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Cirrhosis

Definition

Cirrhosis is a disease in which the liver becomes permanently damaged and the normal structure of the liver is changed. Healthy liver cells are replaced by scarred tissue. The liver is not able to do its normal functions, such as detoxifying harmful substances, purifying blood, and making vital nutrients.
In addition, scarring slows down the normal flow of blood through the liver, causing blood to find alternate pathways. This may result in bleeding blood vessels known as gastric or esophageal varices .
Cirrhosis of the Liver
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Causes

Causes of cirrhosis include:

Risk Factors

Factors that may increase your chance of having cirrhosis include:

Symptoms

Cirrhosis often does not cause symptoms early in the disease process. Symptoms start when the liver begins to fail, as scar tissue replaces healthy cells. Symptom severity depends on the extent of liver damage.
Cirrhosis may cause:
As cirrhosis progresses, it may cause:
Complications of cirrhosis may include:

Diagnosis

You will be asked about your symptoms and medical history. A physical exam will be done.
Your bodily fluids may be tested. This can be done with:
Images may be taken of your bodily structures. This can be done with:
Other tests may include:

Treatment

There is no cure for cirrhosis. The goals of treatment are to keep the condition from getting worse, including:
Talk with your doctor about the best treatment plan for you. Options include:

Medication

Medication may be advised to:
  • Treat hepatitis and complications that arise
  • Reduce the absorption of waste products and toxins in the digestive system
  • Reduce the risk of a broken blood vessel
  • Fight infections
  • Shed excess fluids

Surgery

Liver transplant —may be done if:
  • Complications can no longer be controlled using medical therapy
  • The liver stops functioning
Endoscopy may be used to tie off bleeding blood vessels or to inject drugs to cause clotting. A thin tool with a lighted tip is inserted down the throat to help the doctor see and access the blood vessels, which are located in the esophagus.

Self-care

  • Stop drinking alcohol completely.
  • Do not take any medications without your doctor's approval, including over-the-counter drugs.
  • Eat a balanced diet . Choose a variety of fruits and vegetables, as well as lean proteins, like beans and poultry.
  • If your liver disease is more advanced, you may need to limit protein intake. Your weakened liver will not be able to process it properly.
  • You may need to limit salt in your diet, because it increases water retention.
  • Take any vitamin supplements your doctor recommends.
  • Put your feet and legs up to decrease swelling.
  • Due to increased risk of infections, take these steps:
    • Get vaccines for flu , pneumonia , and hepatitis .
    • Avoid raw seafood.
    • Avoid people who are sick with communicable diseases, like the flu or common cold.
    • Wash your hands often.

Prevention

To help reduce your chance of developing cirrhosis, take these steps:

RESOURCES

American Gastroenterological Association http://www.gastro.org

American Liver Foundation http://www.liverfoundation.org

CANADIAN RESOURCES

Canadian Liver Foundation http://www.liver.ca

Health Canada http://www.hc-sc.gc.ca

References

American Academy of Family Physicians. Information from your family doctor. Cirrhosis and chronic liver failure: what you should know. Am Fam Physician. 2006;75(5):781.

Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://digestive.niddk.nih.gov/ddiseases/pubs/cirrhosis. Updated April 23, 2014. Accessed September 12, 2014.

Cirrhosis of the liver. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed. Updated June 13, 2014. Accessed September 12, 2014.

Hirschfield GM, Gershwin ME. Primary biliary cirrhosis: one disease with many faces. Isr Med Assoc J. 2011;13(1):55-59.

Molodecky NA, Kareemi H, Parab R, Barkema HW, Quan H, Myers RP, Kaplan GG. Incidence of primary sclerosing cholangitis: a systematic review and meta-analysis. Hepatology. 2011;53(5):1590-1599.

Understanding cirrhosis of the liver. American Gastroenterological Association website. Available at: http://www.gastro.org/patient-center/digestive-conditions/cirrhosis-of-the-liver. Accessed September 12, 2014.

2/12/2010 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Chang Y, Ryu S, Sung E, et al. Weight gain within the normal weight range predicts ultrasonographically detected fatty liver in healthy Korean men. Gut. 2009;58(10):1419-1425.

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