Treatment
Cirrhosis can't be cured, so treatment aims to manage the symptoms and any complications, and stop the condition getting worse.
Stopping cirrhosis getting worse
Making healthy lifestyle changes and talking medicine to treat the underlying cause of the liver damage can help stop cirrhosis getting worse. It can also reduce your risk of developing further health problems.
Lifestyle changes
There are a number of things you can do to help stay healthy and reduce your chances of developing further problems:
- avoid alcohol if your liver problems are alcohol-related
- lose weight if you're overweight or obese
- take regular exercise to reduce muscle wasting
- practice good hygiene to reduce your chances of developing infections
- speak to your GP or pharmacist if you're talking over-the-counter or prescription medications, as cirrhosis can affect the way some medicines work
Dietary changes
Malnutrition is common in people with cirrhosis, so it's important you have a balanced diet to help you get all the nutrients you need.
Cutting down on salt can help reduce your risk of developing swelling in your legs, feet and tummy caused by a build-up of fluid.
The damage to your liver can also mean it's unable to store glycogen, which provides short-term energy.
When this happens, the body uses it's own muscle tissue to provide energy between meals, which leads to muscle wasting and weakness. This means you may need extra calories and protein in your diet.
Healthy snacking between meals can top up your calories and protein. It may also be helpful to eat three or four small meals a day, rather than one or two large meals.
Medication
The medication you need will depend on the specific cause of the damage to your liver. For example, if you have viral hepatitis, anti-viral medication may be prescribed.
Easing symptoms
Treatments, to ease the symptoms of cirrhosis include:
- a low salt diet or tablets called diuretics to reduce the amount of fluid in your body
- tablets reduce high blood pressure in your portal vein, the main vein that transports blood from the gut to the liver
- creams to reduce itching
Swollen veins in the oesophagus
If you vomit blood or have blood in your poo, the veins in your oesophagus (gullet), the tube that carries food from the throat to the stomach, may be swollen and leaking blood. These are known as oesophageal varices.
You need urgent medical attention if you have oesophageal varices. See your GP or go to your nearest accident and emergency (A&E) department immediately.
An endoscopy is used to help diagnose oesophageal varices. A number of treatments can also be carried during the procedure to stop the bleeding and reduce the swelling.
The Chesterfield Royal Hospital has more information about treating oesophageal varices (PDF, 360kb).
You may also be given a type of medication called a beta-blocker, such as propranolol or carvedilol, to reduce the risk of bleeding.
Fluid in the tummy and legs
A build-up of fluid around your stomach area or legs and ankles is a common complication of advanced cirrhosis.
The main treatments are cutting salt in your diet and taking duretic tablets, such as spironolactone or furosemide.
If the fluid around your stomach becomes infected, you may need antibiotics. In severe cases, you may need to have the fluid drained from your tummy with a tube.
Encephalopathy
People with cirrhosis can sometimes develop problems with their brain function (encephalopathy).
Symptoms include confusion, drowsiness and problems concentrating. This happens because the liver isn't clearing toxins properly.
The main treatment for encephalopathy is lactulose syrup. This acts as a laxative and helps clear the toxins that have built up. Resistant cases may be treated with a special type of antibiotic called Rifaximin.
Bleeding
Cirrhosis can affect the liver's ability to make the blood clot, leaving you at risk of severe bleeding if you cut yourself.
In emergencies, vitamin K and a blood product called plasma can be given to treat bleeding. You'll need to apply pressure to any cuts that bleed.
You should get specialist advice before having medical procedures, including any dental work.
Liver transplant
Your liver may stop functioning if it's severly damaged by scarring. In this situation, a liver transplant is the only option.
This is a major procedure that involves removing your diseased liver and replacing it with a healthy donor liver.
You'll probably have to wait a long time for a liver transplant as there are more people waiting for a transplant than there are donors.
You won't be able to have a liver transplant if you're still drinking excessive amounts of alcohol.
The Organ Donation Wales website has more information.
Cirrhosis and diabetes
Your diabetes may get worse if you have type 2 diabetes and develop cirrhosis.
This is because cirrhosis can increase your resistance to insulin, a hormone produced by the body to control blood sugar levels.
If this happens, you should discuss the implications with your GP.