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What is cirrhosis?

Cirrhosis is a liver disease caused by scarring of the liver over a long period of time (months to years).

The liver is a very important part of the body.

  • It helps the body get rid of harmful substances, including alcohol, nicotine, and other poisons.
  • It helps the body digest fats.
  • It stores sugar, which the body uses for energy.
  • It makes many proteins, which are the building blocks for all cells in the body.
  • It stores vitamins.
  • It is part of the blood-clotting system.

Scarring of the liver causes permanent damage and makes it hard for the liver to do its job.

How does it occur?

In the US, cirrhosis most often results from alcohol abuse. Many other things can cause it as well, such as chronic infectious hepatitis, inherited diseases, long-term exposure to toxic chemicals, some medicines, and intestinal bypass surgery.

The changes in the liver that lead to cirrhosis are gradual. At first liver cells are injured. If the cause of the injury continues (for example, illness or alcohol abuse), the liver cells start to die. After a while the liver cells are replaced with scar tissue. This scar tissue cannot do the work the liver needs to do. The poisons the liver normally clears from the body start to build up in the blood and make you sick.

What are the symptoms?

The symptoms of early liver damage depend on what is causing it. At first there may not be any symptoms, or the symptoms may be very mild. Symptoms may include:

  • tiredness
  • easy bruising
  • loss of appetite
  • fever
  • nausea or vomiting
  • jaundice (yellow skin)
  • itching
  • abdominal pain
  • swelling of the belly or ankles
  • bloody vomit
  • bloody or tarlike bowel movements
  • weight loss.

How is it diagnosed?

Both a medical history and physical exam are very important in the diagnosis of cirrhosis. The medical history helps your healthcare provider find what is causing the liver damage. The physical exam helps your provider know how much the liver is damaged.

Blood tests give information on how well the liver is working. They also may help find the cause of the cirrhosis; for example, hepatitis B infection.

You may need to have a liver biopsy to see how much the liver is damaged. When you have this test you usually don't have to stay in a hospital overnight. Your skin will be numbed and then a needle will be put through your skin and into your liver. The needle is used to get a small piece of the liver for tests.

How is it treated?

Liver damage from cirrhosis is permanent, but treatment can stop or delay more damage. Treatment can also help prevent some complications.

The first important step is to remove what is causing the damage, if possible. For example, you must stop drinking any alcohol. If you have infectious hepatitis, the infection may be treated with medicine. If an intestinal bypass for obesity is the cause, the intestine needs to be reconnected to allow normal digestion.

In all cases, no matter what is causing the liver damage, you must eat a healthy diet. The body needs all recommended nutrients to keep the tissues healthy. You may need vitamin supplements and may have to change your diet. Your healthcare provider or dietitian can tell you what your diet needs are, depending on how much your liver is damaged. As you get better, your diet may be adjusted until it is the same as the diet recommended for someone without liver disease.

Cirrhosis can cause problems in other parts of the body and these will need to be treated. For example, fluid may build up in your belly. Or you may have bleeding from the esophagus (the tube that connects your throat to your stomach), causing bloody vomit, or bleeding in the stomach, causing bloody or tarlike bowel movements. Medicine can help control the buildup of fluid in the belly. Surgery may be needed to treat bleeding in the stomach and esophagus.

A liver transplant is a possible treatment for a failing liver, but whether you are a candidate for this surgery depends on a number of factors, such as your overall health and whether you have stopped drinking. Also, there are many more people who need a liver transplant than there are liver donors, so the wait for an available liver to transplant may be long.

How long will the effects last?

If the liver keeps getting injured, the cirrhosis will get worse and more liver cells will stop working. This can kill you.

If your liver stops being damaged, the problem may not get worse and the remaining unscarred cells will keep do the important work of the liver.

How can I take care of myself?

  • Follow your healthcare provider's recommendations.
  • Eat the diet your provider recommends.
  • Don't drink alcohol.
  • Follow your provider's advice about avoiding medicines that may damage the liver more. This includes nonprescription drugs.

What can be done to help prevent cirrhosis?

  • Limit your use of alcohol: no more than 1 drink a day for women and no more than 2 drinks a day for men. If you have a drinking problem, get help from a counselor or Alcoholics Anonymous (AA).
  • Ask your healthcare provider how you can help prevent hepatitis B and C.

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIA File gase4006.htm Release 13/2010

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