What is Cirrhosis? Causes, Symptoms, and Treatment 

Dr.Sharad Malhotra, 4 mins read

What is cirrhosis of the liver?

Cirrhosis refers to severe scarring of the liver and failing liver function, which occurs at the end stages of chronic liver disease. This liver scarring is caused most often by long-term consumption of alcohol, exposure to viral infections, autoimmune illness and uncontrolled fatty liver disease.  The liver performs essential body functions, such as appetite generation, digestion of food, production of essential elements which are vital for life, producing bile which assists the body in absorbing dietary fats, cholesterol, and essential vitamins. Purifying blood by way of removing toxins and bacteria from the system, storing sugar and vitamins for energy, 

and creating blood clotting proteins are some other significant functions the liver performs. 

Over ten lakh Indians are diagnosed with liver cirrhosis, one in five Indians are affected by it in variable extent and liver disease is the tenth leading cause of death in the country, it is also likely to affect men due to more alcohol consumption. 

Understanding cirrhosis begins with the liver, which is a very robust and tough organ that can regenerate its damaged cells if healthy. Cirrhosis develops when alcohol and chronic viral infections become factors that are present over long periods of time; injuring and scarring the liver. A scarred liver won’t function normally, and this can eventually cause cirrhosis, which shrinks and hardens the liver, making it difficult for nutrient-rich blood to flow into the liver. This can cause a very serious condition called portal hypertension wherein veins develop high liver pressure and become enlarged veins in food pipe called esophageal varices , which can burst and bleed. 

Causes of cirrhosis

For understanding cirrhosis, one must begun by looking at the major causes long-term viral hepatitis B and  C and prolonged and heavy alcohol consumption. Obese people are also at increased risk of cirrhosis due to fatty liver; obesity can also contribute towards cirrhosis in combination with hepatitis C and/or alcoholism. 

Alcohol intake 

Women who drink more than two drinks a day for many years, and men who have more than three drinks for similar amounts of time; put themselves at risk of developing cirrhosis.

The exact amount of regular alcohol intake it would take for a person to develop cirrhosis will vary, and not everyone who has had more than a few drinks will develop liver disease; cirrhosis develops after at least a decade of regular drinking. 

Hepatitis 

Hepatitis B and C are known causes of cirrhosis, and the infection can be transmitted through unprotected sexual intercourse or exposure to infected blood or blood products by way of contaminated needles, including those at piercing and tattoo parlours, intravenous drug abuse, and needle sharing. 

Hepatitis B and autoimmune hepatitis can also cause liver inflammation which can lead to cirrhosis while hepatitis D causes cirrhosis as well. 

Other causes include damaged bile ducts, diseases like Wilson’s disease and hemochromatosis, along with prescription and over-the-counter drugs like acetaminophen, indigenous medications and certain antibiotics and some antidepressants. 

Symptoms of cirrhosis

Cirrhosis symptoms occur as a result of the liver being unable to perform its regular functions and usually, there are no noticeable symptoms till the disorder progress. Some common symptoms like regular nose bleeds, loss of appetite, unexpected weight loss, jaundice, anorexia, weakness, itchy skin, and the appearance of spider shaped veins under the skin are associated with cirrhosis. 

There are severe symptoms associated with cirrhosis that include abdominal swelling, impotence, swelling in the legs, confusion, and gynecomastia (development of female type breasts in males). 

Diagnosing cirrhosis 

A cirrhosis diagnosis will start with a doctor taking a complete medical history to look for alcoholism, exposure to hepatitis B and  C, and a family history of autoimmune diseases. This will be followed up with a physical exam to look for common signs of cirrhosis like yellow eyes, pale skin, reddened palms, swelling of feet and abdomen , an enlarged liver ,trembling hands, small testicles, excess breast tissue in men and decreased alertness

Some tests to assess liver damage because of cirrhosis include a complete blood count, coagulation blood tests, albumin, liver function tests and an alpha fetoprotein to screen for liver cancer. Other tests like an upper endoscopy, MRI, ultrasound, CT scan and liver biopsy can also be used to evaluate the liver.

There are four stages of liver cirrhosis and the cirrhosis stages are numbered 1-4 depending upon the extent of liver damage or failure.

Treatment for cirrhosis 

This varies based on what caused cirrhosis and the stage to which the disorder has progressed. Some mainstream treatment options are  quitting alcohol, medications like beta blockers or nitrates, banding procedures to control bleeding from esophageal varices, intravenous antibiotics, hemodialysis to purify blood, 

lactulose and a low protein diet. 

Liver transplantation is the definitive treatment of cirrhosis if other treatments fail.

Cirrhosis prevention 

Practicing safe sex using protection reduces the risk of getting hepatitis B and C, and this is also the reason all infants and at-risk adults like healthcare professionals need to be vaccinated against hepatitis B.

Limiting the amount of alcohol, or avoiding it altogether, a balanced diet, adequate exercise, and stress management can help prevent cirrhosis.

Annual health checkups are encouraged to look for signs of early liver disease.

Also, Read: Everything You Need To Know About Hepatitis