What is cirrhosis?
Cirrhosis is the last stage of scarring (fibrosis) of the liver, which is caused by a variety of liver diseases and conditions including hepatitis and chronic alcoholism.
Every time your liver is injured, due to illness, heavy drinking, or some other reason, it tries to repair it. In this process, scar tissue forms. As cirrhosis progresses, more scar tissue forms, making it harder for the liver to function (decompensated cirrhosis). Advanced cirrhosis is fatal.
Symptoms of cirrhosis
You may not see symptoms at first. But as time goes on and the damage to your liver worsens, you may notice things like:
- Fatigue and weakness
- Loss of appetite and weight loss
- You may easily have bleeding or bruising and swelling in your legs or abdomen. You may also notice changes in your skin
- Jaundice (when the skin and eyes turn yellow)
- Severe itching
- Cobweb-shaped blood vessels in the skin
- Redness of the palms of the hands or whitening of the nails
There may be some changes in your thinking, such as concentration or memory problems. If you are a woman, you may not have periods. If you are male, you may lose your sex drive, begin to develop breasts, or see some contraction in your testicles.
Some other features it may have:
- Vomiting blood
- Severe muscle cramps
- Brown urine
- Enlarged spleen
- Bone disease, bones break more easily
- Keep in mind that you may not have all of these symptoms and even signs of some other condition in these problems.
Causes of cirrhosis
The most common causes of cirrhosis are chronic viral infections of the liver (hepatitis B and C), obesity associated with obesity and diabetes, and alcohol abuse. Also, any liver damage can cause cirrhosis, including the following inherited diseases:
- Cystic fibrosis
- Glycogen storage diseases in which the body cannot process glycogen (which converts sugar to glucose and acts as an energy source for the body)
- Alpha-1 antitrypsin deficiency (lack of a specific enzyme in the liver)
- Diseases caused by abnormal liver function, such as hemochromatosis (a condition in which too much iron is absorbed and deposited in the liver and other organs) and Wilson’s disease (abnormal storage of copper in the liver)
- Autoimmune liver diseases (chronic conditions in which the body’s own immune system attacks the liver or cells of the bile ducts), including autoimmune hepatitis. Primary biliary cholangitis and primary sclerosing cholangitis. And overlapping syndromes.
- The bile duct carries bile formed in the liver to the intestines, where it helps in the digestion of fats.
- Recurring bouts of heart failure causes fluid to flow back into the liver, causing congestion.
Although less likely, other causes of cirrhosis include reactions to prescription drugs, long-term exposure to environmental toxins, or parasite infections.
Risk factors of cirrhosis
You are at risk for cirrhosis of the liver if you have one of the following conditions:
- Chronic hepatitis B
- Chronic hepatitis C
- Chronic excessive alcohol intake
- Fatty liver disease (nonalcoholic steatohepatitis)
- Autoimmune liver disease (autoimmune hepatitis, primary biliary cirrhosis, or primary sclerosing cholangitis)
- Wilson’s disease, hemochromatosis, and other rare inherited liver diseases
Diagnosis of cirrhosis
People with early-stage cirrhosis of the liver usually have no symptoms. Often, cirrhosis is first detected by a simple blood test or a checkup. To help confirm the diagnosis, a combination of laboratory and imaging tests is usually done.
Your doctor may order one or more tests that may indicate a problem with your liver, including:
Lab tests: Your doctor may order blood tests for certain enzymes that indicate liver dysfunction, such as high bilirubin, as well as liver damage. To assess kidney function, your blood will be tested for creatinine. You will be tested for the hepatitis virus. Your international normalized ratio (INR) is also checked to determine your blood clotting ability.
Based on the results of the blood test, your doctor can diagnose the cause of cirrhosis. You can also use blood tests to determine how severe your cirrhosis is.
Imaging tests: Magnetic resonance elastography (MRA) may be recommended. This advanced non-invasive imaging test detects the hardening or hardening of the liver. Other imaging tests such as MRI, CT scan, and ultrasound may also be done.
Biopsy: A tissue sample (biopsy) is not required for diagnosis. However, your doctor may use it to determine the severity, extent, and cause of liver damage.
If you have cirrhosis, your doctor will likely recommend routine diagnostic tests to monitor for signs of disease progression or problems, especially esophageal varices and liver cancer. Non-invasive tests are more available for follow-up.
Treatment for cirrhosis
Treatment of cirrhosis depends on its cause and the progression of the disorder. Some treatments prescribed by your doctor are:
- Beta-blockers or nitrates (for portal hypertension)
- Alcohol withdrawal (if cirrhosis is caused by alcohol)
- Bandage procedures (used to control bleeding from esophageal varices)
- Intravenous antibiotics (to treat peritonitis caused by ascites)
- Hemodialysis (to purify the blood of people with kidney failure)
- Low protein and lactulose diet (to treat encephalopathy)
- Liver transplantation is the last resort when other treatments fail.
All patients must refrain from consuming alcohol. Do not take over-the-counter medications without consulting your doctor.
Diet for cirrhosis
Foods to avoid:
- Alcohol is one of the main causes of fatty liver disease, as well as other liver diseases.
- Added sugar Avoid sugary foods like candy, cookies, soda, and fruit juices. High blood sugar increases fat in the liver.
- Fried food. They are high in fat and calories.
- Eating too much salt causes your body to trap excess water. Consumption of sodium to less than 1,500 milligrams per day.
- White bread, rice, and pasta. White means it is generally high in starch, which raises blood sugar more than whole grains due to a lack of fiber.
- Red meat. Beef and deli are high in saturated fat.
Foods to eat:
- Fruits and vegetables (raw or cooked without butter, oil, or salt)
- Eggs, egg whites
- Cooked fish (salmon, tuna)
- Lean chicken or turkey (without the skin)
- Low-fat Greek yogurt
- Cream cheese, ricotta
- Hard cheeses (cheddar, mozzarella)
- Nuts and seeds (unsalted)
- Dried beans and legumes
- Nut butter (unsalted)
- Fortified milk alternatives (almond, soy, rice)
- Whole grain bread, crackers, and cereals
- Brown rice
- Olive oil
- Fresh herbs
- Low-fat milk
- Quinoa, couscous
- Granola and cereal bars
- Coconut water
- Meal/nutritional supplements, as approved
Complications of cirrhosis
Cirrhosis is a chronic (ongoing) liver disease in which scar tissue replaces normal liver cells over time. This is an irreversible condition caused by:
- Diseases of the biliary tract (primary biliary cirrhosis)
- Excessive alcohol consumption
- Fatty liver disease (nonalcoholic type)
- Metabolic storage disorders (hemochromatosis, Wilson’s disease, and antitrypsin deficiency)
- Chronic viral hepatitis (caused by hepatitis B and C viruses)
- Cirrhosis affects the way the blood flows in the liver and processes toxins, nutrients, hormones, and medications. It also affects the way the liver makes proteins and other important substances.
Prevention of cirrhosis
- Don’t abuse alcohol. If you drink alcohol, limit how much you drink and how often. If you drink more than 2 drinks a day, you increase your risk. Drink means a 12-ounce or 1 1/2 ounce glass of wine or beer can of hard liquor.
- Avoid high-risk sexual behaviors, such as unprotected sex with multiple partners.
- Be careful around synthetic chemicals like cleaning products and pesticides. If you come into contact with chemicals frequently, wear protective clothing and a mask.
- Get vaccinated against hepatitis B
- Eat a well-balanced, low-fat diet. Poor nutrition, usually associated with alcohol or drug abuse, can lead to cirrhosis.
- Visit your doctor regularly for checkups. Follow medical advice to control obesity, diabetes, hypertension (high blood pressure), and dyslipidemia (high bad cholesterol [LDL], high triglycerides, and/or good low cholesterol [HDL]).