Contents
Cirrhosis refers to scarring of the
liver. Scar tissue forms because of injury or long-term disease. It
replaces healthy tissue.
Scar tissue cannot do what healthy
liver tissue does—make protein, help fight infections, clean the
blood, help digest food, and store energy for when you need it. Scar
tissue also blocks the normal flow of blood through the liver. Too
much scar tissue means that your liver cannot work properly. To
live, you need a liver that works.
Cirrhosis can be life-threatening,
but it can also be controlled if treated early.
You may have no symptoms at all in
the early stages. As cirrhosis progresses you may
- feel tired or weak
- lose your appetite
- feel sick to your stomach
- lose weight
Cirrhosis can also lead to other
problems.
- You may bruise or bleed easily,
or have nosebleeds.
- Bloating or swelling may occur
as fluid builds up in the abdomen or legs. Fluid build up in the
abdomen is called ascites (ah-SI-teez) and in the legs is called
edema.
- Medications may have a stronger
effect on you because your liver does not break them down as
quickly.
- Waste materials from food may
build up in the blood or brain and may cause confusion or
difficulty thinking. For example, protein that you eat breaks down
into chemicals like ammonia. When red blood cells get old, they
break down and leave a substance called bilirubin (bil-ih-ROO-bun).
A healthy liver removes these byproducts, but a diseased liver
leaves them in the body.
- Blood pressure may increase in
the vein entering the liver, a condition called portal
hypertension.
- Enlarged veins, called varices (VARE-ah-seez),
may develop in the esophagus and stomach. Varices can bleed
suddenly, causing vomiting of blood or passing of blood in a bowel
movement.
- The kidneys may not work
properly or may fail.
As cirrhosis progresses, your skin
and the whites of your eyes may turn yellow, a condition called
jaundice (JON-diss). You may also develop severe itching or
gallstones.
In the early stages, cirrhosis
causes your liver to swell. Then, as more scar tissue replaces
normal tissue, the liver shrinks.
About 5 percent of patients with
cirrhosis also get cancer of the liver.
Cirrhosis has many causes,
including
- alcohol abuse (alcoholic liver
disease)
- chronic viral hepatitis
(hepatitis B, C, or D)
- autoimmune hepatitis, which is
destruction of liver cells by the body’s immune system
- nonalcoholic fatty liver disease
or nonalcoholic steatohepatitis (NASH), which is fat deposits and
inflammation in the liver
- some drugs, toxins, and
infections
- blocked bile ducts, the tubes
that carry bile from the liver
- some inherited diseases such as
- hemochromatosis (HEE-moh-KROH-muh-TOH-sus),
a disease that occurs when the body absorbs too much iron and
stores the excess iron in the liver, pancreas, and other organs
- Wilson’s disease, which is
caused by the buildup of too much copper in the liver
- protoporphyria (PROH-toh-pour-FEAR-ee-uh),
a disorder that affects the skin, bone marrow, and liver
Sometimes the cause of cirrhosis
remains unknown even after a thorough medical examination.
Your symptoms, a physical
examination, and certain tests can help your doctor diagnose
cirrhosis. Some tests are
- Blood tests to see whether your
liver is working properly. Routine blood tests may be normal in
cirrhosis. However, with advanced cirrhosis, blood tests may
reveal abnormal levels of bilirubin and other substances.
- X rays, magnetic resonance
imaging, or ultrasound images, which are pictures developed from
sound waves, may show an enlarged or shrunken liver.
- Liver biopsy, an examination of
a piece of your liver under a microscope, to look for scar tissue.
This is the most accurate way to diagnose cirrhosis.
In a liver biopsy, a needle is used
to take a small piece of liver tissue. That sample is then examined
under a microscope.
Once you have cirrhosis, nothing
can make the scar tissue go away completely. However, treating the
cause will keep cirrhosis from getting worse. For example, if
cirrhosis is due to alcoholic liver disease, the treatment is to
completely stop drinking alcohol. If cirrhosis is caused by
hepatitis C, then that disease may be treated with medication.
Your doctor will suggest treatment
based on the cause of your cirrhosis and your symptoms. Early
diagnosis and carefully following an appropriate treatment plan can
help many people with cirrhosis. In very advanced cirrhosis,
however, certain treatments may not be possible. In that situation,
your doctors will work with you to prevent or manage the
complications that cirrhosis can cause.
What if the treatment doesn’t
work?
If too much scar tissue forms,
your liver could fail. Then you may need to consider a liver
transplant. A liver transplant can return you to good health. For
information about liver transplantation, please see the What I
need to know about Liver Transplantation booklet from the National
Institute of Diabetes and Digestive and Kidney Diseases.
- See your doctor for treatment of
your liver disease. Many of the causes of cirrhosis are treatable,
and early treatment may prevent cirrhosis.
- Follow a healthy lifestyle, eat
a healthy diet, and stay active.
- Try to keep your weight in the
normal range. Being overweight can make several liver diseases
worse.
- Do not drink alcohol. Alcohol
can harm liver cells, and chronic alcohol use is one of the major
causes of cirrhosis.
- Stay away from illegal (street)
drugs, which can increase your chances of getting hepatitis B or
hepatitis C.
- See your doctor if you have
chronic viral hepatitis. Effective treatments for both hepatitis B
and hepatitis C are available. If you are on treatment, follow
your treatment directions exactly.
- If you have autoimmune
hepatitis, take medications and have regular check-ups as
recommended by your doctor or a liver specialist (hepatologist).
- Stop drinking alcohol
completely.
- Do not take any medications,
including those you can buy without a prescription such as
vitamins and herbal supplements, without discussing them with your
doctor. Cirrhosis makes your liver sensitive to certain
medications.
- Get vaccinated against hepatitis
A and hepatitis B. These forms of liver disease are preventable.
Also, ask your doctor about getting a flu shot and being
vaccinated against pneumonia.
- Avoid eating raw oysters or
other raw shellfish. Raw shellfish can harbor bacteria (Vibrio
vulnificus) that cause severe infections in people with cirrhosis.
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