Cirrhosis is scarring (fibrosis) of the liver caused by long-term liver damage. The scar tissure prevents the liver working properly.
Cirrhosis is sometimes called end-stage liver disease because it happens after other stages of damage from conditions that affect the liver, such as hepatitis.
Your liver may keep working even when you have cirrhosis. However, cirrhosis can eventually lead to liver failure, and you can get serious complications, which can be life threatening.
Treatment may be able to stop cirrhosis from getting worse.
Symptoms
You may not have any symptoms during the early stages of cirrhosis. As your liver becomes more damaged, you may:
- feel very tired and weak
- feel nauseous
- lose your appetite
- lose your sex drive
As the condition gets worse, further symptoms can include:
- yellowing of the skin and whites of the eyes (jaundice)
- vomiting blood
- itchy skin
- dark, tarry-looking poo
- a tendency to bleed or bruise more easily
- swollen legs (odema) or tummy (ascites) from a build-up of fluid
- loss of sex drive (libido).
See your GP if you think you may have cirrhosis.
Diagnosing cirrhosis
If your GP suspects cirrhosis, they'll check your medical history and carry out a physical examination to look for signs of long-term liver disease.
You may have tests to confirm the diagnosis. Tests include:
- blood tests
- scans - an ultrasound scan, transient elastography scan, CT scan, or MRI scan
- liver biopsy - a fine needle is used to remove a sample of liver cells so they can be examined under a microscope
- endoscopy - a thin, felxibile tube with a light and camera at the end (an endoscope) is passed down your throat and into your stomach, imahes of your oesophagus and stomach can show swollen veins (varices), which are a sign of cirrhosis
Treating cirrhosis
There's currently no cure for cirrhosis. But it's possible to manage the symptoms and any complications, and slow its progression.
Treating the underlying cause, such as using anti-viral medication to treat a hepatitis C infection, can also stop cirrhosis getting worse.
You may be advised to cur down on or stop drinking alcohol, or lose weight if you are overweight. A wide range of alcohol support services are available.
If your liver is severely scarred, it can stop functioning. In this case, a liver transplant is the only treatment option.
What causes cirrhosis?
In the UK, the most common causes of cirrhosis are:
- drinking too much alcohol over many years
- being infected with hepatitis for a long time, particularly hepatitis C
- non-alcoholic steatohepatitis – a more severe form of non-alcoholic fatty liver disease, where the liver becomes inflamed as the result of a build-up of excess fat
Cirrhosis can also be caused by a problem affecting your bile ducts (such as primary biliary cholangitis) or immune system (such as autoimmune hepatitis), some inherited conditions, and the long-term use of certain medicines.
Alcohol consumption
Drinking to much alcohol can damage the liver's cells.
Alcohol-related cirrhosis usually develops after 10 or more years of heavy drinking.
Women who drink heavily are more likely to get liver damage than man, partly because of their different size and build.
Preventing cirrhosis
Limit alcohol
The best way of preventing alcohol-related cirrhosis is to drink within the recommended limits:
- men and women shouldn't regularly drink more than 14 units of alcohol a week
- spread your drinking over three days or more if you drink as much as 14 units a week
You should stop drinking alcohol immediately if you have alcohol-related cirrhosis. Alcohol speeds up the rate at which cirrhosis progresses, regardless of the cause.
Your GP can give you help and advice if you're finding it difficulat to cut down the amount of alcohol you drink.
Protect yourself from hepatitis
Hepatitis B and C are infections in the liver caused by a virus.
The hepatitis B virus is spread in blood and body fluids. The hepatitis C virus is usually spread in blood.
Common ways of spreading these viruses include having sex with an infected person without using a condom, or close contact with an infected person's blood, such as sharing their toothbrush or sharing needles to inject drugs.
Vaccination for hepatitis B is part of the NHS childhood vaccination schedule. The vaccine is also available to anyone who has an increased chance of getting hepatitis B.
There is no vaccine for hepatitis C at the moment.
Aim for a healthy weight
To reduce your risk of developing non-alcoholic fatty liver disease, which can lead to cirrhosis, try to maintain a healthy weight by having a healthy, balanced diet and exercising regularly.
The liver
The liver is an important organ that carries out hundreds of jobs vital for sustaining life.
For example, it:
- stores glycogen, a carbohydrate that produces short-term energy
- makes bile, which helps digest fats
- makes substances that clot the blood
- processes and removes alcohol, toxins or drugs
- helps the body fight infections
Your liver is very tough. It'll keep working even if badly damaged, and can continue to repair itself until it's severely damaged.