Cirrhosis of the Liver

WHAT IS YOUR LIVER AND WHAT DOES IT DO?

The liver is a large reddish-brown solid organ that is approximately 3 to 4 pounds. Located in the upper part of the abdomen, it is tucked away under the right side of the rib cage. It is one of the largest organs in the body, second only to the skin. It is shaped like a pyramid and is divided into the right and left lobes.

The liver is a unique organ that performs many complex functions in your body every day. It acts as a filter to clean and clear your body of waste, thus helping your body fight infection. The liver is like a big chemical laboratory. It manages the nutrients that have been absorbed by the gut from food, removes toxins from the blood, makes big proteins like albumin and clotting factors (these help our blood clot), and secretes bile
which helps digest our food.

  • The liver is the largest internal organ in the body weighing 3-4 pound.
  • The liver performs some 500 different functions daily!
  • There are over 100 forms of liver disease affecting everyone from infants to older adults.
  • In the US, alcoholism and Hepatitis C are the most common causes of cirrhosis.
  • Cirrhosis is a chronic disease in which normal live cells are damaged and then replaced by scar tissue.
  • Many times, people with cirrhosis have no symptoms or vague symptoms.
  • Treatment for cirrhosis depends cirrhosis depends on the underlying cause.
Cirrhosis

WHAT IS CIRRHOSIS?

Cirrhosis is scarring of the liver which causes healthy tissue to be replaced with scar tissue. It is a slowly progressing disease that eventually prevents the liver from functioning properly and effectively. The liver attempts to repair the damaged areas by replacing it with scar tissue. Unfortunately, since scar tissue doesn’t function like normal tissue, this interferes with the essential liver functions and at times causes the liver to fail.

WHY IS CIRRHOSIS A PROBLEM?

As the liver deteriorates, one or more complications may develop. Ascites (a buildup of fluid in the abdomen,) bleeding from the mouth, nose or gums, severe infections, and hepatic encephalopathy (impaired mental functioning) may occur when the liver is not working properly. Cirrhosis causes hepatocellular carcinoma which is a primary liver cancer. The percentage of Americans developing liver cancer has been slowly rising for several decades. About 30,000 new cases will be diagnosed yearly in the United States.

WHAT CAUSES CIRRHOSIS?

Cirrhosis is caused by chronic (long term) liver diseases that damage the liver. A wide range of diseases and conditions can damage the liver leading to cirrhosis (scarring of the liver tissue). In the United States chronic alcoholism and chronic hepatitis C are the most common cause of cirrhosis. There are over 100 known forms of liver disease affecting everyone from infants to older adults.

Chronic Alcohol Use and Abuse
Chronic alcoholism can develop after many years of heavy drinking. The amount of alcohol that can injure the liver varies greatly from person to person. Alcohol causes the liver to enlarge, or inflame, which over many years can lead to cirrhosis.

Chronic Viral Hepatitis
Infections with Hepatitis C are the leading cause of liver transplantation in the US. These viruses cause the liver to enlarge, or inflame, which over time can lead to cirrhosis. There are several types of viral hepatitis—type A, B, C, D and E.

Nonalcoholic Fatty Liver Disease (NAFLD)
The rate of obesity has doubled in the US in the past 25 years, so has the incidence of fatty liver disease, making it the most prevalent liver disease in the US. People with fatty liver disease have an accumulation of fat in their liver that is not caused by alcohol use. The fat causes the liver to expand and enlarge and can lead to cirrhosis. Many people with a fatty liver also have other health concerns including, but not limited to diabetes, high cholesterol, high blood pressure, obesity, and coronary artery disease.

Biliary Disease Leading to Cirrhosis
Bile ducts are long tube-like structures that carry bile and waste products out of the liver. When these ducts are diseased, bile backs up into the liver causing the liver to be damaged. The two most common diseases are primary biliary cirrhosis and primary sclerosing cholangitis. Untreated, these diseases can lead to need for liver transplantation or cancer of the bile ducts.

Genetic Diseases of the Liver
People with genetic liver diseases are different from those who develop cirrhosis from chronic hepatitis C or alcoholism—they are less common. Some of these diseases include Alpha 1 Antitrypsin Deficiency, Wilson Disease, Autoimmune Hepatitis, and Genetic Hemochromatosis.

HOW IS CIRRHOSIS DIAGNOSED?

Liver disease can be difficult to diagnose because its symptoms can be vague. A visit to your physician for blood tests, a complete physical exam and medical history are necessary. At that time he/she may wish to perform imaging, a CT scan or an Ultrasound scan of your liver. A liver biopsy may be ordered for further evaluation. A small piece of your liver will be removed and analyzed under a microscope to assess for damage to
your liver.

WHAT ARE THE SIGNS AND SYMPTOMS OF LIVER DISEASE?

Many people have no signs or symptoms or vague symptoms of liver disease. This does not mean that your liver hasn’t suffered significant damage. Some common symptoms include: fatigue, decreased appetite, pain to the right upper quadrant of the abdomen, weight loss, weakness, nausea and vomiting, jaundice (yellowing of the skin), bruising of your skin.

HOW IS CIRRHOSIS TREATED AND MANAGED?

Treatment for cirrhosis depends on the underlying cause. Medications, lifestyle changes and close follow up with a liver physician called a hepatologist are recommended. It is possible to prevent further damage to the liver with the proper management. Liver transplant is a treatment
option that your hepatologist may consider if the liver can no longer preform its functions adequately.

  • Avoid/stop drinking alcohol
  • Eat a healthy diet and maintain a healthy weight
  • Wash your hands regularly
  • Practice safe sex
  • Avoid risky behaviors, drug use
  • Vaccinate against Hepatitis A and B
  • Avoid eating raw or under-cooked shellfish
  • Close follow up with your physician
  • Speak to your physician about all of the medications you are taking
  • Use clean needles for tattoos or piercings and do not share needles, toothbrushes, razors with others