Cirrhosis of the liver: Causes, symptoms, and treatments

Cirrhosis of the liver describes a condition where scar tissue gradually replaces healthy liver cells.

It is a progressive disease, developing slowly over many years. If it is allowed to continue, the buildup of scar tissue can eventually stop liver function.

For cirrhosis to develop, long-term, continuous damage to the liver needs to occur. When healthy liver tissue is destroyed and replaced by scar tissue, the condition becomes serious, because it can start blocking the flow of blood through the liver.

This MNT Knowledge Center article explains the symptoms, causes, and treatments of liver cirrhosis, including information about complications.

Symptoms

blood being tested in a lab
One of the primary methods of diagnosis is through a blood test.

Symptoms are not common during the early stages of cirrhosis.

However, as scar tissue accumulates, the ability of the liver to function properly is undermined. The following signs and symptoms may occur:

blood capillaries become visible on the skin on the upper abdomen.

fatigue

insomnia

itchy skin

loss of appetite

loss of bodyweight

nausea

pain or tenderness in the area where the liver is located

red or blotchy palms

weakness

The following signs and symptoms may appear as liver cirrhosis progresses:

accelerated heartbeat

personality changes

bleeding gums

lost mass in the body and upper arms

difficulties processing drugs and alcohol

confusion

dizziness

fluid buildup on ankles, feet, and legs, known as edema

hair loss

higher susceptibility to bruising

jaundice, or yellowing of the skin, whites of the eyes, and tongue

loss of sex drive

memory problems

more frequent fevers and increased risk of infection

muscle cramps

nosebleeds

pain in the right shoulder

breathlessness

stools become black and tarry, or very pale.

urine becomes darker.

vomiting blood

problems with walking and mobility

The liver tissue is replaced by fibrous scar tissue. Regenerative nodules may also form. These are lumps that appear as the liver tries to heal the damage.

Treatment

If the cirrhosis is diagnosed early enough, damage can be minimized by treating the underlying cause or the various complications that arise.

Treatment for alcohol dependency: It is important for the patient to stop drinking if their cirrhosis was caused by long-term, regular heavy alcohol consumption. In many cases, the doctor will recommend a treatment program for treating alcohol dependency.

Medications: The patient may be prescribed drugs to control liver cell damage caused by hepatitis B or C.

Controlling pressure in the portal vein: Blood can “back up” in the portal vein that supplies the liver with blood, causing high blood pressure in the portal vein. Drugs are usually prescribed to control the increasing pressure in other blood vessels. The aim is to prevent severe bleeding. Signs of bleeding can be detected via an endoscopy.

If the patient vomits blood or passes bloody stools, they probably have esophageal varices. Urgent medical attention is required. The following procedures may help:

Banding: A small band is placed around the base of the varices to control bleeding.

Injection sclerotherapy: After an endoscopy, a substance is injected into the varices, which triggers a blood clot and scar tissue to form. This helps stem the bleeding.

A Sengstaken-Blakemore tube with a balloon: A balloon is placed at the end of the tube. If endoscopy does not stop the bleeding, the tube goes down the patient’s throat and into their stomach. The balloon is inflated. This places pressure on the varices and stops the bleeding.

Transjugular intrahepatic portosystemic stent shunt (TIPSS): If the therapies mentioned above do not stem the bleeding, a metal tube is passed across the liver to join the portal and hepatic veins, creating a new route for the blood to flow through. This reduces the pressure that was causing the varices.

Other complications are handled in different ways:

Infections: The patient will be given antibiotics for any infections that arise.

Screening for liver cancer: Patients with cirrhosis have a much higher risk of developing liver cancer. The doctor may recommend regular blood tests and imaging scans.

Hepatic encephalopathy, or high blood toxin levels: Drugs can help treat excessive blood toxin levels.

In some cases, the damage caused by cirrhosis covers most of the liver and cannot be reversed. In these cases, the person may need a new, transplanted liver. It can take time to find a suitable donor, and this procedure is often advised only as a last resort.

pouring a glass of vodka
Frequent heavy drinking is a cause of cirrhosis.

Common causes of cirrhosis are:

long-term alcohol abuse

hepatitis B and C infection

fatty liver disease

toxic metals

genetic diseases

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