Cirrhosis is a scarring of the liver that can result from alcohol-related liver disease, chronic hepatitis, nonalcoholic fatty liver disease, or other conditions. As scar tissue replaces healthy tissue, the flow of blood through the liver becomes partially blocked. Scarring also inhibits the liver’s ability to process nutrients, remove bacteria and toxins from the blood, and control infections.
As liver function deteriorates, complications including fluid collection in the legs (edema) and in the abdomen (ascites), easy bruising or bleeding, and yellowing of the eyes or skin (jaundice) may develop.
About 30 percent of patients with cirrhosis will develop liver cancer over a 20-year time period, so if you have cirrhosis, it’s important that you be screened for liver cancer on a regular basis.
Symptoms of Liver Cirrhosis
If scarring has begun to interfere with liver function, you may start experiencing one or more of the following symptoms:
- Swelling in the feet
- Swelling in the abdomen (ascites)
- Mental confusion (hepatic encephalopathy) or progressive memory loss, caused by a buildup of toxins in the brain
- Difficulty sleeping at night and increased sleeping during the day
- Vomiting blood
- Passing bloody, purple, or black bowel movements
- Yellow eyes or skin (jaundice)
- Tremors or “flapping” of the hands when extended (asterixis)
- Muscle loss
Diagnosing Liver Cirrhosis
Your physician will ask about your medical history, your symptoms, and potential risk factors for cirrhosis (especially alcohol use). He or she will then perform a physical exam to check for clinical signs of cirrhosis; for example, the liver may feel hard and enlarged.
A blood test will check for high bilirubin, low albumin, low cholesterol, low platelets, and low clotting factors, any of which might support a cirrhosis diagnosis. Imaging tests (CT, MRI, or ultrasound) allow your physician to get a closer look at the liver, and a biopsy can confirm the diagnosis but is not always necessary.
Complications of Liver Cirrhosis
Complications of liver cirrhosis can include:
- Difficulty fighting off infections
- Malnutrition, due to your liver’s decreased ability to process nutrients
- Confusion and difficulty concentrating (hepatic encephalopathy)
- Internal bleeding caused by an increase in pressure in the main vein that brings blood to the liver (portal hypertension)
- Swelling in the abdomen and the legs
- Increased risk of liver cancer
Treating Liver Cirrhosis
Before treatment begins, your physician will calculate your model for end-stage liver disease (MELD) score, which measures the severity of your case of cirrhosis. (You can determine your score using the online MELD Calculator from the Organ Transplantation and Procurement Network.) If it turns out that you need a liver transplant, the MELD score will play an important role in determining your position on the transplant waiting list.
Treatment will vary with the exact cause of the cirrhosis and your specific symptoms. Your physician will probably discuss some lifestyle changes with you, such as cutting out alcohol, switching to a low-sodium diet (to reduce fluid retention), and discontinuing certain medications such as acetaminophen or ibuprofen. He or she may also prescribe antibiotics, diuretics, or other medications to relieve your symptoms.
When scarring in the liver interferes with blood flow through the organ, the buildup of pressure can cause blood vessels to rupture and lead to a gastrointestinal bleed into the stomach. If this occurs, your doctor may discuss a transjugular intrahepatic portosystemic shunt (TIPS) with you. In a TIPS procedure, your physician inserts a metal mesh stent into the liver to connect the portal and hepatic veins, with the goal of improving blood flow and reducing the risk of bleeding.
If complications from cirrhosis cannot be controlled by these treatments, a liver transplant may be recommended.
To find out more about the Methodist Center for Liver Disease and Transplantation, call us at 713-441-8839 or 866-94-LIVER (866-945-4837) or send us an email.