Overview – What is it?
Liver cirrhosis is the scarring of the liver due to other liver conditions and diseases such as chronic alcoholism and hepatitis. The liver is the largest internal organ of the body, the main functions of which are to filter blood, break down proteins and excrete bile (which helps in absorption of fats).
Some of the symptoms of liver cirrhosis include jaundice, itching of the skin and swelling of the legs. Diagnosing this condition can involve testing for hepatitis B and C as well as laboratory tests to check liver function and kidney function.
The treatment for liver cirrhosis includes medication to control hepatitis and any other condition that could be causing liver cirrhosis and liver transplant in cases where the liver is badly damaged.
To prevent yourself from getting liver cirrhosis, you should avoid excessive alcohol intake and eat healthy, among other measures that can reduce your risk of suffering from this condition.
Causes – What causes it?
There are a number of factors that can lead to liver cirrhosis such as:
- Chronic hepatitis: Viral hepatitis especially hepatitis B and C are more likely to cause chronic infection which can lead to cirrhosis of the liver.
- Chronic alcohol abuse: The more alcohol you take and the more frequently you take alcohol, the greater your risk of developing liver cirrhosis because excessive alcohol intake causes liver damage.
- Fatty liver disease: This is when there is accumulation of fat and water in the liver causing the liver to swell. Other forms of this disease such as non-alcoholic steatohepatitis can result from conditions like diabetes, metabolic syndrome and obesity.
- Some inherited liver disorders such as Wilson’s disease which inhibits the body’s ability to metabolize copper can also to liver cirrhosis
Risk factors for liver cirrhosis include:
- Other conditions such as cystic fibrosis and schistosomiasis
Blockage of the bile duct due to conditions such as pancreatic cancer
- Certain medications such as methotrexate which can increase liver cirrhosis risk
- Autoimmune hepatitis that occurs when the body’s immune system attacks the liver
Symptoms – What do you feel?
Liver cirrhosis usually has no symptoms until the liver is very damaged. Some of the symptoms you may experience are:Small, skin-coloured or slightly darker bumps which may appear on the penis, scrotum, thighs, groin or inside the anus, in men. They can also appear on or inside the vagina or anus and cervix, in women. They can be spread or close together appearing like cauliflower.
- Jaundice (yellowing of the skin and the white part of the eye)
- Easy bruising and bleeding due to decreases in the production of blood clotting factors
- Itching of the skin
- Swelling of the legs
- Nausea and vomiting
- Loss of appetite
- Loss of weight
- Accumulation of fluid in the abdomen
- Breast enlargement in men
- Confusion and memory problems
- Redness of the palms
- Dark urine and stool
- Mobility problems
Diagnosis – How do you diagnose it?
- Physical exam: This is done during the initial consultation when the doctor also finds out your symptoms, your medical history and your family’s health history. The physical exam is aimed at checking for any signs of liver cirrhosis such as swelling of the legs, jaundice and enlarged liver. After this, the doctor can then do tests to determine whether you have the condition and what the underlying cause is.
Other tests include:
- Blood test: This is done to test for liver and kidney function. By testing your blood, the doctor may also be able to know whether you have the hepatitis virus and your blood’s ability to clot.
- Imaging tests: This allows the doctor to check the inside of the abdomen by giving images of the liver from which it is possible to see if there are any abnormalities. These tests are done using computerised tomography (CT), magnetic resonance imaging (MRI) scans or through an ultrasound.
- Biopsy: This test involves taking a sample of liver tissue and viewing it under a microscope to determine whether there is damage to the liver, how severe it is, and what its cause is.
Treatment – How do you treat it?
The treatment of liver cirrhosis depends of how much damage has been caused to the liver and what has caused it. It aims at slowing down progression of scarring and to prevent and treat the symptoms. The treatment includes:
- Treating underlying causes of the condition such as:
- Alcohol dependency by stopping alcohol use and if it is hard for you to stop, the doctor may recommend that you go through alcohol rehabilitation because if you have liver cirrhosis any amount of alcohol will make your condition worse.
- Medication to control hepatitis as that may limit further damage to the liver.
- Medication to control other causes and relieve the symptoms of liver cirrhosis and so slow down the progression of the scarring.
- Weight loss if the cirrhosis is caused by non-alcoholic fatty liver disease. By losing weight and controlling sugar levels, you may become healthier. However, it is important to maintain an adequate protein level as you lose weight.
- Treating liver cirrhosis complications like:
- Infections which are treated using antibiotics and other treatments. You may also need to get vaccinated for conditions like hepatitis and influenza.
- Excess fluid in your body which can be treated using a low-sodium diet and medications to prevent excess fluid and so help in controlling ascites and swelling. If the fluid build-up is severe, it can be drained, or other procedures can be done to relieve pressure.
- Increased liver cancer risk which may require that you get tested for liver cancer more frequently, for instance every 6 months.
- Hepatic encephalopathy which is treated using medication to prevent the build-up of toxins in the blood due to poor liver function.
- Portal hypertension which is treated using medications to reduce blood pressure in the veins that supply blood to the liver thereby preventing severe bleeding.
- Liver Transplant: This refers to replacing a damaged liver with a healthy liver from a donor.
Prevention – How do you prevent it?
Prevention against liver cirrhosis is based on reducing the risk factors by:
- Limiting alcohol intake
- Maintaining a healthy diet rich in fruits and vegetables and reducing fatty and fried foods
- Maintaining a healthy body weight
- Getting vaccinated against hepatitis B
- Avoiding the sharing of cutting or piercing objects to protect yourself from getting hepatitis
- Practising safe sex to protect yourself from getting the hepatitis virus
- Getting regular testing if you are at a high risk of developing liver problem
- Avoiding exposure to toxins