Dr. M.J. Bazos, MD Patient Handout


About Your Diagnosis

Cirrhosis is chronic scarring of the liver. The scarring prevents the liver from functioning normally. There are many causes of cirrhosis. Alcoholism is the most common cause in the United States. Inherited diseases such as Wilson’s disease, hemochromatosis, and cystic fibrosis are also known causes. Chronic viral hepatitis and exposure to toxic substances can also cause cirrhosis. Primary biliary cirrhosis, which causes blockage of the bile duct, can likewise cause this condition. Cirrhosis is one of the top 10 causes of death in the United States. It is more common in men. History and physical examination are key in detecting this condition. Blood work and a liver biopsy may also help in the diagnosis. The prognosis is dependent on the amount of liver damage done and its cause; the more damage, the worse the prognosis. If the cause is treatable and the liver damage stops, the prognosis is good. However the liver damage is not reversible.

Living With Your Diagnosis
The early stages of cirrhosis are associated with fatigue, nausea, decreased appetite, and weight loss. Physical signs in the early stages are enlargement of the liver and redness of the palms of the hands. In the later stages of the disease, jaundice, diarrhea, and dark urine are present. Spider blood vessels (fine vessels spreading out from a central point) of the skin, easy bruising and bleeding, enlargement of the breasts in men, and hair loss are present also. Physical signs in the late stages are enlargement of the spleen, fluid accumulation in the abdomen (ascites) and legs (edema), mental confusion, and coma. Complications such as gastrointestinal (GI) bleeding from portal hypertension (high blood pressure within the liver), kidney failure, and infections can occur.

The key to treatment is removing the cause. After removal of the offending cause, the primary treatment is supportive. A high-calorie diet may help. Salt (sodium) and/ or fluid restriction may be necessary to control fluid accumulation. If the ascites or edema is severe, diuretic medications can be given to remove the fluid. Medications can also be given to help with the mental confusion and coma. The treatment of portal hypertension is dependent on its severity. Medications are the first option. Endoscopy (a lighted flexible tube used to view the esophagus, stomach, and small intestines) with sclerosing of the bleeding areas is an option if bleeding is occurring. If severe, surgery is an option. A portacaval shunt is done to relieve the pressure on the blood vessels. Liver transplantation is a final option.

The DOs
• Eat a well-balanced diet. Protein may need to be avoided in the diet because the liver may not be able to break down the protein.
• Modify activity according to the symptoms. A good fitness program may help with the fatigue.
• If alcohol abuse is the cause, seek treatment through an alcohol rehabilitation program.
• Obtain prompt treatment for hepatitis.
• If there is a family history of cirrhosis or inherited diseases that cause cirrhosis, family members should be observed for sign of cirrhosis.
• If exposed to blood and body fluid on the job, use proper protective equipment such as gloves and eye protection to lessen the chance of accidental exposure.
• If you are in a high-risk group, you should receive the hepatitis B vaccine. High-risk groups are health workers, homosexual men, and household contacts of carriers.

The DON’Ts
• Avoid alcohol.
• Avoid medications that can be harmful to the liver such as acetaminophen, sedatives, and tranquilizers.
• Avoid chemicals and other substances that could be harmful to your liver.

When to Call Your Doctor
• If you have symptoms of cirrhosis.
• If during treatment for cirrhosis you have vomited blood, have passed a black stool or bright red blood, have mental confusion, or have fever or other signs of infection.