Cirrhosis of the Liver

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The liver is one of your body’s most important organs, with the chief functions of turning food into energy and removing toxins and alcohol. If the liver is diseased or compromised over time, it could lead to scarring, or cirrhosis.

Cirrhosis is the presence of late-stage, permanent scar tissue that replaces healthy tissue, causing damage that could block blood flow through the organ.

An estimated one in 400 U.S. adults has cirrhosis, with one in 200 being between the ages of 45 to 54. However, many people with the condition are not diagnosed so the rates may be higher.

It can be caused by a range of conditions and/or diseases, such as hepatitis, fatty liver, and hemochromatosis (iron buildup), but also can result from chronic alcohol abuse.

Patients with cirrhosis may not experience any symptoms until the condition is severe.

Signs include:

  • Fatigue
  • Easily bleeding or bruising
  • Loss of appetite and weight loss
  • Nausea
  • Fluid buildup in the legs, feet, or abdomen
  • Itchy skin (could be severe)
  • A yellowing of the skin and eyes (jaundice)
  • For women, loss of periods (not from menopause)
  • For men, loss of sex drive and breast enlargement
  • Confusion, drowsiness, and slurred speech

During a physical exam, your doctor will check for pain and tenderness in the abdomen and feel if the liver is enlarged.

If cirrhosis is suspected, the following tests may be ordered:

  • Blood tests – This test checks the levels of liver enzymes, blood proteins, and other signs of damage. A blood test also can measure blood counts (anemia), identify viral infections such as hepatitis B or C, or detect autoimmune liver conditions.
  • Imaging tests are used to view the liver and assess damage and may include:
    • Abdominal ultrasound –a tool sends sound waves that would bounce against hardened tissue.
    • CT (computerized tomography) scan or MRI (magnetic resonance imaging) – specialized X-rays.
    • MRE (magnetic resonance elastography) – a test that combines imaging and soundwaves, creating a visual map to detect tissue hardening.
  • Liver biopsy A tissue sample may be taken and examined under a microscope to determine the severity, extent, and cause of the damage.

Caring for cirrhosis requires treating the underlying cause and slowing the progress of scar tissue. It is very important to regularly follow up with your gastroenterologist if you are diagnosed with cirrhosis. Your gastroenterologist may use one or more of the following screenings/treatments:

  • Right upper quadrant ultrasound – Cirrhotic patients need to obtain imaging every six months to screen for hepatocellular carcinoma as they are at higher risk of the disease.
  • Upper endoscopy – Cirrhotic patients need to be surveyed for esophageal and gastric varices, as this can be life-threatening if not properly managed.
  • Managing complications – Accumulation of fluid and confusion are some of the complications of cirrhosis that gastroenterologists manage and prevent with medications and lifestyle interventions.
  • Liver transplant – When appropriate, patients will be monitored for referral for liver transplantation.

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