Cirrhosis of the Liver

Cirrhosis of the Liver

What causes Cirrhosis of the Liver ?

Cirrhosis has many possible manifestations. These signs and symptoms may be either as a direct result of the failure of liver cells or secondary to the resultant portal hypertension. There are also some manifestations whose causes are nonspecific but may occur in cirrhosis. Likewise, the absence of any does not rule out the possibility of cirrhosis. Cirrhosis of the liver is slow and gradual in its development. It is usually well advanced before its symptoms are noticeable enough to cause alarm. Weakness and loss of weight may be early symptoms.

What does the liver do?

The liver is in the upper right part of the abdomen. It has many functions which include:

• Storing glycogen (fuel for the body) which is made from sugars. When required, glycogen is broken down into glucose which is released into the bloodstream.
• Helping to process fats and proteins from digested food.
• Making proteins that are essential for blood to clot (clotting factors).
• Processing many medicines that you may take.
• Helping to remove or process alcohol, poisons and toxins from the body.
• Making bile which passes from the liver to the gut and helps to digest fats.

There are many causes of cirrhosis. The most common causes are heavy alcohol drinking and infection with the hepatitis C Virus.

Alcoholic cirrhosis

Your liver cells break down alcohol, but too much alcohol can damage the liver cells. As a rule, the heavier your drinking, the more your risk of developing cirrhosis. However, alcoholic cirrhosis is not just a condition of alcoholics. People who are social heavy drinkers can also develop cirrhosis.

About 1 in 10 heavy drinkers will eventually develop cirrhosis. It tends to occur after 10 or more years of heavy drinking. It is not clear why some people are more prone to their liver cells becoming damaged by alcohol and to developing cirrhosis. There may be a genetic tendency. Women who are heavy drinkers seem to be more prone to cirrhosis than men.

Hepatitis C and cirrhosis

Chronic (persistent) infection with the hepatitis C virus causes long-term inflammation in the liver. This can eventually lead to liver scarring and cirrhosis. Up to 1 in 5 people with chronic hepatitis C develop cirrhosis but this usually takes about 20 years or even longer from the initial infection.

How is cirrhosis diagnosed ?

A doctor may suspect, from your symptoms and a physical examination, that you have cirrhosis. (For example, a doctor may detect that your liver is enlarged, or that you are retaining fluid.) A doctor may especially think of cirrhosis as a cause of your symptoms if you have a history of heavy alcohol drinking or have had a previous episode of hepatitis.

Blood tests may show abnormal liver function. (Blood Test - Liver Function Tests' for more details.) An ultrasound scan (or a CT or MRI scan) may show that you have a damaged liver. To confirm the diagnosis, a biopsy (small sample) of the liver may be taken to be looked at under the microscope. The scarring of the liver and damage to liver cells can be seen on a biopsy.

If the underlying cause of the cirrhosis is not clear, then further tests may be done to clarify the cause. For example, to check for antibodies to hepatitis viruses, to check for autoantibodies that may have attacked your liver cells, to look in a blood sample for excess iron or copper, etc.

What is the treatment for cirrhosis?

Cirrhosis tends to get progressively worse if the underlying cause persists and is not treated. In general, once the damage is done the scarring is not able to reverse. Therefore, the aim of treatment is, if possible, to prevent further liver scarring, or to slow the progression of the scarring process. Treatments that may be advised include the following.

Stop drinking alcohol

Whatever the cause of cirrhosis, you should stop drinking alcohol completely. Drinking alcohol will increase the rate of progression of cirrhosis from whatever cause.

Be cautious when taking medicines

Always tell your doctor or pharmacist that you have cirrhosis if you take any prescribed or over-the-counter medicines. Some medicines that are processed in the liver may need their dose adjusted if you have liver problems, or even should not be used at all.

Treatment for underlying causes

Some of the underlying causes of cirrhosis can be treated. This may slow down, or halt, the progression of cirrhosis. For example:

• Not drinking alcohol if alcohol is the cause.
• Interferon and other medication may be used to treat viral hepatitis.
• Steroid medicines or other immunosuppressant medicines may be used to treat autoimmune diseases causing liver damage.
• Regular removal of a pint or so of blood can remove excess iron which occurs in haemochromatosis.

How Can I Prevent Cirrhosis of the Liver ?

There are several ways to reduce your risk of developing cirrhosis of the liver:

• Don't abuse alcohol. If you do drink alcohol, limit how much you drink and how often. Remember, it's not only the heavy drinker who gets cirrhosis. If you drink more than 2 drinks a day, you are increasing your risk. A drink is a 5-oz glass of wine, a 12-oz can of beer, or a 1 1/2-oz portion of hard liquor.
• Avoid high-risk sexual behavior such as unprotected sexual contact with multiple partners.
• Be careful around synthetic chemicals, such as cleaning products and pesticides. If you come into contact with chemicals often, wear protective clothing and a facemask.
• Get vaccinated against hepatitis B.
• Eat a well-balanced, low-fat diet high in fruits and vegetables and take vitamins.
• Maintain a healthy weight, because excess body fat can cause fatty liver, which may lead to liver disease.