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Cirrhosis of the Liver

Cirrhosis is defined as a late-stage liver disease and is characterized by generally irreversible scarring of liver tissue.   At Northwest Gastroenterology Clinic, we can diagnose cirrhosis and help patients prevent complications related to cirrhosis. If you are seeking treatment or support for cirrhosis, call our cirrhosis specialists at (503) 229-7137 or contact us online.

Causes of Cirrhosis

Viruses, substances, and genetic disorders are among the causes of cirrhosis.  In the United States, the most common causes of cirrhosis are:

  • Alcoholic liver disease
  • Chronic viral hepatitis (Hepatitis C and Hepatitis B)
  • Nonalcoholic liver disease or fatty liver disease

Other causes include:

  • Autoimmune hepatitis
  • Primary and secondary biliary cirrhosis
  • Primary sclerosing cholangitis
  • Celiac disease
  • Wilson Disease
  • Alpha-1 antitrypsin deficiency
  • Polycystic liver disease
  • Medications

Signs and Symptoms of Cirrhosis

The manifestation of signs and symptoms depends on whether a patient’s cirrhosis compensated (under control) or decompensated (not under control):

  • Fatigue
  • Weight loss
  • Poor appetite
  • Weakness
  • Easy bleeding and bruising
  • Itchy skin
  • Nausea
  • Abdominal distension
  • Swelling of the lower extremities
  • Redness in the palms
  • Spiderlike blood vessels in the skin
  • Enlarged blood vessels in the esophagus and stomach (varices)
  • Testicular shrinkage
  • Breast enlargement (or gynecomastia)
  • Jaundice

Seek medical attention immediately if you experience any of these potentially life-threatening complications:

  • Confusion, drowsiness, and slurred speech (hepatic encephalopathy)
  • Yellow discoloration of the skin and eyes (jaundice)
  • Shortness of breath
  • Muscle wasting
  • Reduced urine output
  • Abdominal distension
  • Change in bowel habits
  • Blood in your stool
  • Severe vomiting
  • Fever

Diagnosis

Cirrhosis may be suspected on a routine blood test if there are abnormalities in clotting factors (INR) and a patient’s platelet count.  Typically, cirrhosis is diagnosed by imaging (ultrasound, CT, or MRI).   Rarely is a biopsy required to confirm its presence.

Complications of Cirrhosis

There is no cure for cirrhosis except for liver transplantation.  It is a chronic illness and the management of cirrhosis includes preventing or treating its complications.  The five complications of cirrhosis include:

  1. Ascites or fluid in the abdomen that can accumulate and may require diuretics to treat
  2. Varices, or abnormally large blood vessels, in the esophagus and the stomach
  3. Jaundice
  4. Hepatic encephalopathy, or confusion
  5. Liver cancer

Prognosis of Cirrhosis

The prognosis for cirrhosis is variable and depends on whether the liver disease is compensated or decompensated.  Factors influencing prognosis also include the specific cause of the patient’s liver disease, the presence of substance dependence, and other medical problems.

Treatment and Management of Cirrhosis

The treatment for cirrhosis consists of preventing or managing its complications and co-morbid medical conditions that may exacerbate it.

If you have cirrhosis, the most important lifestyle change that you can make is to stop drinking alcohol.

Other modifiable changes include:

  • Immunization against hepatitis A, hepatitis B, influenza, and pneumococcus
  • Adherence to a low-sodium diet
  • Safe and sustainable weight loss, especially for patients with nonalcoholic fatty liver disease

Management of cirrhosis may include treating its complications.  For instance, diuretics may be used to treat ascites and lactulose may be required to treat hepatic encephalopathy.  If the cause of cirrhosis is a chronic viral infection like Hepatitis B or Hepatitis C, treatment targeting these viruses may also be indicated.   Screening for liver cancer is also recommended for patients with cirrhosis since the risk of hepatocellular carcinoma among those with advanced liver disease.

Contact a Cirrhosis Specialist Today!

Northwest Gastroenterology Clinic’s team of providers includes experts who can help you prevent complications of cirrhosis. For more information or to schedule an appointment, please call (503) 229-7137 or request an appointment online.

Frequently Asked Questions

What can be done for cirrhosis of the liver?

Typically, cirrhosis is irreversible and can only be cured by liver transplantation.  Management of cirrhosis depends on preventing complications of it, namely preventing or managing ascites, varices, hepatic encephalopathy, jaundice, or liver cancer.

What are the first signs of cirrhosis of the liver?

Signs and symptoms of cirrhosis vary depending on a patient’s disease course; sometimes, patients can be asymptomatic and symptoms are non-specific.  Patients with the decompensated disease may develop jaundice or bleeding.

What does liver pain feel like?

Usually, there is no stereotypical abdominal “pain” symptom that is associated with cirrhosis.  Pain in the right upper quadrant may be related to the gallbladder if still present, but occasionally “capsular stretch” of the liver may be related to abdominal pain.  If a patient’s cirrhosis is severe enough to be associated with enlargement of the spleen, at times this may also contribute to pain.

What foods should be avoided by cirrhosis patients?

Patients with cirrhosis need to adhere to a strict 2gm low sodium diet.  Strict alcohol abstinence is also recommended.