepatitis. Hepatitis is inflammation of the liver. The liver can become inflamed for various reasons, discussed below. In instances where liver inflammation is chronic, the liver attempts to repair itself by scarring. Too much scarring will prevent your liver from functioning fully.
What causes cirrhosis?
There are many causes of cirrhosis, some of the most common include:
- Alcohol abuse
- Metabolic conditions
- Viral infections
- Toxic substances
- Genetic conditions
- Chronic liver diseases
This list also covers the most frequent causes of liver inflammation, which over time can lead to cirrhosis.
What are the stages of cirrhosis?
There are two stages of cirrhosis, the first is called compensated cirrhosis where the body makes adjustments to compensate for reduced liver function. Typically, there are no noticeable symptoms at this stage. As cirrhosis progresses, liver function declines further and symptoms become noticeable. This second stage is called decompensated cirrhosis.
What are the symptoms of cirrhosis?
Often, cirrhosis does not have any symptoms until the damage to the liver is serious. When symptoms do appear, they may include:
- Yellowing of the eyes and skin (jaundice)
- Itchy skin
- Bleeding & bruising easily
- Loss of appetite
- Redness in the palms
- Small, yellow bumps of fat deposits on skin/eyelids
- Nausea/vomiting
- Unintended weight loss
- Swelling in the legs, feet or ankles
- Fatigue (tiredness)
- Dark-colored pee & light-colored poop
- Digestive issues (especially with fats)
- Confusion / slurred speech
How is cirrhosis diagnosed?
Cirrhosis is typically diagnosed through a combination of physical exam, medical history and the results of blood tests, imaging and in some cases a liver biopsy.
Blood tests: Liver function blood panels can reveal signs of liver disease/failure.
Imaging: Common imaging tools such as ultrasound, CT scan or MRI are able to show details such as the shape, size and texture of your liver. Elastography, a special imaging test, is able to measure the fibrosis (level of stiffness) in your liver.
Biopsy: This procedure involves the use of a long, thin needle to remove a small tissue sample from your liver. The tissue is then examined in a lab to confirm cirrhosis and may aid in determining the cause.
Can you cure cirrhosis?
Cirrhosis causes permanent scarring of your liver. It cannot be reversed since there is no longer enough healthy cells left for the liver to repair itself. Some people are able to slow or stop the progression of cirrhosis. This will depend on a few factors: what is causing it, if the cause is treatable and how well you respond to treatment.
How is cirrhosis treated?
Treatment for cirrhosis will likely include a combination of the following:
- Treating the cause
- Lifestyle modifications
- Managing the condition
- Transplantation
If you have alcohol-related or toxin-induced liver disease, removing those from your life is the only 'treatment'. If your liver disease is due to metabolic conditions, managing your weight, blood sugar and cholesterol can help slow or stop your cirrhosis.
There are some medications which can treat liver disease, but with mixed levels of success. For example, chronic hepatitis C (which can cause cirrhosis) can be cured with medications, but chronic hepatitis B can only be suppressed, not cured.
Many people will need to pursue both lifestyle modifications and medications to help treat or manage their symptoms. In instances when your health continues to decline, for example you are near or are in active liver failure, are no longer responding to liver disease treatment, etc., your provider may recommend a liver transplant.
Living with cirrhosis
Receiving a cirrhosis diagnosis can feel heavy, but with focused efforts you may be able to maintain your current health. Even though your liver function cannot improve, it may not get worse either. If you are able to stop or minimize the inflammation causing your cirrhosis, there is a chance that it will not progress to stage two: decompensated cirrhosis.
Keeping your liver healthy, through lifestyle modifications and medications (if applicable), will be essential for the rest of your life. Work with your hepatologist to create a plan and follow it as closely as possible is the best way to approach life with cirrhosis.