Liver Cirrhosis: Symptoms, Causes, Stages, Diagnosis, and Treatment

Alcohol…People consume it for several purposes. Some take it for relaxation, others for social purposes, while some even believe it has some health benefits. Whatever the reasons, a good number of people consume alcohol in excess, creating several health problems for themselves. One of such problems alcohol has made very common is liver damage, medically called liver cirrhosis. Even though liver cirrhosis has other causes, long term consumption of alcohol is the 2nd most common cause of liver cirrhosis, after hepatitis C infection.

WHAT IS LIVER CIRRHOSIS?

Liver cirrhosis is a condition in which the liver is scarred and permanently damaged. Scar tissue replaces healthy liver tissue and prevents the liver from working normally. As cirrhosis gets worse, the liver begins to fail.

The liver is an important organ that does hundreds of jobs that are vital for sustaining life. For example, it:

•Stores glycogen, a type of fuel the body needs for energy

•Makes bile, which helps us digest fats

•Makes substances that help blood to clot 

•Repairs damaged tissues

•Processes and removes alcohol, toxins, or medicines from the blood

•Helps the body fight infections

The liver is very tough. It’ll keep working even when it’s damaged and can continue to repair itself until it’s severely damaged.

Cirrhosis is sometimes called end-stage liver disease because it happens after other stages of damage from conditions that affect the liver.

The liver may keep working even when there is cirrhosis. However, cirrhosis can eventually lead to liver failure, and a person can get serious complications, which can be life-threatening.

WHAT CAUSES CIRRHOSIS?

The most common causes of cirrhosis are:

1. Drinking too much alcohol over many years.
2. Being infected with hepatitis for a long time, particularly hepatitis B or hepatitis C
3. A severe form of non-alcoholic fatty liver disease (NAFLD), called non-alcoholic steatohepatitis, where the liver becomes inflamed from a build-up of excess fat
4. Cirrhosis can also be caused by a problem affecting your bile ducts (such as primary biliary cholangitis) or immune system (such as autoimmune hepatitis), some inherited conditions.
5. The long-term use of certain medicines.

WHO IS LIKELY TO HAVE LIVER CIRRHOSIS?

People are more likely to get cirrhosis if they have certain health conditions. People are also more likely to get cirrhosis if: 

1. They have abused alcohol for a long time
2. They have type 2 diabetes
3. They are men(male gender)
4. They are older than age 50
5. Severe adverse reactions to prescription drugs, such as isoniazid and methotrexate.

HOW COMMON IS LIVER CIRRHOSIS?

About 1 in 400 adults in the United States has liver cirrhosis.

Cirrhosis is more common in adults aged 45 to 54. About 1 in 200 adults ages 45 to 54 in the United States has cirrhosis.

 In Nigeria, there are about 100,000 cases per year.

The actual numbers may be higher because many people with cirrhosis are not diagnosed.

WHAT ARE THE SYMPTOMS OF LIVER CIRRHOSIS?

A person who has liver cirrhosis may have no signs or symptoms of cirrhosis until their liver is badly damaged.

Early symptoms of cirrhosis may include:

• Feeling tired or weak
• Poor appetite
• Losing weight without trying
• Nausea and vomiting
• Mild pain or discomfort in the upper right side of the abdomen.

As liver function gets worse, an affected person may have other symptoms, including:

• Bruising and bleeding easily
• Confusion, difficulties thinking, memory loss, personality changes, or sleep disorders
• Swelling in your lower legs, ankles, or feet, called edema
• Bloating from the buildup of fluid in your abdomen, called ascites
• Severe itchy skin
• Darkening of the color of your urine
• Yellowish tint to the whites of your eyes and skin called jaundice.

HOW IS LIVER CIRRHOSIS DIAGNOSED?

Doctors diagnose liver cirrhosis based on your medical history, a physical exam, and the results of tests.

1. Medical history:

Your doctor will ask about your symptoms, and if you have a history of health conditions that make you more likely to develop cirrhosis. Your doctor will also ask about your use of alcohol and medicines.

2. Physical exam:

Your doctor will examine your body, use a stethoscope to listen to sounds in your abdomen, and tap or press on specific areas of your abdomen, to check to see if your liver is larger than it should be. Your doctor will also check for pain in your abdomen.

3. Blood tests:

Your doctor may recommend the following blood tests:

1. Liver tests can show abnormal liver enzyme levels, which may be a sign of liver damage. 
2. Full blood count, which can show signs of infection and low blood levels.
3. Tests for viral infections to see if you have hepatitis B or hepatitis C
4. Blood tests for autoimmune liver conditions, Imaging tests.

      4. Imaging tests:

Such as magnetic resonance imagining (MRI), computerized tomography (CT scan). These can show the size, shape, texture, and stiffness of your liver. Measuring the stiffness of the liver can show scarring. Your doctor can use stiffness measures to see if the scarring is getting better or worse. magnetic resonance imaging.

      5.  Liver biopsy

Your doctor may perform a liver biopsy to see how much scarring is in your liver. A liver biopsy can diagnose cirrhosis when the results of other tests are uncertain.

HOW IS IT TREATED?

The goal of treatment is to slow down the buildup of scar tissue and prevent or treat other health problems.

Your treatment may include:

• Eating a healthy diet, low in sodium
• Not having alcohol or illegal drugs
• Managing any health problems that happen because of cirrhosis  
• Talk to your healthcare provider before taking prescription medicines, over-the-counter medicines, or vitamins.
• If you have severe cirrhosis, treatment can’t control other problems. A liver transplant may be needed.
• Other treatments may be specific to the cause of the cirrhosis.

PREVENTING LIVER CIRRHOSIS

To prevent liver cirrhosis, avoid doing things that could make you likely to have cirrhosis.

If you already have liver cirrhosis, you should eat a healthy, well-balanced diet. You should avoid eating raw or undercooked shellfish, fish, and meat. Bacteria or viruses from these foods may cause severe infections in people with cirrhosis.

Talk with your doctor, a dietician, or a nutritionist about healthy eating.

You can speak with a doctor for free on the flexicare HMO plan by initiating a message via the AI health messenger here or via your dashboard on the website.

Your doctor may recommend limiting salt in your diet and limiting your intake of fats or protein.

You should completely stop drinking alcohol because it can cause more liver damage.