What You'll Learn Here:
~ by Jo Jordan
You cannot live without a properly functioning liver. About 26,000 Americans die each year of cirrhosis of the liver, making it the twelfth leading cause of death in the United States. The most common cause of cirrhosis, chronic alcoholism accounts for approximately forty percent of the 26,000 people who die from the disease.1
Our largest organ, the liver works to keep us healthy, converting food into substances needed for life and growth, and storing glycogen, amino acids, protein, and fat. It also produces the enzymes and bile that help digest food, neutralizes toxins in our blood, and produces immune agents to control infection.
When liver cirrhosis sets in, liver scarring begins to replace healthy tissue and the result is a hardened liver. The scar tissue blocks the flow of blood through the liver, preventing the organ from functioning properly.
Chronic alcoholism and hepatitis C are the most common causes of cirrhosis in the United States. Other causes include,
- Alcoholic liver disease
- Autoimmune hepatitis
- Blocked bile ducts
- Chronic hepatitis B and D
- Chronic hepatitis C
- Exposure to toxins such as alcohol, certain pharmaceutical drugs, and infections
- Inherited illnesses such as alpha-1 antitrypsin deficiency, hemochromatosis, Wilson’s disease, galactosemia, and glycogen storage diseases
- Nonalcoholic steatohepatitis (NASH)
- Prolonged exposure to environmental toxins such as arsenic
Note that men tend to develop cirrhosis of the liver more often than women.
Cirrhosis symptoms and complications
During the early stages, many people with cirrhosis experience no symptoms. However, as scar tissue replaces healthy cells, and liver function begins to fail, a person may experience a variety of symptoms and complications (*):
- Abdominal pain
- Abnormal accumulation of fluid in the abdominal cavity (ascites)
- Bleeding from engorged veins in your esophagus or intestines
- Dark, cola-colored urine
- Easy bruising
- Gallstones *
- Insulin resistance and type 2 diabetes *
- Itchy hands and feet
- Lack of appetite
- Liver cancer *
- Liver failure *
- Loss of interest in sex
- Other system malfunctioning such as impotence, kidney dysfunction and failure, and osteoporosis *
- Portal hypertension (an increase in blood pressure in veins that carry blood from the abdominal organs to the liver) *
- Sensitivity to medications *
- Small, spider-like blood vessels under the skin
- Swelling of legs and feet from retained fluid (edema)
- Hepatic encephalopathy (toxins in the blood or brain – signs include forgetfulness, confusion, trouble concentrating; change in sleeping habits; behavioral, personality, and mood changes; and in advanced cases, delirium and coma) *
- Varix (an abnormally dilated or swollen vein, artery, or lymph vessel) *
- Weight loss
- Yellowing of skin and eyes (jaundice)
Screening and diagnosis
In addition to a personal history and physical examination, various testing methods are used to diagnose cirrhosis:
- Blood tests (to measure bilirubin levels)
- Computerized tomography (CT or CAT scans take cross-sectional X-ray images of your internal organs)
- Elevated liver enzymes (liver blood tests)
- Liver biopsy
- Magnetic resonance imaging (MRI scans use magnetization and radio waves to produce images of the internal organs)
- Ultrasonography/ultrasound (high-frequency sound waves are bounced off internal tissue, and their echoes converted into images)
Cirrhosis care and treatment
While liver damage from cirrhosis is permanent and irreversible, treatment can help to delay the progression of the disease, as well as reduce the likelihood of developing complications. Treatment is dependent upon the cause, and is designed to address any complications a patient may be experiencing.
Regardless of the cause, abstaining from alcohol and following a healthy diet are essential. Nutrition plays a key role in therapy because cirrhosis sufferers are often malnourished. A high-calorie, nutrient-dense diet can help liver cells to regenerate. Restricted salt intake is advised as salt causes water retention. The avoidance of raw shellfish is recommended as they may contain bacteria that could cause further harm to an already fragile liver.
Limiting medications is usually advised because a damaged liver is unable to properly detoxify itself of drugs. Avoid aspirin and other non-steroidal anti-inflammatories such as ibuprofen and naproxen.2
Because liver damage has an effect on immune functioning, it’s wise to keep up with vaccinations such as those for hepatitis A and B, influenza, and bacterial pneumonia. When your liver is damaged, it is a good idea to it is a good idea to avoid contact with people who are ill since the immune system is not functioning at its optimum.3
Ask your health care provider about multi-vitamins and other supplements. For example, omega 3 fatty acids (found primarily in fish, fish oils, flax, flaxseed oils, and walnuts) are believed to provide protection for the liver. And the herb milk thistle (Silybum marianum) is thought to aid in healing and rebuilding the liver.4
Light physical activity can assist in slowing the progression of cirrhosis.
Sometimes complications from cirrhosis cannot be controlled, and/or the liver becomes so damaged from scarring that it ceases to function. In these cases, a liver transplant is necessary and is the only method to overcome cirrhosis of the liver.