Cirrhosis is irreversible scarring of the liver, posing a potential life threatening risk. Approximately 80% to 90% of the liver can be damaged and replace with scarred (death) tissue in an advanced stage. Cirrhosis is caused by alcohol, viral infection, (Hepatitis B, C), toxic substances (e.g. medications, excess copper or iron in the liver), or liver damage of years from blockage of biliary system. The liver goes through a progressive scarring, replacing all normal liver cells gradually.
In most of the cases, the above causes are usually resulted in treatable Hepatitis. However, in case of failure to eliminate or treat the trouble factor, cirrhosis occurs and it is usually too late to alter the course of the disease.
Symptoms of Hepatic Cirrhosis
It initially presents with symptoms including fatigue, drowsiness, yellowing of eyes and urine (mild jaundice), swollen feet, itching, and anemia (lower hemoglobin). In later stages, the patient may suffer from many life-threatening complications such as hematemesis, swollen stomach leading to serious infection due to ascites, mental disorder, coma, severe jaundice, and renal dysfunction.
The patient may also present with hemorrhage due to lower levels of prothrombin, a liver protein, and low blood platelet count. Both are critical to normal blood-clotting.
Living With Cirrhosis
Although cirrhosis means irreversible damage of the liver, an individual in an early stage of cirrhosis (stage Child A or early Child B) is likely to have an active life for long years through an appropriate treatment planned by liver specialists. On the other hand, the progressed cirrhosis or cirrhosis in stage Child C indicates liver transplant requiring an expert opinion
Things To Do
- A detailed evaluation is required with a liver specialist to grade the disease and decide the appropriate treatment.
- Periodic liver function tests are required every 1-3 months in early cirrhosis, and every 1-4 weeks in progressed cirrhosis accompanied by a liver specialist, and follow-up is necessary. Period between the checks will be decided by your physician depending on the symptoms and the severity of the disease.
- In the case of chronic liver disease, healthy nutrition is critical for optimum liver functions. In contrast to common belief, digestion remains normal until the late stages of the liver disease except for the presence of severe jaundice. Thus, it is only myth that we should completely avoid fatty food and proteins in all types of liver diseases. This is not only unnecessary but also very harmful because it results in malnutrition, loss of weight, and quicker impairment of health in most cases.
- In Hepatitis B-related cirrhosis, if HBV DNA test is positive, a specialist in liver should be consulted to consider Lamivudin therapy.
- In early cirrhosis associated with Hepatitis C, a specialist in liver should be consulted to receive Interferon-alpha and ribavirin treatment, which can be useful.
Things To Avoid
- In alcohol-related cirrhosis, in any circumstances you should avoid alcohol and limit alcohol intake in all other types of cirrhosis particularly in Hepatitis C.
- Excessive physical activity should be avoided especially in virus-related cirrhosis.
- Also, requisite bed rest should be avoided, and reasonable level of activity and moves should be maintained.
- In advanced stages of cirrhosis, contact sports should be avoided because of insufficient coagulation and bleeding tendency.
- Self medication methods should be avoided because of the liver failure, and because the medication may have long-term effects and further damage the already damaged liver.