Common GI Conditions
Common GI Condition > GI Tract > Cirrhosis
Cirrhosis
What is cirrhosis?
Cirrhosis is a progressive process causing fibrosis and hardening of the liver. Complications of cirrhosis can result in bleeding from the gastrointestinal tract, ascites (accumulation of water in the abdominal space).
What causes cirrhosis?
Cirrhosis develops from chronic damage to the liver. Continuous damage from Hepatitis B, Hepatitis C, alcohol, non-alcoholic steatohepatitis (the progressive variant of fatty liver disease), can all lead to cirrhosis.
What are the symptoms of cirrhosis?
Some patients with early cirrhosis may have no symptoms. When symptoms do occur, they can include: Swelling in the abdomen (ascites), bleeding from the gastrointestinal tract (especially oesophagal varices – abnormal blood vessels in the food pipe connecting the mouth to the stomach), confusion and/or drowsiness progressing to coma, yellowing of the skin/eyes (jaundice)
Cirrhosis also weakens your immune system, making it easier for you to get infections.
Patients with cirrhosis are also more likely to have cancer of the liver (hepatocellular carcinoma).
Is there a test for cirrhosis?
Yes. Usually, a diagnosis of cirrhosis is made based on clinical findings, blood tests and imaging findings. In cases of doubt, a liver biopsy may be helpful to confirm cirrhosis and may be helpful to find out the cause of the cirrhosis. Typical tests that are ordered in the investigation of cirrhosis include:
- Blood tests – Blood tests may be done to find out the cause of the cirrhosis. Blood tests also may be used as part of scoring criteria to determine the stage of cirrhosis and severity of liver dysfunction.
- Imaging – An Ultrasound, CT or an MRI of the liver may be ordered assess for imaging features of cirrhosis, to screen for any masses suspicious for liver cancer and to evaluate the patency of blood vessels around the liver.
- Liver biopsy – A doctor puts a needle into your liver and takes out a small sample of tissue. This may be helpful in some cases to confirm cirrhosis and to ascertain the underlying cause of cirrhosis, especially when there are competing causes.
Is there anything I can do to prevent further liver damage?
Yes. To help protect your liver:
- Avoid alcohol
- Talk to your doctor before you start taking any new medicines, including painkillers such as ibuprofen, naproxen or acetaminophen. Also talk to your doctor before taking any herbs, vitamins, or supplements. Some medicines and supplements can damage the liver.
- Get vaccinated against hepatitis A and B if you have not had the infections before
How is cirrhosis treated?
Treatments depend on the cause of cirrhosis, how severe it is, and what symptoms you have. Treatments fall into a few main categories, including those that:
- Lifestyle and diet control
- A low salt diet is key to prevent fluid accumulation in the abdomen
- Medications
- To treat the underlying liver disease: For example specific medications for treatment of Hepatitis B or C
- Medications to prevent bleeding: In patients with abnormal blood vessels in the oesophagus (varices), beta blockers can reduce the risk of bleeding
- Medications to treat confusion related to liver dysfunction (hepatic encephalopathy): Lactulose and Rifaximin can treat and prevent episodes of hepatic encephalopathy
- Diuretics: Spironolactone and Lasix and reduce the build-up of fluid in the abdomen
- Antibiotics: May be required in patients who have had the previous infection of the fluid in the abdominal space (previous spontaneous bacterial peritonitis)
- Surgery and Interventional Procedures
- To treat Liver Cancer
- To treat and/or reduce the risk of bleeding from varices: A TIPS (transjugular intrahepatic portosystemic shunt) in select patients can reduce and treat recurrent episodes of variceal bleeding
- Liver Transplant
Will I need a new liver?
People with severe complications of cirrhosis may need a new liver (a liver transplant). You will need to be assessed by a team of doctors before ascertaining this is indicated and suitable for you.
