Definition of cirrhosis
Cirrhosis is a slowly progressing disease in which healthy liver tissue is replaced with scar tissue, eventually preventing the liver from functioning properly. The scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, hormones, drugs, and naturally produced toxins. It also slows the production of proteins and other substances made by the liver.
Symptoms of cirrhosis
Symptoms of cirrhosis can include:
Causes of Cirrhosis
The causes of cirrhosis include:
Diagnosis of cirrhosis
If your GP suspects cirrhosis, they'll check your medical history and carry out a physical examination to look for signs of chronic liver disease.
If your GP suspects your liver is damaged, you'll be referred for tests to confirm the diagnosis.
Tests
You may have a number of different tests including those described below.
Blood testsBlood tests can measure your liver function and the amount of liver damage. A blood test may be used to measure the levels of the liver enzymes alanine transaminase (ALT) and aspartate transferase (AST) in your blood, as these will be raised if you have inflammation of the liver (hepatitis).
ScansAn ultrasound scan, transient elastography scan, computerised tomography (CT) scan or a magnetic resonance imaging (MRI) scan may be carried out on your liver. A transient elastography scan is similar to an ultrasound scan carried out during pregnancy (it's sometimes known as a Fibroscan).
These scans can produce detailed images of your liver or check liver stiffness to identify any scarring.
The Lab Tests Online UK website has more information about ALT and AST measurements.
Liver biopsyA liver biopsy is where a fine needle is inserted into your body (usually between your ribs) to remove a small sample of liver cells. The sample is sent to a laboratory so it can be examined under a microscope.
The biopsy is usually carried out under local anaesthetic, as a day case or with an overnight stay in hospital. The outcome of the biopsy will confirm a diagnosis of cirrhosis and may provide more information about the cause. However, transient elastography is increasingly being used as an alternative to a biopsy in the diagnosis of cirrhosis.
EndoscopyAn endoscopy is where an endoscope (a thin, long, flexible tube with a light and video camera at the end) is passed down your throat and into your stomach.
Images of your oesophagus (tube from your throat to your stomach) and stomach are transmitted to an external screen where any varices (swollen vessels), which are a sign of cirrhosis, can be seen.
Treatment for cirrhosis
Treatment for cirrhosis varies based on what caused it and how far the disorder has progressed. Some treatments your doctor might prescribe include:
Prevention of cirrhosis
You can reduce your chances of developing cirrhosis by limiting your alcohol consumption and protecting yourself from a hepatitis infection.
Limiting your alcohol consumptionHeavy alcohol consumption is one of the most common causes of cirrhosis of the liver. One of the best ways to avoid this is to keep within recommended limits.
Read more about alcohol misuse.
Protect yourself from hepatitisCirrhosis can be caused by infectious conditions, such as hepatitis B and C. Hepatitis B and C can be caught through having unprotected sex or by sharing needles to inject drugs.
Using a condom when having sex will help you avoid the risk of getting hepatitis, as will avoiding injecting drugs.
Anyone who's at risk of getting hepatitis B, such as police officers and social care workers, can be protected by being vaccinated against the condition. However, there's currently no vaccine for hepatitis C.
People born in areas of the world where hepatitis B and C are widespread, such as parts of South Asia and Africa, need to be screened for hepatitis, as early treatment can help prevent the onset of cirrhosis.
Cirrhosis is a slowly progressing disease in which healthy liver tissue is replaced with scar tissue, eventually preventing the liver from functioning properly. The scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, hormones, drugs, and naturally produced toxins. It also slows the production of proteins and other substances made by the liver.
Symptoms of cirrhosis
Symptoms of cirrhosis can include:
- tiredness and weakness
- loss of appetite
- weight loss and muscle wasting
- feeling sick (nausea) and vomiting
- tenderness or pain around the liver area
- tiny red lines (blood capillaries) on the skin above waist level
- very itchy skin
- yellowing of the skin and the whites of the eyes (jaundice)
- a tendency to bleed and bruise more easily, such as frequent nosebleeds or bleeding gums
- hair loss
- fever and shivering attacks
- swelling in the legs, ankles and feet due to a build-up of fluid (oedema)
- swelling in your abdomen (tummy), due to a build-up of fluid known as ascites (severe cases can make you look heavily pregnant)
Causes of Cirrhosis
The causes of cirrhosis include:
- Hepatitis B: Hepatitis B can cause liver inflammation and damage that can lead to cirrhosis.
- Hepatitis D: This type of hepatitis can also cause cirrhosis. It’s often seen in people who already have hepatitis B.
- Inflammation caused by autoimmune disease: Autoimmune hepatitis may have a genetic cause. According to the American Liver Foundation, about 70 percent of people with autoimmune hepatitis are women.
- Damage to the bile ducts, which function to drain bile: One example of such a condition is primary biliary cirrhosis.
- Disorders that affect the body’s ability to handle iron and copper: Two examples are hemochromatosis and Wilson’s disease.
- Medications: Medications including prescription and over-the-counter drugs like acetaminophen, some antibiotics, and some antidepressants, can lead to cirrhosis.
Diagnosis of cirrhosis
If your GP suspects cirrhosis, they'll check your medical history and carry out a physical examination to look for signs of chronic liver disease.
If your GP suspects your liver is damaged, you'll be referred for tests to confirm the diagnosis.
Tests
You may have a number of different tests including those described below.
Blood testsBlood tests can measure your liver function and the amount of liver damage. A blood test may be used to measure the levels of the liver enzymes alanine transaminase (ALT) and aspartate transferase (AST) in your blood, as these will be raised if you have inflammation of the liver (hepatitis).
ScansAn ultrasound scan, transient elastography scan, computerised tomography (CT) scan or a magnetic resonance imaging (MRI) scan may be carried out on your liver. A transient elastography scan is similar to an ultrasound scan carried out during pregnancy (it's sometimes known as a Fibroscan).
These scans can produce detailed images of your liver or check liver stiffness to identify any scarring.
The Lab Tests Online UK website has more information about ALT and AST measurements.
Liver biopsyA liver biopsy is where a fine needle is inserted into your body (usually between your ribs) to remove a small sample of liver cells. The sample is sent to a laboratory so it can be examined under a microscope.
The biopsy is usually carried out under local anaesthetic, as a day case or with an overnight stay in hospital. The outcome of the biopsy will confirm a diagnosis of cirrhosis and may provide more information about the cause. However, transient elastography is increasingly being used as an alternative to a biopsy in the diagnosis of cirrhosis.
EndoscopyAn endoscopy is where an endoscope (a thin, long, flexible tube with a light and video camera at the end) is passed down your throat and into your stomach.
Images of your oesophagus (tube from your throat to your stomach) and stomach are transmitted to an external screen where any varices (swollen vessels), which are a sign of cirrhosis, can be seen.
Treatment for cirrhosis
Treatment for cirrhosis varies based on what caused it and how far the disorder has progressed. Some treatments your doctor might prescribe include:
- beta blockers or nitrates (for portal hypertension)
- quitting drinking (if the cirrhosis is caused by alcohol)
- banding procedures (used to control bleeding from esophageal varices)
- intravenous antibiotics (to treat peritonitis that can occur with ascites)
- hemodialysis (to purify the blood of those in kidney failure)
- lactulose and a low protein diet (to treat encephalopathy)
Prevention of cirrhosis
You can reduce your chances of developing cirrhosis by limiting your alcohol consumption and protecting yourself from a hepatitis infection.
Limiting your alcohol consumptionHeavy alcohol consumption is one of the most common causes of cirrhosis of the liver. One of the best ways to avoid this is to keep within recommended limits.
- men and women are advised not to regularly drink more than 14 units a week
- spread your drinking over three days or more if you drink as much as 14 units a week
Read more about alcohol misuse.
Protect yourself from hepatitisCirrhosis can be caused by infectious conditions, such as hepatitis B and C. Hepatitis B and C can be caught through having unprotected sex or by sharing needles to inject drugs.
Using a condom when having sex will help you avoid the risk of getting hepatitis, as will avoiding injecting drugs.
Anyone who's at risk of getting hepatitis B, such as police officers and social care workers, can be protected by being vaccinated against the condition. However, there's currently no vaccine for hepatitis C.
People born in areas of the world where hepatitis B and C are widespread, such as parts of South Asia and Africa, need to be screened for hepatitis, as early treatment can help prevent the onset of cirrhosis.