Dr. M.J. Bazos, MD
Patient Handout
CIRRHOSIS OF THE
LIVER
About Your
Diagnosis
Cirrhosis is chronic scarring of the liver. The
scarring prevents the liver from functioning normally. There are many causes of
cirrhosis. Alcoholism is the most common cause in the United States. Inherited
diseases such as Wilson’s disease, hemochromatosis, and cystic fibrosis
are also known causes. Chronic viral hepatitis and exposure to toxic substances
can also cause cirrhosis. Primary biliary cirrhosis, which causes blockage of
the bile duct, can likewise cause this condition. Cirrhosis is one of the top 10
causes of death in the United States. It is more common in men. History and
physical examination are key in detecting this condition. Blood work and a liver
biopsy may also help in the diagnosis. The prognosis is dependent on the amount
of liver damage done and its cause; the more damage, the worse the prognosis. If
the cause is treatable and the liver damage stops, the prognosis is good.
However the liver damage is not
reversible.Living With Your
DiagnosisThe early stages of cirrhosis
are associated with fatigue, nausea, decreased appetite, and weight loss.
Physical signs in the early stages are enlargement of the liver and redness of
the palms of the hands. In the later stages of the disease, jaundice, diarrhea,
and dark urine are present. Spider blood vessels (fine vessels spreading out
from a central point) of the skin, easy bruising and bleeding, enlargement of
the breasts in men, and hair loss are present also. Physical signs in the late
stages are enlargement of the spleen, fluid accumulation in the abdomen
(ascites) and legs (edema), mental confusion, and coma. Complications such as
gastrointestinal (GI) bleeding from portal hypertension (high blood pressure
within the liver), kidney failure, and infections can
occur.TreatmentThe
key to treatment is removing the cause. After removal of the offending cause,
the primary treatment is supportive. A high-calorie diet may help. Salt (sodium)
and/ or fluid restriction may be necessary to control fluid accumulation. If the
ascites or edema is severe, diuretic medications can be given to remove the
fluid. Medications can also be given to help with the mental confusion and coma.
The treatment of portal hypertension is dependent on its severity. Medications
are the first option. Endoscopy (a lighted flexible tube used to view the
esophagus, stomach, and small intestines) with sclerosing of the bleeding areas
is an option if bleeding is occurring. If severe, surgery is an option. A
portacaval shunt is done to relieve the pressure on the blood vessels. Liver
transplantation is a final
option.The
DOs• Eat a well-balanced diet.
Protein may need to be avoided in the diet because the liver may not be able to
break down the protein.• Modify
activity according to the symptoms. A good fitness program may help with the
fatigue.• If alcohol abuse is the
cause, seek treatment through an alcohol rehabilitation
program.• Obtain prompt treatment
for hepatitis.• If there is a family
history of cirrhosis or inherited diseases that cause cirrhosis, family members
should be observed for sign of
cirrhosis.• If exposed to blood and
body fluid on the job, use proper protective equipment such as gloves and eye
protection to lessen the chance of accidental
exposure.• If you are in a high-risk
group, you should receive the hepatitis B vaccine. High-risk groups are health
workers, homosexual men, and household contacts of
carriers.The
DON’Ts• Avoid
alcohol.• Avoid medications that can
be harmful to the liver such as acetaminophen, sedatives, and
tranquilizers.• Avoid chemicals and
other substances that could be harmful to your
liver.When to Call Your
Doctor• If you have symptoms of
cirrhosis.• If during treatment for
cirrhosis you have vomited blood, have passed a black stool or bright red blood,
have mental confusion, or have fever or other signs of
infection.Websites:www.niddk.nih.govnddic@aerie.com