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Cirrhosis of the Liver
What are the Treatments for Cirrhosis?Treatment of cirrhosis is aimed to stop the development of scar tissue in the liver and prevent complications. When cirrhosis is due to an identifiable cause, treatment programs may be specific, such as for management of hepatitis B and C, or steroids and immunosuppressive agents for auto-immune chronic active hepatitis. No matter what the cause of cirrhosis, every patient must avoid all substances, habits, and drugs that may further damage the liver, precipitate complications, or speed the progression to liver failure. Alcohol, in addition to causing cirrhosis, may accelerate the progression of liver scarring due to other causes, such as hepatitis C. All patients with liver disease should not drink alcoholic beverages. Even some non-prescription drugs and vitamins, acetaminophen, in relatively small doses (more than five doses a day) and Vitamin A (more than 25,000 IU/day) may precipitate liver failure. Non-steroidal anti-inflammatory drugs, such as ibuprofen, may precipitate severe bleeding and/or kidney failure. The cirrhotic patient is at increased risk of contracting other infections that may be more severe than in healthy patients. Immunizations for hepatitis A, B, influenza, and pneumococcal pneumonia are available and should be administered. Raw seafood may contain bacteria that can cause life-threatening infections and therefore should be avoided. How are the Complications of Cirrhosis Treated?The abnormal accumulation of fluid may cause swelling of the ankles (edema) and abdomen (ascites). Therefore, patients should reduce the amount of fluid and salt in their diet or use drugs called "diuretics" that mobilize and excrete the excess fluid through the kidneys. Occasionally, the ascites may become infected, a condition known as Spontaneous Bacterial Peritonitis, and require treatment with antibiotics. When the liver does not efficiently function to cleanse the body of toxins and drugs, the mental state of patients may change dramatically and lead to coma, called Hepatic Encephalopathy. Treatment is directed at reducing the protein in the diet, avoiding sedatives and pain medications, and using laxatives and/or antibiotics to decrease the absorption of toxins from the intestines. Sometimes, bleeding from the esophagus or stomach caused by abnormal veins (varices) may occur and is a life-threatening emergency requiring hospitalization. Variceal bleeding can usually be controlled with the use of a flexible tube (endoscope) that is inserted through the mouth into the esophagus and stomach and used to inject clotting agents into the veins or to rubberband ligate the varices. Liver failure refers to the end stage of liver disease and cirrhosis when the liver stops working and cannot support life. Liver failure is difficult to treat and survival is limited. Therefore, patients with any complication of cirrhosis are considered to be at risk of developing liver failure. When complications develop, it may be possible to manage them. When it is likely that liver failure will develop, some patients with cirrhosis are able to undergo liver transplantation. The treating gastroenterologist may recommend liver transplantation when complications of cirrhosis develop in an attempt to avoid liver failure. PreventionAlthough not all cases of cirrhosis are preventable, the following measures can greatly reduce your risk: Avoid alcohol or drink in moderation. Alcohol is a toxin that must be filtered by your liver. In the process, liver cells become damaged. Unfortunately, you may not recognize that you have a problem with alcohol before serious liver damage has occurred. Knowing and recognizing a family history of alcoholism for you or others is an important step in seeking treatment. Protect yourself from hepatitis C. Because there's no vaccine to prevent hepatitis C, the only way to protect yourself is to avoid exposure to the virus. If you aren't absolutely certain of the health status of a sexual partner, use a new condom every time you have sex. Don't use nasal cocaine and avoid sharing needles or other drug paraphernalia. Contaminated drug paraphernalia is responsible for about half of all new cases of hepatitis C. See your doctor if you have or have had hepatitis C or think you may have been exposed to the virus. Protect yourself from hepatitis B. A vaccine for hepatitis B has been available since 1981. Although vaccination is the best way to protect yourself and others, these measures can also keep you safe: Know the health status of every sexual partner. If you don't know, use a new condom every time you have sex. And if you use needles to inject drugs, be sure they're sterile and don't share them.
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