Untreated cirrhosis can lead to cancer

Explain cirrhosis

Cirrhosis scars and damages the liver permanently.  This scarring replaces healthy liver tissue and impairs liver function.  As scar tissue grows, the liver's ability to absorb blood, digest nutrients, and filter pollutants decreases.

Cirrhosis can be caused by drinking too much alcohol over a long period, hepatitis, and metabolic dysfunction-associated steatotic liver disease (MASLD), which used to be called non-alcoholic fatty liver disease.  Cirrhosis moves from compensated, where the liver can still function, to decompensated, where liver function declines.

Cirrhosis won't exhibit symptoms early, but brain poisoning can induce lethargy, jaundice, leg and abdomen swelling, and confusion.  Cirrhosis can cause liver failure, portal hypertension, and liver cancer if untreated.

Cirrhosis

What are the main cirrhosis risk factors?

Cirrhosis risk factors injure livers in distinct ways:

* Chronic alcohol use damages liver cells and causes inflammation.  Such inflammation causes scar tissue to replace healthy liver tissue and hinders function.

* Viral Hepatitis: Chronic B and C infections induce liver inflammation.  The immunological reaction to the virus scars liver cells, causing cirrhosis.

* NAFLD: Steatohepatitis—inflammation and damage caused by liver cell fat accumulation—is a condition.  Chronic inflammation causes scarring and cirrhosis.

* Autoimmune Hepatitis: The immune system targets liver cells, producing inflammation and damage.  Continuous assault causes scarring and cirrhosis.

* Genetic Disorders: Hemochromatosis and Wilson's disease cause liver buildup of these chemicals.  This buildup causes cirrhosis by causing oxidative stress, inflammation, and liver cell destruction.

* Bile Duct Diseases: Primary biliary and primary sclerosing cholangitis can cause liver bile buildup.  Cirrhosis results from trapped bile inflaming, damaging, and scarring liver tissue.

* Other Factors: Diabetes and obesity increase NAFLD risk and cirrhosis.  Some drugs can harm the liver, causing scarring and cirrhosis over time.

Every risk factor damages liver cells and forms scar tissue in its own way.  Cirrhosis occurs when scar tissue affects liver function.

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Liver Cirrhosis Signs

Christina Lindenmeyer, MD, is a gastroenterologist at Cleveland Clinic in Ohio, adds that early scarring may not cause cirrhosis symptoms.  “You can have cirrhosis with normal liver function”—“compensated cirrhosis”—she explains.  “Symptoms appear when the liver decompensates.” 

Cirrhosis is often discovered after a CT scan for another illness.  “Until the scan, they had no idea they had liver disease,” explains Lindenmeyer.

 Cirrhosis can induce symptoms like these:

•  Appetite loss
•  Fatigue
•  Sudden weight increase or loss
•  Itchy skin
•  Brown or orange urine
•  Yellowing of the eyes and skin (jaundice)
•  Leg, ankle, foot, or abdominal swelling
•  Nails are pale
•  Light-colored stools
•  Bloody stool

 Different scarring stages

 Cirrhosis scarring causes liver damage and functional impairment at different stages:

 * Mild Cirrhosis:

Early scarring occurs around the liver's blood arteries and ducts.  Most liver functions are still intact.

 * Moderate Cirrhosis:

 Description: Liver scarring expands.  Liver function declines, although it can compensate.

 * Advanced Cirrhosis:

 Description: More severe scarring impairs liver function.  Liver regeneration is hindered.

 * Compensated cirrhosis:

Despite extensive scarring and liver damage, the liver can execute most of its activities.  The body adjusts for liver weakness.

 * Cirrhosis decompensated:

 Description: The liver is highly damaged and dysfunctional.  Complications include portal hypertension, ascites, and hepatic encephalopathy.

Understanding these stages helps determine the best treatment and management options to halt cirrhosis progression and enhance quality of life.

 How to Diagnose Cirrhosis?

 The diagnosis of cirrhosis involves a medical history, physical examination, and various tests:

 * Medical History: Your doctor will ask about alcohol consumption, medications, liver disease family history, and symptoms.

 * Physical Exam: The doctor will search for cirrhosis symptoms such as jaundice, leg and abdominal edema, and liver size and texture abnormalities.

 * Blood tests: These can measure liver enzymes, bilirubin, and protein.  Reduced albumin and elevated liver enzymes and bilirubin may suggest liver injury.  Testing for hepatitis B and C and autoimmune liver diseases is also possible.

 * Imaging tests: Ultrasound, MRI, and CT scans show liver size, shape, texture, fat, and stiffness.  These tests measure liver scarring and damage.

 * Liver Biopsy: A liver biopsy may be conducted to evaluate a small liver tissue sample under a microscope.  This test can reveal liver disease and scarring.

 * Non-Invasive Tests: Transient elastography and acoustic radiation force impulse imaging evaluate liver stiffness.  Cirrhosis stiffens the liver.

 These diagnostic tools let clinicians assess cirrhosis severity and choose treatment and care.

What are cirrhosis treatments?

The video explains the treatment for cirrhosis

Treating cirrhosis involves managing the cause, preventing liver damage, and managing consequences.  Some common treatments:

 Changes in lifestyle

•  Drinking-related cirrhosis requires abstinence from drinking.
•  Diet: A balanced diet with many fruits, vegetables, and lean proteins.  
•  Limited salt consumption is also necessary.
•  Weight Management: NAFLD patients can lose weight to minimize liver fat and inflammation.

 Medications:

•  Antiviral drugs can treat chronic hepatitis B or C and minimize liver damage.
•  Immunosuppressants can lower liver inflammation in autoimmune hepatitis.
•  Treatments for bile duct illnesses may include drugs or operations to unblock clogged ducts.

 Manage Complications:

•  Diuretics: Reduce abdominal and leg fluid.
•  Beta-blockers lower liver-supplying vein blood pressure.
•  Lactulose reduces brain toxin buildup (hepatic encephalopathy).
•  Regular Monitoring: It's important to regularly monitor liver function and complications.
•  A liver transplant may be needed in extreme cases of liver failure.

These treatments slow cirrhosis, manage symptoms, and improve quality of life.

Which lifestyle changes assist in managing cirrhosis?

Lifestyle adjustments can manage cirrhosis and enhance liver health.  Some specific improvements can make a big difference:

•  Eat Healthy:
•  Eat a balanced diet of fruits, vegetables, whole grains, and lean proteins.
•  Salt restriction reduces fluid retention and edema.
•  Avoid high-fat and sugary foods.
•  Achieve and maintain a healthy weight to reduce liver fat and inflammation, especially if you have NAFLD.
•  Exercise regularly to promote health and weight management.
•  Avoid Toxins: Avoid liver-damaging pesticides and home cleaners.
•  Vaccinate for hepatitis A and B to prevent liver-damaging infections.

These lifestyle adjustments can delay cirrhosis and enhance the quality of life.

 Monitor medications: 

Be careful with OTC, supplement, and prescription pharmaceuticals.  Before taking any new medicine, ask your doctor because some can affect the liver.

 Control Underlying Conditions: 

Diabetes, high blood pressure, and excessive cholesterol can harm the liver.

 Regular Check-Ups: 

Visit your doctor often to monitor liver function and catch problems early.

 Hydrate: 

Drinking water supports liver health and function. 

Liver Cirrhosis Prognosis

• The cirrhosis lifespan depends on severity and etiology.  Early detection, treatment, and slowing the cirrhosis may not affect mortality.
• If cirrhosis is widespread before diagnosis or treatment, or if the patient drinks alcohol or uses liver-toxic medicines after diagnosis (even if substance use wasn't the cause), the prognosis is poor.
• In 2021, the practice guidelines from the American Association for the Study of Liver Diseases connected obesity to a poorer liver cirrhosis prognosis.
• Doctors utilize the Child-Turcotte-Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores to predict cirrhosis mortality.  Both can estimate a person's three-month mortality risk, and the CTP can estimate one- to two-year survival.

UNOS began using the MELD score in 2002 to prioritize deceased donor liver transplants.

Conclusion

It's not unexpected that a wide range of dysfunctions occur when the liver is injured and unable to filter blood or manage blood glucose levels. Your doctor or hospital should compute your score at each visit if you have cirrhosis to decide whether to refer you for a liver transplant examination.