Cirrhosis is a serious condition that causes scarring and permanent damage to the liver. Over time, the disease keeps the organ from working properly and eventually causes failure.
Cirrhosis puts people at greater risk for:. Compensated cirrhosis: People with compensated cirrhosis do not show symptoms, while life expectancy is around 9—12 years. Decompensated cirrhosis: People with decompensated cirrhosis already experience symptoms and complications. Their life expectancy is greatly reduced than those with compensated cirrhosis, while experts recommend referral for a possible liver transplant in these cases. Based on these scores, the system assigns people into different classes:.
Healthcare professionals will project the life expectancy of people with cirrhosis using CTP scores in the following chart :. Following an effective treatment plan, which could slow or stop damage to the liver and manage complications, is the primary way that people with cirrhosis can increase their life expectancy. Treating the cause of the cirrhosis is also crucial.
Even though not all occurrences are due to alcohol abuse, people with this condition can benefit from avoiding alcohol completely, as experts recommend. Antiviral drugs can prevent additional liver damage due to viral hepatitis. People with cirrhosis need to regularly see their medical team to review how their condition is progressing. This also allows for early intervention and treatment of any complications that may arise.
Medications and procedures to treat cirrhosis symptoms include:. According to the VA , although cirrhosis is progressive, some people with the condition can move from decompensated, or symptomatic, back to the asymptomatic stage.
This is a challenging process, although one of the critical steps is avoiding alcohol of any kind. To prevent progressing from the asymptomatic to the symptomatic stage, people can make the following lifestyle changes:. This means eating a healthful diet is crucial for those with this condition.
Cirrhosis itself can affect diet and metabolism, so people should try:. If your liver is very badly damaged, a liver transplant may be needed. This is a procedure where a diseased liver is removed during a lengthy operation and replaced with a healthy donor liver. A liver transplant is usually only recommended if other treatments are no longer helpful and your life is threatened by end stage liver disease. It is a major operation and you will need to plan it carefully with your medical team, family and friends.
Liver transplantation is usually very successful although in some cases it is possible for liver diseases to return and affect your new liver. Discuss any worries you have about your suitability for treatment with your specialist nurse or doctor and those nearest to you.
Anything that leads to the long-term, continuous damage of the liver can cause cirrhosis. These include:. Day-to-day coping strategies In general, it is best to aim for as near to a normal life as possible. However, there are some points that you should keep in mind to help you feel as healthy as you can. If you find yourself becoming depressed, talk this over with your doctor who can discuss ways of overcoming this. If appropriate, certain medications can be helpful in helping you cope.
Remember that liver function can improve if you take care of yourself and receive early treatment. However, you must ensure that health professionals know you have cirrhosis before giving or prescribing any treatment or medication for you. Diet It is important to eat well and to include a good balance of foods in your diet including vitamins, minerals and calcium.
It is likely you will need extra energy and protein. Cirrhosis affects your ability to store glycogen, a carbohydrate that gives you short-term energy. This means that your body has to use its own muscle tissue to provide energy between meals and this can lead to muscle wasting and weakness.
If you are affected in this way, snacking between meals is a way you can top up on calories and protein. Another good method is to eat three or four small meals in a day rather than one large protein or carbohydrate-heavy meal. You may find having nourishing drinks a help. These can include homemade milkshakes or commercially-made products such as Build Up, Complan, Recovery and Nourishment.
These are available at most chemists. It is a good idea to check with your doctor or dietician first to make sure they are suitable for you. Try to avoid salty foods or adding salt to what you eat, to help control fluid retention. Alcohol and cirrhosis Almost everyone who drinks too much alcohol will suffer some liver damage, but this does not necessarily turn into cirrhosis.
As many as nine out of ten people who drink to excess will develop a fatty liver, with one in ten progressing to cirrhosis. In general, the more you drink, the greater your chance of developing alcohol related hepatitis or cirrhosis. A poor diet may make the problem worse. All types of alcoholic drinks can lead to liver disease. If you have cirrhosis — whether it is caused by alcohol or not — you should not drink alcohol at all.
This guideline covers assessing and managing suspected or confirmed cirrhosis in people who are 16 years or older. It aims to improve how cirrhosis is identified and diagnosed.
It recommends tools to assess the severity of cirrhosis and gives advice on monitoring people with cirrhosis to detect and manage complications early, and referral criteria for tertiary care.
Click here to view the guidance. Click here to view the information for the public. They are groups of general practices, which come together in each area to commission the best services for their patients and population. ICS Integrated Care Systems are new partnerships between the organisations that meet health and care needs across an area, to coordinate services and to plan in a way that improves population health and reduces inequalities between different groups.
Devolved nations — health is primarily a devolved matter across the four nations which make up the UK. Cirrhosis of the liver Cirrhosis is the result of long-term, continuous damage to the liver and may be due to many different causes.
Facts about cirrhosis How common is cirrhosis? Who is at risk of cirrhosis? No one knows for sure how many people have cirrhosis as most people do not know they have it until the condition is serious. However, there is no doubt that the number of people with the condition continues to increase.
Around people have to have a liver transplant each year to survive. Cirrhosis can affect anyone — men and women, young and old. You are most at risk of having cirrhosis if you: drink too much alcohol have a long-term chronic liver infection, such as hepatitis B or hepatitis C have an inherited liver disease, such as genetic haemochromatosis.
Download the publication Cirrhosis of the liver Download. What are the different stages of cirrhosis? Cirrhosis is classified as compensated or decompensated. If you have cirrhosis, you have develop one or more of the symptoms below. Red flag symptoms If you have any of the following symptoms you must see a doctor straight away, especially if you have recently been diagnosed with cirrhosis: fever with high temperatures and shivers, often caused by an infection shortness of breath vomiting blood very dark or black tarry stools faeces periods of mental confusion or drowsiness.
Some of the tests which may be used for cirrhosis include: Blood tests Liver blood tests are used to gain an idea of how different parts of your liver are functioning. Imaging tests Your liver may be scanned using ultrasound, computerised tomography CT or magnetic resonance imaging MRI. These are all symptoms of hepatic encephalopathy.
With encephalopathy, a persons may have problems driving, writing, calculating, and performing other activities of daily living. Signs of encephalopathy are trembling and hand "flapping. A liver that is working poorly cannot get rid of bilirubin, a substance that produces a yellowing of the eyes and skin called jaundice. Too much alcohol and some medicines can also lead to jaundice. The model for end-stage liver disease MELD score measures the severity of cirrhosis.
The MELD score was developed to predict the day survival of people with advanced cirrhosis. The MELD score is based on three blood tests:. MELD scores usually range between 6 and 40, with a score of 6 indicating the best likelihood of day survival.
The diagnosis of cirrhosis is usually based on the presence of a risk factor for cirrhosis, such as alcohol use or obesity, and is confirmed by physical examination, blood tests, and imaging.
The doctor will ask about the person's medical history and symptoms and perform a thorough physical examination to observe for clinical signs of the disease.
For example, on abdominal examination, the liver may feel hard or enlarged with signs of ascites. The doctor will order blood tests that may be helpful in evaluating the liver and increasing the suspicion of cirrhosis.
Patient with cirrhosis may have an upper endoscopy pronounced "en-dahs-cup-ee" periodically see figure at right. A thin tube with a camera can be inserted into the mouth to look for varices in the esophagus food tube and the stomach. The endoscopy is repeated every few years to monitor for varices. To view the liver for signs of enlargement, reduced blood flow, or ascites, the doctor may order a computerized tomography CT scan, ultrasound, magnetic resonance imaging MRI , or liver scan.
The doctor may look at the liver directly by inserting a laparoscope into the abdomen. A laparoscope is an instrument with a camera that relays pictures to a computer screen. A liver biopsy can confirm the diagnosis of cirrhosis but is not always necessary.
A biopsy is usually done if the result might have an impact on treatment. The biopsy is performed with a needle inserted between the ribs or into a vein in the neck. Precautions are taken to minimize discomfort. A tiny sample of liver tissue is examined with a microscope for scarring or other signs of cirrhosis.
Sometimes a cause of liver damage other than cirrhosis is found during biopsy. Treatment for cirrhosis depends on the cause of the disease and whether complications are present.
The goals of treatment are to slow the progression of scar tissue in the liver and prevent or treat the complications of the disease. Hospitalization may be necessary for cirrhosis with complications. Because malnutrition is common in people with cirrhosis, a healthy diet is important in all stages of the disease. Health care providers recommend a meal plan that is well balanced.
If ascites develops, a sodium-restricted diet is recommended. A person with cirrhosis should not eat raw shellfish, which can contain a bacterium that causes serious infection. To improve nutrition, the doctor may add a liquid supplement taken by mouth or through a nasogastric tube-a tiny tube inserted through the nose and throat that reaches into the stomach. People with cirrhosis are encouraged not to consume any alcohol or illicit substances, as both will cause more liver damage. Because many vitamins and medications-prescription and over-the-counter-can affect liver function, a doctor should be consulted before taking them.
For edema and ascites, the doctor will recommend diuretics-medications that remove fluid from the body. Large amounts of ascitic fluid may be removed from the abdomen and checked for bacterial peritonitis.
Oral antibiotics may be prescribed to prevent infection. Severe infection with ascites will require intravenous IV antibiotics. The doctor may prescribe a beta-blocker or nitrate for portal hypertension. Beta-blockers can lower the pressure in the varices and reduce the risk of bleeding. Gastrointestinal bleeding requires an immediate upper endoscopy to look for esophageal varices. The doctor may perform a band-ligation using a special device to compress the varices and stop the bleeding.
People who have had varices in the past may need to take medicine to prevent future episodes. Hepatic encephalopathy is treated by cleansing the bowel with lactulose-a laxative given orally or in enemas. Antibiotics are added to the treatment if necessary. Patients may be asked to reduce dietary protein intake. Hepatic encephalopathy may improve as other complications of cirrhosis are controlled.
Some people with cirrhosis who develop hepatorenal failure must undergo regular hemodialysis treatment, which uses a machine to clean wastes from the blood.
Medications are also given to improve blood flow through the kidneys. Other treatments address the specific causes of cirrhosis. Treatment for cirrhosis caused by hepatitis depends on the specific type of hepatitis.
For example, interferon and other antiviral drugs are prescribed for viral hepatitis, and autoimmune hepatitis requires corticosteroids and other drugs that suppress the immune system. Medications are given to treat various symptoms of cirrhosis, such as itching and abdominal pain. When is a liver transplant indicated for cirrhosis? A liver transplant is considered necessary when complications cannot be controlled by treatment.
Liver transplantation is a major operation in which the diseased liver is removed and replaced with a healthy one from an organ donor. A team of health professionals determines the risks and benefits of the procedure for each patient. Survival rates have improved over the past several years because of drugs that suppress the immune system and keep it from attacking and damaging the new liver. The number of people who need a liver transplant far exceeds the number of available organs.
A person needing a transplant must go through a complicated evaluation process before being added to a long transplant waiting list. Generally, organs are given to people with the best chance of living the longest after a transplant. Survival after a transplant requires intensive follow-up and cooperation on the part of the patient and caregiver. What causes cirrhosis? Most people who consume alcohol do not suffer damage to the liver.
But heavy alcohol use over several years can cause chronic injury to the liver. The amount of alcohol it takes to damage the liver varies greatly from person to person. For women, consuming two to three drinks-including beer and wine-per day and for men, three to four drinks per day, can lead to liver damage and cirrhosis.
In the past, alcohol-related cirrhosis led to more deaths than cirrhosis due to any other cause. Deaths caused by obesity-related cirrhosis are increasing. Chronic hepatitis C The hepatitis C virus is a liver infection that is spread by contact with an infected person's blood. Chronic hepatitis C causes inflammation and damage to the liver over time that can lead to cirrhosis. Chronic hepatitis B and D The hepatitis B virus is a liver infection that is spread by contact with an infected person's blood, semen, or other body fluid.
Hepatitis B, like hepatitis C, causes liver inflammation and injury that can lead to cirrhosis.
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