What is cirrhosis of the liver?
Liver cirrhosis results from disease or chemical-induced injuries to the liver over a sustained period. As the injuries kill liver cells, your body attempts to rebuild the damage. In the process, the existing cells are inflamed and scar tissue results, compromising the structure of the liver and hampering its function. Your liver may become cirrhotic in response to a disease or toxins, such as alcohol. Sometimes cirrhosis results from a liver processing disorder or an autoimmune disorder that prompts the body’s defense mechanisms to attack the liver tissue. Treatment exists to slow the scarring and improve function, but in general, the scarring of liver cirrhosis is permanent.
What is the treatment for liver cirrhosis?
Treatment of cirrhosis is highly variable depending on the severity of the liver dysfunction and includes:
- Preventing further damage to the liver
- Treating the complications of cirrhosis
- Preventing liver cancer or detecting it early
- Liver transplant
- Consuming a balanced diet and a multivitamin daily. Patients with PBC with impaired absorption of fat-soluble vitamins may need additional vitamins D and K.
- Avoiding drugs (including alcohol) that cause liver damage.
- All people with cirrhosis should avoid alcohol. Most of those with alcohol-induced cirrhosis experience an improvement in liver function with abstinence from alcohol. Even people with chronic hepatitis B and C can substantially reduce liver damage and slow the progression towards cirrhosis with abstinence from alcohol.
- Avoiding nonsteroidal anti-inflammatory drugs (NSAIDs, such as ibuprofen or naproxen). Patients with cirrhosis can experience worsening of liver and kidney function with NSAIDs.
- Eradicating hepatitis C virus by using anti-viral medications. Not all patients with cirrhosis due to chronic viral hepatitis are candidates for drug treatment. Some patients may experience serious deterioration in liver function and/or intolerable side effects during treatment. Decisions to treat viral hepatitis have to be individualized, after consulting with doctors experienced in treating liver diseases (hepatologists).
- Removing blood from patients with hemochromatosis to reduce the levels of iron and prevent further damage to the liver. In Wilson disease, medications can be used to increase the excretion of copper in the urine to reduce the levels of copper in the body and prevent further damage to the liver.
- Suppressing the immune system with drugs such as prednisone and azathioprine (Imuran) to decrease inflammation of the liver in autoimmune hepatitis.
- Treating patients with PBC with a bile acid preparation, ursodeoxycholic acid (UDCA), also called ursodiol (Actigall). Results of an analysis that combined the results from several clinical trials showed that UDCA increased survival among PBC patients during 4 years of therapy. The development of portal hypertension also was reduced by UDCA. Despite producing clear benefits, UDCA treatment primarily slows progression and does not cure PBC. Other medications such as colchicine (Colcrys) and methotrexate (Rheumatrex, Trexall) also may have benefit in subsets of patients with PBC.
- Immunizing people with cirrhosis against infection with hepatitis A and B to prevent a serious deterioration in liver function. There are currently no vaccines available for immunizing against hepatitis C.
What type of doctor treats liver cirrhosis?
Hepatology is the study of liver disease, and a liver specialist or hepatologist will likely be part of your medical team in treating liver cirrhosis. Hepatology is a subspecialty of gastroenterology (GI doctor). The liver is the body's largest internal organ, and the study of hepatology includes the study of acute and chronic hepatitis, viral hepatitis, cirrhosis, genetic and metabolic liver diseases and their complications, liver cancer, liver transplantation, drug metabolism (which depends largely upon the liver), and immunology as it pertains to the liver.
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Bruha, R, et al. Alcoholic liver disease. World J Hepatol. 2012 Mar 27; 4(3): 81–90. Published online 2012 Mar 27. doi: 10.4254/wjh.v4.i3.81<https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3321494/>
Chopra, MD, et al. Patient education: Cirrhosis (Beyond the Basics). UpToDate. Updated: May 2018.