Liver cirrhosis refers to a shrunken, scarred and hardened liver with failure of liver function. It results from chronic (long-term) damage to the liver from various causes, leading to progressive scarring of the liver over years. Common causes of liver cirrhosis include chronic viral hepatitis infection (chronic hepatitis B or C), excessive alcohol intake, autoimmune liver disease and fatty liver disease.
Liver cirrhosis is a serious condition because once the liver becomes cirrhotic, the damage to the liver is irreversible. This leads to progressive liver failure, complications of cirrhosis, liver cancer and eventual death.
Portal hypertension refers to increased blood pressure in the blood vessels supplying the liver (the portal vein). This is a common complication of liver cirrhosis. The hardened liver obstructs blood flow from the portal vein, leading to elevated pressures in the portal vein. This results in enlargement of the spleen (splenomegaly), development of swollen veins in the stomach and esophagus (varices) and accumulation of fluid in the abdomen (ascites). Most of the symptoms and signs of liver cirrhosis are a result of the development of portal hypertension.
Patients with early liver cirrhosis often have no detectable symptoms or signs of disease. Such patients may feel completely well and healthy and are often diagnosed based on abnormal blood tests or liver scans. This condition is known as compensated cirrhosis, which is associated with a favorable median survival of more than 10 years. Patients with early, compensated cirrhosis are often diagnosed on regular ultrasound screening during follow-up for chronic liver disease (e.g. chronic viral hepatitis or fatty liver disease).
Patients with more advanced liver cirrhosis may develop the following signs and symptoms:
You may be at risk of liver cirrhosis if you have one of the following conditions:
Liver cirrhosis is diagnosed via the following modalities:
The doctor may suspect liver cirrhosis in people with risk factors for cirrhosis who have abnormal blood tests, abnormal liver imaging or one of the signs and symptoms listed above.
Liver imaging is highly specific for the diagnosis of liver cirrhosis in which the liver has a shrunken and nodular appearance. Early cirrhosis is more difficult to diagnose as these patients may show a normal liver image during the scan. Early cirrhosis is often diagnosed by liver stiffness measurement (Fibroscan®). Sometimes a liver biopsy is required to confirm the diagnosis of early cirrhosis.
Patients with liver cirrhosis will benefit from the following treatment which include:
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