What is cirrhosis of the liver?
When the liver is damaged soft healthy liver tissue is replaced by hard scar tissue. If the liver is damaged repeatedly over a long period of time, scar tissue may take over the entire liver. This is cirrhosis.
The scar tissue prevents the liver from working properly and may eventually cause liver failure.
There are two types of cirrhosis - compensated and decompensated. Compensated cirrhosis is where the liver is still managing to function relatively well. In decompensated cirrhosis the liver is not able to function normally.
The Child Pugh score is used to grade the severity of cirrhosis from A (relatively mild) to C (severe).
What causes cirrhosis?
Cirrhosis is caused by ongoing damage to the liver tissue due to a disease. Cirrhosis normally only occurs after many years of liver damage.
Symptoms of cirrhosis
There might not be any symptoms in the early stages of cirrhosis, however, over time you might start to:
- feel very weak and tired
- feel nauseous
- lose your appetite
- lose weight and muscle tone
- experience abdominal pain
As the condition gets worse you may also experience:
- jaundice (yellowing of the whites of the eyes and skin)
- severe itching
- a tendency to bruise or bleed more easily
- high blood pressure in the liver (portal hypertension)
- swelling in the abdomen (ascites)
- swelling in the legs, ankles and feet (edema)
- dark urine
If you have any of the following symptoms it is important to seek immediate medical advice:
- fever with high temperatures and shivers (people with cirrhosis are prone to infections)
- shortness of breath vomiting blood (can be caused by bleeding from veins in the oesophagus – known as oesophageal varices)
- very dark or black tarry stools memory loss and confusion (can be caused by a condition called hepatic encephalopathy).
Diagnosis
People who already have a diagnosis of a chronic liver disease should receive regular check-ups to test for the development of cirrhosis. If cirrhosis is suspected in someone who does not already have a diagnosed liver condition, the physician will take a thorough medical history, carry out a physical examination and may request further testing.
A blood test called a Liver Function Test (LFT) may be used. This test measures levels of enzymes and proteins which indicate how well the liver is working. When the results of this test are judged to be abnormal it can indicate a problem in the liver.
There are several non-invasive tests that can help to diagnose cirrhosis, these include; ultrasound scan, Fibroscan, CT scan and MRI scan.
A liver biopsy is a test whereby a fine needle is passed through the skin and into the liver so that a small sample of liver tissue can be withdrawn. The tissue sample is then analysed in a laboratory for information regarding the health of the cells.
Treatment
Treatment options will depend upon the underlying cause of the cirrhosis. For example, if the cirrhosis is found to be caused by the hepatitis C virus anti-viral medication may be needed.
Regardless of the cause of the cirrhosis lifestyle changes may also be recommended. Your health care team will be able to advise you regarding any specific lifestyle changes that you may need to make.