The Ultimate Guide To Prevent Cirrhosis!

Medically reviewed by Aaron L Weigmann MD., MS Plastic Surgeon May 23, 2024| Written by Godfrey M. Wesutsa

The Ultimate Guide To Prevent Cirrhosis!

Cirrhosis is a condition characterized by the scarring of the liver, which negatively impacts its normal functioning. Thescarred tissue slowly replaces the healthy liver cells. This takes place as time goes by due to alcohol addiction, viral hepatitis, and infections. As the condition worsens, it is bound to lead to liver failure.

In 2007, Cirrhosis accounted for29,165 deathsin the United States, which translates into a mortality rate of 9.7 for every 100,000 persons. To date, it is regarded as the12th leading cause of death in the U.S. 

If you catch cirrhosis early, some treatments can fix it. But mostly, it is hard to treat a damaged liver. This article will demystify liver Cirrhosis, its symptoms, and the available treatment options for this liver disease.

What Are the Symptoms of Cirrhosis?

In the early stages, it is hard to tell if a person has liver cirrhosis as there may be nosymptoms at all. But as the liver damage increases, the signs become increasingly clear. 

Early signs and symptoms:

  • Fatigue or body weakness
  • Nausea and Vomiting
  • Loss of appetite
  • Itchy skin
  • Muscle cramps
  • Discomfort or mild pain in the liver
  • Weight loss
  • Muscle weakness and loss
  • Redness on your palms (palmar erythema)
  • Visible blood vessels which resemble spiders (spider angiomas)

Symptoms of Advancing Liver Cirrhosis

What are the Four Stages of Cirrhosis?

Cirrhosis worsens as time goes by. The scarred tissue develops and replaces the healthy liver. 

In the early stages of cirrhosis, the body adjusts to compensate for the reduction in the functionality of the liver. At this stage, you might not notice any signs or symptoms. This is referred to ascompensated cirrhosis, which can be stopped from becoming liver failure through treatment. 

As the liver becomes more damaged, signs and symptoms will be visible. It leads todecompensated cirrhosis, where there will be symptoms such as hepatic encephalopathy, bleeding of veins, gallstones, jaundice, and ascites. 

Liver cirrhosis is a progressive condition classified into the followingfour stages.

1. Hepatitis

Hepatitis is characterized by theinflammation of liver tissues or bile ducts. This is a response of the liver to toxicity or injury to fight an infection or disease and initiate the healing process. Due to the inflammation of the liver tissue, you may begin to feel some discomfort. 

The immediate response normally accomplishes the healing; however, the inflammation worsens when the toxicity or injury continues. Chronic inflammation leads to hyperreactive healing and eventually causes fibrosis (scarring of liver tissues).

2. Fibrosis

Most people realize they have a liver illness at thisstage.The scarred tissues slowly add up, stiffening the liver and obstructing function, interfering with access to nutrients and oxygen. However, some scarred tissues can be reversed through the regeneration of liver cells. 

Proper treatment will also prevent more damage to the liver.

3. Cirrhosis

It is theirreversible destructionof liver cells through scarring. At this point, the liver doesn’t have sufficient healthy cells to function normally. The scarred tissues cannot regenerate again.Cirrhosis does occur as the liver disease continues to advance because there is no replacement of the scarred tissue. So, the liver becomes shriveled and lumpy. 

At this stage, you will notice some symptoms such as discomfort, pain, jaundice, itching around the liver, fluid retention, appetite loss, and fatigue. But you can slow down and stop the damage at this juncture.

4. Liver Failure

Liver failureis the last stage, whereby the liver can no longer function to accomplish your body's needs. The liver cannot repair itself, and no treatment will be effective. This stage is also referred to as decompensated cirrhosis. The only remedy for liver failure is a liver transplant. 

Symptoms of liver failure are loss of appetite, disorientation, confusion, weight loss, and diarrhea. 

Failure of the liver can either beacute or chronic. For acute liver failure, it takes place within 48 hours as a result of a drug overdose or toxicity. Chronic liver failure is gradual and follows the four stages of liver disease. 

Diagnosis

Diagnosis of cirrhosis is based on physical examination, blood tests, imaging tests, liver biopsy, andmedical history.

1. Physical Examination

The physical exam entails:

  • Checking outstretched hands for tremor
  • Checking the liver to determine if it has increased in size 
  • A stethoscope is used to listen to theabdomen, belly, lungs, and heart.
  • Checking the skin for rashes
  • Checking the legs for swelling
  • Looking for jaundice or yellowish tint on the skin and eyes
  • Pressing or tapping the area around the abdomen to check for tenderness or swelling

2. Family and Medical History

The doctor will want to know your symptoms and if yourmedical history increases the chances of developing liver cirrhosis. Some of the questions you will be asked include:

  • Alcohol consumption
  • Usage of herbal supplements, over-the-counter medication, and prescription drugs.
  • Changes in appetite and weight
  • Family history of liver conditions

3. Imaging Tests

Imaging testsshow the shape, texture, and size of the liver and the fat in this organ. These tests can also reveal if the liver is stiff. They include:

  • Magnetic resonance imaging (MRI) uses magnets and radio waves to produce comprehensive and detailed images of soft tissues and organs.
  • Elastography measures if the liver is stiff enough for scarring or fibrosis. The doctor will use these tests to determine if you have cirrhosis or whether the liver scarring can get better or not.
  • Ultrasound uses sound waves to produce images of the liver.
  • Computed tomography (CT) scans which combine computer technology and X-rays, produce images of your liver.

4. Blood tests

Below are some of thetests that the doctor will perform:

  • Liver tests determine liver enzyme levels as their abnormality can signify liver damage. High levels ofbilirubin, liver enzymes alanine aminotransferase (ALT), alkaline phosphatase and aspartate aminotransferase, immunoglobulins, and lower albumin levels are considered signs of cirrhosis.
  • Immune liver condition tests include anti-mitochondrial antibody (AMA), antinuclear antibody(ANA), and anti-smooth muscle antibody(SMA) tests.
  • Viral infection tests are used to identify Hepatitis B or C.
  • Complete Blood Count reveals signs of anemia and infection resulting from internal bleeding.

5. Liver Biopsy

A liver biopsy determines the extent of scarring on the liver. It is an effective diagnosis for cirrhosis when other tests are providing unclear results. The doctor takes some small liver tissue using a hollow needle and conducts a test in the lab with a microscope. This biopsy helps determine the cause of liver cirrhosis and therefore, the most effective treatment plan.

Can You Recover From Cirrhosis?

You cannot fully recover from cirrhosis unless you have aliver transplant. It is a progressive condition that gets worse with time. If diagnosed early, liver damage can be reversed. But if not, the condition can only be managed through various treatments depending on what caused it. 

Treatments

Cirrhosis is a chronic liver disease that hasno cure. It can only be treated by managing the symptoms and complications and preventing them from causing liver failure. There are no specific treatments that reverse liver damage or cure cirrhosis. 

So, doctors only treat it to prevent cirrhosis from worsening and slow down liver damage or failure. Thesetreatments include:

1. Treating the Triggers of Cirrhosis

Medicine will be administered depending on the triggers of Cirrhosis. If the cause of the cirrhosis is viral hepatitis, then the doctor will prescribeantiviral medicine. The doctor can also prescribe medication to help you manage the symptoms of this liver condition. They include:

The doctor will recommend that you avoid medications that worsen the symptoms of cirrhosis. Such medications include sedatives, opiates, and nonsteroidal anti-inflammatory drugs (NSAIDs).

If your liver cirrhosis is a result of too much consumption of alcohol, then the doctor will advise that you quit drinking. Fornonalcoholic-related cirrhosis, you will need to manage metabolic factors such as blood sugar levels, weight, and cholesterol.

2. Managing Complications

Cirrhosis is a progressive condition that keeps getting worse if no serious intervention is taken at earlier stages to prevent liver damage. When the liver reaches a point where it can no longer function, there will be somecomplicationsthat require treatment. The complications include:

  • Swollen legs, feet, or ankles (edema): The doctor may prescribe medication that gets rid of the fluid causing the swelling. Besides, the doctor will recommend a reduction in sodium intake.
  • Portal hypertension: The complication is treated by medications that reduce high blood pressure in the hepatic portal vein.
  • Varices (enlarged veins in the stomach or esophagus): Medications that lower blood pressure in your veins will prevent the veins from enlarging and bursting, resulting in internal bleeding. The doctor may use surgical procedures like upper GI endoscopy to stop internal bleeding.
  • Hepatic encephalopathy: It is the increase of toxins in the brain that leads to personality changes, sleep disorders, memory loss, difficulty thinking, disorientation, or confusion. This results from the brain being unable to clear the toxins. Medications such aslactulose syrup that reduce toxins levels in the brain can enhance the brain's functionality.
  • Ascites: Cirrhosis can lead to fluid buildup in the belly or abdomen. Medications that get rid of excess fluid, such asfurosemide orspironolactone can help with ascites. A tube or needle can also be used to remove the fluid. The fluid is then tested for infections so a suitable medication can be prescribed.
  • Infections: Antibiotics can be administered to manage bacterial infections.
  • Liver Cancer: Ultrasound and other related imaging tests can be used to diagnose liver cancer every six months. If the cancer is caught in its initial stages, medical procedures such as chemotherapy, radiation therapy, and surgery will help get rid of cancerous cells.
  • Liver failure: At this stage, the liver can no longer function and only a liver transplant is the remedy.

3. Liver Transplant

Liver transplantation will only be used if you have liver cancer, liver failure, or you are not responding to the administered treatment options. 

Role of Lifestyle and Diet in Preventing Cirrhosis

a) Lifestyle Changes

Certain lifestyle changes can help manage the complications that arise from cirrhosis. Thesechangesinclude:

  • Avoid smoking
  • Lose weight if you are obese.
  • Regular physical activity to minimize muscle loss.
  • Quit drinking alcohol 
  • Maintain fitness and hygiene to prevent infections that may otherwise damage the liver.

b) Dietary Changes

According to research,50% to 90% of people suffering from cirrhosis havemalnutrition. Malnutrition results from nausea and vomiting, leading to irregularity in meals. People with liver cirrhosis should avoid fasting or not eating for long hours. They must eat ahealthy and balanced diet to acquire important nutrients such as minerals and vitamins. 

That’s why doctors often recommend a professional dietitian to cirrhosis victims to help them develop an appropriate meal plan - that provides sufficient vitamins, minerals, proteins, and dietary supplements.

What Foods To Avoid For Cirrhosis?

Eliminateundercooked or rawmeat, fish, and shellfish and unpasteurized milk and its products. Such foods may contain viruses orbacteria that can cause severe infections among people suffering from cirrhosis. Besides, the doctor will recommend reducing the consumption of foods or drinks rich in sodium.

Conclusion

Cirrhosis leads to the scarring of liver tissues. These scarred tissues gradually replace the healthy tissues, interfering with the functioning of the liver. Cirrhosis is a chronic liver disease that gets worse over time and can lead to liver failure if it is not diagnosed and treated early. The causes of liver cirrhosis include hepatitis, alcohol abuse, non-alcoholic fatty liver disease, autoimmune disorders, damaged or blocked bile ducts, exposure to certain toxic chemicals, parasite infections, heart failure, and certain medicines. 

So, you must watch your lifestyle and what you eat to prevent or manage cirrhosis.

Liver cirrhosis has no cure. Proper management of symptoms and various treatment options can be used to prevent liver failure. In case of liver failure, the only perfect remedy will be a liver transplant.