Cirrhosis slows the liver’s ability to filter medications from the blood. Because the liver does not remove drugs from the blood at the usual rate, they act longer than expected and build up in the body. This causes a person to be more sensitive to medications and their side effects.
Normally, blood from the intestines and spleen is carried to the liver through the portal vein. But cirrhosis slows the normal flow of blood through the portal vein, which increases the pressure inside it. This condition is called portal hypertension.
When blood flow through the portal vein slows, blood from the intestines and spleen backs up into blood vessels in the stomach esophagus. These blood vessels may become enlarged because they are not meant to carry this much blood. The enlarged blood vessels, called varices, have thin walls and carry high pressure, and thus are more likely to burst. If they do burst, the result is a serious bleeding problem in the upper stomach or esophagus that requires immediate medical attention.
Problems in other organs
Cirrhosis can cause immune system dysfunction, leading to infection. Ascites (fluid) in the abdomen may become infected with bacteria normally present in the intestines, and cirrhosis can also lead to kidney dysfunction and failure.
Diagnosis of Cirrhosis of Liver
The doctor may diagnose cirrhosis on the basis of symptoms, laboratory tests, the patient’s medical history, and a physical examination. For example, during a physical examination, the doctor may notice that the liver feels harder or larger than usual and order blood tests that can show whether liver disease is present.
If looking at the liver is necessary to check for signs of disease, the doctor might order a computerized axial topography (CAT) scan, ultrasound, or a scan of the liver using a radioisotope (a harmless radioactive substance that highlights the liver). Or the doctor might look at the liver using a laparoscope, an instrument inserted through the abdomen that relays pictures back to a computer screen.
A liver biopsy will confirm the diagnosis. For a biopsy, the doctor uses a needle to take a small sample of tissue from the liver, then examines for scarring or other signs of disease.
Treatment of Cirrhosis of Liver
Liver damage from cirrhosis cannot be reversed, but treatment can stop or delay further progression and reduce complications. Treatment depends on the cause of cirrhosis and any complications a person is experiencing. For example, cirrhosis caused by alcohol abuse is treated by abstaining from alcohol. Treatment for hepatitis–related cirrhosis involves medications used to treat the different types of hepatitis, such as interferon for viral hepatitis and corticosteroid for autoimmune hepatitis. Cirrhosis caused by Wilson’s disease, in which copper builds up in organs, is treated with medications to remove the copper. These are just a few examples–treatment for cirrhosis resulting from other diseases will depend on the underlying cause. In all cases, regardless of the cause, following a healthy diet and avoiding alcohol are essential because the body needs all the nutrients it can get, and alcohol will only lead to more liver damage.
Treatment will also include remedies for complications. For example, for ascites and edema, the doctor may recommend a low–sodium diet or the use of diuretics, which are drugs that remove fluid from the body. Antibiotics will be prescribed for infections, and various medications can help with itching. Protein causes toxins to form in the digestive tract, so eating less protein will help decrease the buildup of toxins in the blood and brain. The doctor may also prescribe laxatives to help absorb the toxins and remove them from the intestines.
For portal hypertension, the doctor may prescribe blood pressure medication such as a beta–blocker. If varices bleed, the doctor may either inject them with a clotting agent or perform a rubber–band ligation, which uses a special device to compress the varices and stop the bleeding.
When complications cannot be controlled or when the liver becomes so damaged from scarring that it completely stops functioning, a liver transplant is necessary. In liver transplantation surgery, a diseased liver is removed and replaced with a healthy one from an organ donor.
About 80 to 90% of people survive liver transplantation. Survival rates have improved over the past several years because of drugs such as cyclosporine and tacrolimus, which suppress the immune system and keep it from attacking and damaging the new liver.