Cirrhosis, also known as hepatic fibrosis, is late stage scarring and deterioration of the liver. Resulting from various liver diseases, the scarring from cirrhosis affects blood flow in the liver, reducing the organ's ability to function. Because the liver plays many important roles in the body, including detoxifying the blood, aiding digestion, fighting infection, producing clotting factors and storing energy, cirrhosis is a life-threatening disorder. The condition is one of the leading causes of disease deaths in the United States.

Causes of Cirrhosis

In patients with cirrhosis, scar tissue forms and builds up in response to ongoing damage. The more the scar tissue builds up, the worse the liver function becomes. Although cirrhosis is an irreversible condition, if detected early, it can be treated by addressing its underlying causes.

Inherited Causes of Cirrhosis

There are several reasons for cirrhosis to develop as a result of inherited diseases or congenital defects. These include:

  • Hemochromatosis (excessive iron buildup in the blood)
  • Cystic fibrosis
  • Wilson's disease (copper buildup in the liver)
  • Biliary atresia (malformed bile ducts)
  • Autoimmune hepatitis

Inherited disorders of sugar metabolism or genetic digestive disorders may also cause cirrhosis.

Other Causes of Cirrhosis

  • Chronic alcohol abuse
  • Hepatitis B or C
  • Nonalcoholic fatty liver disease
  • Certain viruses or parasitic infections
  • Autoimmune disease
  • Bile duct disorders

Cirrhosis may also be caused by reactions to particular medications and exposure to environmental toxins.

Symptoms of Cirrhosis

Many people are not aware of the damage that cirrhosis is causing, since they do not experience symptoms during early stages of the disease. As the amount of scar tissue increases and liver function is affected, patients may experience:

  • Fatigue and weakness
  • Loss of appetite, nausea weight loss
  • Abnormal bleeding and bruising
  • Itchy skin
  • Abdominal pain
  • Jaundice and light-colored stool
  • Swelling of the abdomen (ascites) and legs(edema)
  • Kidney failure
  • Mental Confusion

The abnormal bleeding of cirrhosis may manifest itself in nosebleeds or increased development of spider veins on the skin.

Diagnosis of Cirrhosis

Early stages of cirrhosis do not often cause symptoms and the disease may be detected during a routine medical examination when palpation of the abdomen indicates an enlarged spleen. If cirrhosis is suspected, a series of diagnostic tests are performed, including:

  • Liver function test
  • Kidney function test
  • Blood tests for hepatitis B and C
  • Blood-clotting tests
  • Endoscopy
  • Liver biopsy

Diagnostic imaging tests are also administered to assist in diagnosing cirrhosis. These may include a magnetic resonance elastography (MRE), an MRI or CT scan, and an ultrasound of the liver.

Treatment of Cirrhosis

In some types of cirrhosis, such as primary biliary cirrhosis, medication can slow disease progression to the point that the patient remains asymptomatic. Most cirrhosis cases, however, must focus on preventing further damage, since existing damage cannot be repaired or cured. Methods of treatment for cirrhosis depend on the cause of the condition, and may include:

  • Abstaining from alcohol use
  • Weight loss
  • Counseling to assist in positive lifestyle changes
  • Medication to control hepatitis
  • Medication to relieve symptoms, such as itching or pain
  • Nutritional supplements to control malnutrition
  • Nutritional supplements to prevent osteoporosis

In cases of advanced cirrhosis, patients may be put on low-sodium diets, prescribed diuretics to control edema and ascites, and prescribed medications to help eliminate toxins from the blood. Blood pressure medication may also be prescribed to control portal hypertension and prevent bleeding.

Patients with cirrhosis may be at increased risk of infection and so must be especially careful to receive necessary vaccinations and to take antibiotics when appropriate. Because patients with cirrhosis are also at greater risk of developing liver cancer, they should be screened for the disease periodically.

In the most advanced cases of cirrhosis, when liver function is completely disrupted, a liver transplant is necessary to save the patient's life.

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