Liver Cirrhosis: Understanding the Condition, Causes, and Management

Recent studies show that 38% of Indians have fatty liver or non-alcoholic fatty liver disease. This is not limited to adults but also affects nearly 35% of children as well. 

Do you know nearly 10 lakh new patients are diagnosed with liver cirrhosis annually? Is it serious? 

Let’s understand what it is. 

Cirrhosis is a severe liver condition where healthy liver tissue is replaced with scar tissue, damages the liver cells, and impairs the liver's ability to function properly. This condition develops slowly over time, often due to chronic liver diseases, including alcohol abuse, hepatitis, or fatty liver disease. It can be a life-threatening condition, but with proper treatment and lifestyle modifications, you can stop it from getting worse. In this article, let’s cover everything about liver cirrhosis in detail. 

Symptoms of Liver Cirrhosis

Cirrhosis symptoms may vary depending on the stage of the disease. Early-stage cirrhosis may not show noticeable signs, but as it progresses, symptoms may include:

• Fatigue and weakness
• Unexplained weight loss
• Loss of appetite
• Nausea and vomiting
• Abdominal pain or discomfort
• Yellowing of the skin and eyes (jaundice)
• Swelling in the legs, ankles, or abdomen (edema and ascites)
• Easy bruising or bleeding
• Itchy skin
• Dark urine and pale-colored stools

Severe symptoms of liver cirrhosis

As the condition gets worse, people with cirrhosis may develop severe symptoms, including-

• Bruising and bleeding 
• Mental problems, like confusion, difficulty thinking, memory loss, 
• Internal bleeding —in the esophagus, stomach, or intestines
• Severe itchy skin
• Darkening of the color of the urine
• Jaundice
• Swelling in the ankles, lower legs, or feet, called 
• Edema
• Personality changes, or sleep disorders,

Read more: Silent Signs Of Liver Diseases Everyone Must Be Aware Of

Common Causes of Liver Cirrhosis

Cirrhosis may have different causes. Some people with cirrhosis may have more than one cause of liver damage. The most common causes of cirrhosis are-

Cirrhosis develops from various long-term liver conditions and lifestyle factors. Common causes include:

1. Chronic Alcohol Consumption- Excessive alcohol intake over several years can lead to liver inflammation and scarring, known as alcoholic liver disease.
2. Viral Hepatitis—Hepatitis B, C, and D infections are major contributors to cirrhosis if left untreated.
3. Non-Alcoholic Fatty Liver Disease (NAFLD)- a buildup of fat in the liver, called NAFLD, which is one of the most common in obesity, diabetes, and high cholesterol.
4. Autoimmune Hepatitis- This condition occurs when the immune system mistakenly attacks the liver, causing inflammation and damage.
5. Bile Duct Diseases- Conditions like primary biliary cholangitis and primary sclerosing cholangitis can block bile flow, resulting in liver damage.
6. Genetic Disorders- Conditions such as hemochromatosis (iron overload) and Wilson’s disease (copper buildup) can cause liver scarring.
7. Long-Term Medication Use- Certain medications, when taken for longer periods, may contribute to liver damage.
8. Parasitic Infections- In some regions, infections like schistosomiasis can lead to liver fibrosis.

However, timely diagnosis and lifestyle modifications may help to manage these risk factors and prevent cirrhosis. 

How does Cirrhosis Affect the liver?

Scarring in the liver blocks blood and oxygen flow through your liver tissues. This slows your liver's ability to process your blood, metabolize nutrients, and filter out toxins. Cirrhosis reduces your liver's ability to produce bile and essential blood proteins. Impaired protein production can lead to swollen legs (edema) and abdominal bloating (ascites). Bile juice helps to digest fats and absorb fat-soluble vitamins. Cirrhosis may affect the bile flow, which causes jaundice and digestive issues. 

Important Diagnostic Tests for Liver Cirrhosis

Doctors may diagnose cirrhosis based on your medical history, physical examination, and other imaging tests. Here are some important tests to diagnose liver cirrhosis conditions. These include:

1. Blood Tests:
• Liver function tests (ALT, AST, ALP, and bilirubin levels)
• Complete blood count (CBC)
• Prothrombin time (PT) to assess blood clotting
2. Imaging Tests:
• Ultrasound to detect liver abnormalities
• CT scan or MRI for detailed liver imaging
• FibroScan to measure liver stiffness
3. Liver Biopsy: A small liver tissue sample is taken for microscopic examination to confirm cirrhosis and its severity.

Also read: Blood Tests For Liver Function: Know the Comprehensive List

Who is at High Risk of Liver Cirrhosis?

Certain factors in developing liver cirrhosis include lifestyle, medical conditions, or genetic factors. Those at higher risk include:

• People who consume excessive alcohol for several years are at high risk of cirrhosis. 
• People infected with Hepatitis B, Hepatitis C, or Hepatitis D are prone to developing cirrhosis.
• People who are obese, have type 2 diabetes, high cholesterol, or metabolic syndrome are at risk of liver cirrhosis.
• Those with autoimmune hepatitis.
• People with genetic disorders.
• People with conditions like hemochromatosis (iron overload) or Wilson’s disease (copper buildup) are prone to liver scarring.
• People who are taking long-term medications.

People under the above categories must take regular liver function tests, maintain a healthy lifestyle, and seek medical advice. However, early diagnosis can significantly improve outcomes and prevent cirrhosis complications.

Complications of Complications of Liver Cirrhosis

Cirrhosis leads to serious and potentially life-threatening complications as the liver becomes increasingly damaged. Common complications include:

• Portal Hypertension- Cirrhosis restricts blood flow through the liver and increases the pressure in the portal vein. This may cause- 
• Enlarged veins (varices) in the stomach or esophagus may rupture and cause severe bleeding.
• Ascites (Fluid Buildup)- A condition where fluid collects in the abdominal cavity, which causes swelling, discomfort, and breathing difficulties.
• Hepatic Encephalopathy (Brain Dysfunction)- A buildup of toxins in the blood that causes poor liver function can impair brain activity. Symptoms may include confusion, forgetfulness, mood changes, and, in severe cases, coma.
• Jaundice- Cirrhosis reduces the liver's ability to process bilirubin and causes yellowing of the skin and eyes.
• Increased Risk of Infections- Cirrhosis weakens the immune system, making people vulnerable to infections like spontaneous bacterial peritonitis (SBP).
• Bleeding Disorders- The liver produces proteins that help with blood clotting. Cirrhosis may reduce these proteins, increasing the risk of bruising and uncontrolled bleeding.
• Liver Cancer- People with cirrhosis are at high risk of developing hepatocellular carcinoma, a common form of liver cancer.
• Kidney Failure (Hepatorenal Syndrome)- Cirrhosis can impair kidney function, causing life-threatening complications.
• Malnutrition- Poor liver function leads to insufficient nutrient absorption, which results in loss, muscle wasting, and vitamin deficiencies.
• Insulin Resistance and Diabetes- Liver dysfunction may impair blood sugar regulation and lead to type 2 diabetes.

Management and Treatment of Liver Cirrhosis

Cirrhosis cannot be reversed but managed with proper treatment and improved quality of life.

Lifestyle and Dietary Changes

• Avoid alcohol consumption completely.
• Maintain a healthy, balanced diet with low sodium to reduce fluid buildup.
• Exercise regularly to improve overall health.
• Hepatitis A and B vaccination to prevent further liver damage.

Medications

• Antiviral medications for hepatitis treatment.
• Diuretics to reduce fluid retention.
• Beta-blockers to lower the risk of variceal bleeding.
• Lactulose to manage hepatic encephalopathy by lowering ammonia levels.

Advanced Treatment Options

• Endoscopic procedures
• Blood transfusion to replace blood cell count.
• Kidney dialysis.
• Oxygen therapy.
• Paracentesis and antibiotics for ascites.
• Liver transplantation

Tips to Prevent Liver Cirrhosis

While complete treatment is not possible for cirrhosis, here is what you can do to prevent liver cirrhosis. Key steps include:

• Limit alcohol intake- Avoid alcohol and cigarette drugs as much as possible. 
• Eat healthy- Consume green vegetables, fruits, and whole grains.
• Get vaccinated- Vaccination against hepatitis A and B can protect your liver.
• Medications- Take regular medicines as prescribed by your doctor or physician.
• Practice safe hygiene- Avoid sharing needles or personal items
• Manage weight- Regular exercise and a balanced diet can help prevent fatty liver disease.
• Regular health checkups- Get routine health checkups to know your condition and avoid complications.

Foods to eat and Foods to Avoid in Liver Cirrhosis

Diet plays an important role in managing liver cirrhosis. Here is what to eat and what to avoid:

Foods to Eat (Liver-Friendly Options)

• Lentils, beans, and tofu
• Leafy greens, carrots, beets, and citrus fruits
• Brown rice, quinoa, oats, and whole wheat 
• olive oil, avocados, and nuts to reduce inflammation.
• Low sodium foods
• Green tea and ginger tea
• Foods Rich in Vitamin B & C

Foods to Avoid (Harmful for the Liver)

• Alcohol
• Packaged snacks, fried foods, and sugary items
• Processed meats, canned soups, and salted snacks
• Red Meat & Fatty Cuts
• White bread, pastries, and sugary cereals
• Cheese, butter, and cream 
• Raw or Undercooked Seafood

Also read: Food for Healthy Liver: Enhance Liver Performance

The Final Words

Liver cirrhosis is a serious condition but can be managed with timely and proper diagnosis. The condition develops slowly, and you will not know your liver is suffering until you experience symptoms. However, if you notice any visible symptoms of liver disease, you must consult a healthcare professional for guidance. Early diagnosis, lifestyle changes, and medical intervention can help manage cirrhosis and prevent severe complications. 

FAQ’s

1. What is the main cause of cirrhosis of the liver?

The major causes of liver cirrhosis include chronic alcohol use, hepatitis B and C infections, nonalcoholic fatty liver disease, autoimmune liver conditions, and genetic disorders. 

2. How long can a person live with liver cirrhosis?

The life expectancy of liver cirrhosis depends on the stage of the liver disease. However, it can be over 15 years. 

3. What is stage 4 cirrhosis of the liver?

Stage 4 liver cirrhosis, also known as end-stage liver disease (ESLD) or liver failure. This is the final and most severe stage of liver disease. At this stage, the liver is unable to or no longer function effectively. 

4. Can cirrhosis of the liver be healed?

Liver cirrhosis cannot be reversed. However, treatment can help slow its progression, prevent complications, manage symptoms, and improve quality of life.