Liver Cirrhosis

Cause

Heavy drinkers are at risk of developing liver cirrhosis in the long term. Other causes are chronic liver infections, such as hepatitis B and C or iron deposit (hemochromatosis). Additionally, liver cirrhosis can sometimes also be the result of other conditions that may or may not be hereditary. Less common are the cases of liver cirrhosis which are a consequence of severe responses to medications. Prolonged exposure to toxins, such as arsenic, can also cause liver cirrhosis. Some people develop liver cirrhosis without a plausible reason at first sight. In these special cases, it will be extremely difficult to recognize liver cirrhosis as such.

Symptoms

In the initial stage, there are no symptoms that suggest liver cirrhosis. The following signs and symptoms indicate liver cirrhosis in an advanced stage:

• Extreme weakness or fatigue.
• Nosebleeds and bruises.
• Weight loss.
• Pain or discomfort in the abdomen.
• Yellowing of the skin.
• Itch.
• Accumulation of moisture in the legs and abdomen.
• Confusion.

Diagnosis

The doctor will first perform a general examination, including asking questions about lifestyle, drinking behavior, diseases in the family, etc. When suspecting liver cirrhosis, radiographic examination (ultrasound, CT scan and/or MRI scan) will be performed. This will tell whether there is indeed liver cirrhosis and to what extent the liver has been damaged. In order to determine the final diagnosis, the doctor may perform a liver biopsy. Here, a piece of the liver is tested for the presence of liver cirrhosis.

Treatment

Liver cirrhosis cannot be cured, the damage to the liver is irreversable. The liver is a large organ, with plenty of spare capacity. It’s therefore of great importance to bring the process of liver cirrhosis to a halt. When a portion of the liver is and remains healthy, the patient may well live on. This is, of course, depending on how large the remaining, healthy part of the liver is. When the cause of the liver cirrhosis is known, the doctor can treat this cause. For example, treatment of hepatitis B or C with medicines. If this disease cures, the development of new scar tissue stops.
When a too large portion of the liver has been damaged, a liver transplant is the only option. This is, however, a major operation, with a high risk of complications.
It is sometimes possible to treat complications resulting from liver cirrhosis. This can reduce the symptoms:

• Patients with liver cirrhosis are more susceptible to infections. When an infection occurs, a doctor can prescribe antibiotics.
• If an accumulation of moisture in the abdominal cavity occurs (ascites), the doctor may prescribe moisture-drifting drugs (diuretics). This is combined with a salt-restricted diet.
• Confusion or dizziness may occasionally be treated with medication.
• Sometimes, the doctor can treat varicose veins in the esophagus and stomach endoscopically. During a gastroscopy, the doctor can inject medication in or near the varicose vein, causing the vein to be constricted. The doctor can also try to tie off the varicose veins with rubber bands during a gastroscopy.
• Itch can be treated with medication.

Prognosis

The prognosis for liver cirrhosis depends on the extent to which the liver is affected. The prospects may therefore be highly variable. If the condition is mild, people can still live for many years.

Considerations

The following tips can ensure to keep the liver in shape as well as possible:

• Don’t use alcohol at all.
• Some particular medicines strain the liver too much. Therefore, always consult the doctor for medication.
• Eat healthy and varied. Make sure to get enough calories; people with liver cirrhosis often become malnourished. If necessary, consult a dietician for personal dietary advice.
• Try to exercise daily. By exercising, a person remains in good shape.
• Keep the immune system on level and try to avoid infections.
• Provide sufficient (night)rest.

Facts

• The term ‘cirrhosis’ is derived from the Greek word kirros (pale yellow), followed by the suffix -osis (morbid condition which is not the result of inflammation).
• The prevalence of liver cirrhosis is 0.1%.
• In people aged 45 to 65 years, liver cirrhosis is the third cause of death, after cardiovascular diseases and cancer.