Hepatology is a subspecialty of gastroenterology (GI doctor). The liver is the body's largest internal organ, and the study of hepatology includes the study of acute and chronic hepatitis, viral hepatitis, cirrhosis, genetic and metabolic liver diseases and their complications, liver cancer. Cirrhosis is a chronic (ongoing, long-term) disease of the liver. It means scarring to the normal liver tissue that keeps this important organ from working as it should. If the damage is not stopped, the liver gradually loses more of its ability to carry out its normal functions.

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What is Liver Cirrhosis?

Liver cirrhosis is another name for extensive scarring of the liver (scarring is also called fibrosis). It may also be called cirrhosis of the liver. Cirrhosis is generally irreversible, but if caught early, further damage can be limited. Advanced cirrhosis is life-threatening.

What Causes Liver Cirrhosis?

Liver cirrhosis may be caused by any disease or condition that repeatedly or continuously damages liver cells. The liver attempts to repair this damage, but this results in the formation of scar tissue. Unlike liver cells, scar tissue performs no function. Large areas of scar tissue start to interfere with blood flow to functioning liver cells, causing them to die and resulting in the formation of more scar tissue. Blood pressure in the vein that supplies the liver with blood (called the portal vein) also increases, resulting in portal hypertension.

The most common causes of Liver Cirrhosis include:

• Chronic alcohol abuse
• Chronic hepatitis B or C
• Nonalcoholic fatty liver (which is more common in people who are obese, have diabetes, or have high levels of cholesterol or triglycerides).

What are the Symptoms of Liver Cirrhosis?

Most people have few symptoms (if any) in the early stages of cirrhosis. If signs and symptoms are present they may include:

• Ascites (fluid accumulation in the abdomen)
• Confusion, drowsiness, and slurred speech (hepatic encephalopathy)
• Easy bruising or bleeding
• Edema (swelling in the legs, feet or ankles)
• Gynecomastia (breast enlargement) in men
• Jaundice (yellow discoloration of the skin and eyes)
• Loss of appetite
• Loss of libido
• Menstrual changes (an absence or loss of periods not related to menopause)
• Nausea
• Pruritus (itchy skin)
• Redness in the palms of the hands
• Spider-like blood vessels on the skin
• Testicular atrophy
• Tiredness
• Weight loss.

How is Liver Cirrhosis Diagnosed?

See your doctor if you have any signs or symptoms listed above, particularly if you also have one of the common causes of liver cirrhosis. Routine blood tests taken for an unrelated condition may reveal that your liver is not functioning normally which may prompt further investigation.

Other tests may include

• Further blood tests
• Imaging tests (ultrasonography, CT, MRI) to detect abnormalities that can accompany cirrhosis and portal hypertension (such as an enlarged spleen or varices).

How is Liver Cirrhosis Treated?

Scarring that is already present cannot usually be reversed so treatment focuses on treating the underlying condition to prevent further liver damage. Treatment may include:

• Antiviral medications is the cause is due to hepatitis
• Avoiding alcohol
• Using medications or substances that remove heavy metals form the blood (such as copper in people with Wilson’s disease)
• Stopping any medications that may be contributing to the condition
• Removing or dissolving bile duct blockages
• Losing weight and improving diabetes and cholesterol management.

Topics under Liver Cirrhosis

• Cirrhosis(0 drugs)

• Primary Biliary Cholangitis (8 drugs)

Alternative treatments for Liver Cirrhosis

The following products are considered to be alternative treatments or natural remedies for Liver Cirrhosis. Their efficacy may not have been scientifically tested to the same degree as the drugs listed in the table above. However there may be historical, cultural or anecdotal evidence linking their use to the treatment of Liver Cirrhosis.

Further information

Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.

Doctor's Notes on Cirrhosis of the Liver: Symptoms, Stages, Diet, and Life Expectancy

Cirrhosis refers to scarring of the liver with loss of normal liver cells. It develops as a complication of a number of different conditions that can cause liver damage. Alcohol abuse and alcohol damage to the liver is a common cause of cirrhosis, along with viral hepatitis B and C. However, there are other causes of cirrhosis. Toxic metals and other chemicals may cause liver damage leading to scarring. In certain genetic diseases, toxic metals or fats accumulate in the liver to abnormal amounts. Autoimmune liver disease in which the body's immune system attacks the liver is another potential cause.

Some people with cirrhosis may have few or no symptoms or signs of liver disease. Others may show some common symptoms and signs of cirrhosis including jaundice, a yellowing of the skin and whites of the eyes, fatigue, weakness, and loss of appetite. Other associated symptoms can include itching and easy bruising due to decreased production by the liver of the substances needed for blood clotting. Individuals with cirrhosis also develop symptoms and signs from the complications of cirrhosis like hepatic encephalopathy or ascites.

Cirrhosis of the Liver: Symptoms, Stages, Diet, and Life Expectancy Symptoms

Many people with cirrhosis have no symptoms during the early phases of the disease. Symptoms are caused by either of 2 problems:

• Gradual failure of the liver to carry out its natural functions
• Distortion of the liver's usual shape and size because of scarring

The most common symptoms of cirrhosis are as follows:

• Tiredness (fatigue) or even exhaustion
• Weakness
• Loss of appetite leading to weight loss
• Loss of sex drive

Symptoms may not appear until complications of cirrhosis set in. Many people do not know they have cirrhosis until they have a complication.

• Jaundice - Yellowing of the skin and eyes from deposition of bilirubin in these tissues. Bilirubin is a product of the breakdown of old blood cells in the liver.
• Vomiting
• Itching - From deposition in the skin of products of the breakdown of bile
• Abdominal pain - From enlargement of the liver or formation of gallstones
• Abdominal swelling or bloating - From fluid retention
• Weight gain - From fluid retention
• Swelling in ankles and legs (edema) - From fluid retention
• Difficulty breathing - From fluid retention
• Sensitivity to medications - Due to impairment of the liver's ability to filter medications from blood
• Confusion, delirium, personality changes, or hallucinations (encephalopathy) - From buildup of drugs or toxins in the blood, which then affect the brain
• Extreme sleepiness, difficulty awakening, or coma - Other symptoms of encephalopathy
• Bleeding from gums or nose - Due to impaired production of clotting factors
• Easy bruising - Due to impaired production of clotting factors
• Blood in vomit or feces - Due to bleeding of varicose veins caused by liver congestion
• Hemorrhoids - Varicose veins in rectum due to liver congestion
• Loss of muscle mass (wasting)
• In women, abnormal menstrual periods - Due to impairment in hormone production and metabolism
• In men, enlargement of the breasts (gynecomastia), scrotal swelling, or small testes - Due to impairment in hormone production and metabolism

Cirrhosis of the Liver: Symptoms, Stages, Diet, and Life Expectancy Causes

Cirrhosis can be caused by a number of conditions, including long-standing inflammation, poisons, infections, and heart disease, as well as chronic alcoholism and chronic hepatitis, the most common causes. For 30-50 percent of cirrhosis cases, however, no cause can be found. Often, the progress toward liver failure is slow and gradual. There is no cure for cirrhosis, but removing the cause can slow the sidease. If the damage is not too devere, the liver can heal itself over time.

Chronic alcoholism: Alcohol can poison all living cells, causing liver cells to become inflamed and die.

• The death of liver cells leads your body to form scar tissue around veins of your liver. Healing liver cells form nodules, which also press on the liver veins.
• This scarring process occurs in a significant percentage of alcoholics and is the most common form of cirrhosis in the United States.
• The severity of the process depends on how much you drink and how long you have been abusing alcohol. The amount of alcohol needed to injure the liver varies widely from individual to individual.
• Some families are more susceptible to cirrhosis than others.

Hepatitis: Hepatitis means inflammation of the liver from any cause, but it usually refers to a viral infection of the liver.

• Over many years the inflammation damages liver cells and leads to scarring.
• Hepatiti A, hepatitis B, hepatitis C, and hepatitis D all can cause cirrhosis.
• Worldwide, hepatitis B is the most common cause of cirrhosis, but in the United States hepatitis C is a more common cause.

Biliary cirrhosis: Bile is a substance produced by the liver to help the body digest fats. Nitto 1320 legends official site.

• Bile is carried from the liver to the gallbladder and eventually into the intestines by small tubes called bile ducts.
• If these ducts become blocked, the bile backs up and can damage the liver. The liver becomes inflamed, starting the long process of cell damage that leads to cirrhosis.
• Children may be born with a condition that blocks the bile ducts called biliary atresia.
• This disease usually affects women aged 35-60 years.

Autoimmune cirrhosis: The body's immune system defends against 'invaders' such as bacteria, viruses, or allergens.

• Autoimmune diseases occur when the immune system instead begins to fight healthy body tissues and organs.
• In autoimmune hepatitis, the body's immune system attacks the liver, causing cell damage that leads to cirrhosis.

Nonalcoholic fatty liver: This is a condition in which fat builds up in the liver, eventually causing scar tissue to form.

• This kind of cirrhosis is linked to diabetes, obesity, coronary artery disease, protein malnutrition, and treatment with corticosteroids such as prednisone.
• It is sometimes called 'steatohepatitis.'

Inherited diseases: A variety of genetic diseases can damage the liver.

• These are diseases that interfere with the metabolism of different substances by the liver.
• They include Wilson's disease, cystic fibrosis, alpha-1 antitrypsin deficiency, hemochromatosis, galactosemia, and glycogen storage disease.
• Most of these diseases are not common but they can be devastating.

Drugs, toxins, and infections: Various substances and germs can cause damage to the liver.

• Certain medications (for example, acetaminophen [Tylenol]), poisons, and environmental toxins can lead to cirrhosis.
• Reactions to certain drugs can damage the liver. This is rare.
• Long-term infections with various bacteria or parasites can damage the liver and cause cirrhosis.

Cardiac cirrhosis: Your heart is a pump that pushes blood throughout your body. When your heart doesn't pump well, blood 'backs up' into the liver.

• This congestion causes damage to your liver.
• It may become swollen and painful. Later it becomes hard and less painful.
• The cause of the heart failure may be a heart valve problem, smoking, or infection of the heart muscle or the sac around the heart.

Alcohol consumption can cause numerous diseases. Many people know that heavy drinking can lead to cirrhosis of the liver and is a leading cause of automobile accidents. But did you know chronic drinking could also lead to cancer and heart attack? Read on to find out consequences of heavy drinking.

Alcohol : Alcoholism & Health Effects Quiz

Long-term heavy alcohol consumption can cause:

REFERENCE:
Kasper, D.L., et al., eds. Harrison's Principles of Internal Medicine, 19th Ed. United States: McGraw-Hill Education, 2015.