Cirrhosis

What is cirrhosis?

Cirrhosis occurs when the normal liver cells are replaced by scar tissue which can cause liver dysfunction.

What does the liver do?

The liver is the largest solid organ in the body. It plays a vital role in regulating numerous processes in the body, including storage of nutrients, filtration of bloodstream, digestion, and fighting off infection.

How is cirrhosis diagnosed?

Cirrhosis is confirmed with liver biopsy. However, clinicians can commonly diagnose cirrhosis based on interpreting physical exam findings and lab and X-ray data after taking a detailed history.

What are the most common causes of cirrhosis in the U.S.?

Viral hepatitis, alcohol, and non-alcoholic fatty liver disease. It is a common misconception that cirrhosis equates excessive alcohol usage.

Does cirrhosis cause any symptoms?

Patients with cirrhosis are commonly free of symptoms and referred to as being in a ‘compensated’ state of disease. ‘Decompensated’ cirrhosis manifests in symptoms of a failing liver, notably fluid retention, gastrointestinal bleeding, or changes in personality or cognition. The latter is termed hepatic encephalopathy and ranges in severity from subtle word finding problems to overt unresponsiveness.

Are there any options for treatment of cirrhosis?

In a few circumstances, cirrhosis can be reversed by treatment of the underlying disease. More commonly, cirrhosis is not reversible. Focus shifts to prevention and identification of complications of liver disease, notably gastrointestinal bleeding and liver cancer.

Can liver cancer be prevented?

Liver cancer cannot be prevented per se. Any patient with cirrhosis, regardless of cause, is at increased risk for primary liver cancer. Similar to the role of mammography in the detection of breast cancer, various X-ray technologies can be used to screen for liver cancer. Liver cancer is treatable at an early stage and can often be used to increase an individual’s standing on a waitlist for liver transplantation.

When does liver transplantation need to be considered?

Any individual with ‘decompensated’ cirrhosis of any severity should at least be considered for liver transplantation.