CIRRHOSIS OF THE LIVER

General Information

DEFINITION--Chronic scarring of the liver, leading to loss of normal liver function.

BODY PARTS INVOLVED--Liver and its major blood vessels.

SEX OR AGE MOST AFFECTED--Adults of both sexes, but twice as common in men.

SIGNS & SYMPTOMS

Early stages:

• Fatigue; weakness.
• Poor appetite; nausea; weight loss.
• Enlarged liver.
• Red palms.

Late stages:

• Jaundice (yellow skin and eyes).
• Dark yellow or brown urine.
• Spider blood vessels of the skin (fine vessels that spread out from a central point).
• Hair loss.
• Breast enlargement in men.
• Fluid accumulation in the abdomen and legs.
• Enlarged spleen.
• Diarrhea; stool may be black or bloody.
• Bleeding and bruising.
• Mental confusion; coma.

CAUSES--

Inflammation of the liver, accompanied by destruction of liver cells, cell regeneration and scarring. These may be preceded by:

• Prolonged, excess alcohol consumption.
• Hepatitis.
• Exposure to toxic chemicals.
• Inherited causes.

RISK INCREASES WITH

• Poor nutrition.
• Hepatitis.
• Excess alcohol consumption. Individuals vary widely in the amount and duration of alcohol consumption necessary to cause cirrhosis.
• Occupational exposure to chemicals toxic to the liver.

HOW TO PREVENT

• Obtain treatment for alcoholism.
• Obtain prompt medical treatment for hepatitis.
• Survey your work environment for possible exposure to toxic chemicals.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory studies, such as blood and urine tests of liver function.
• X-ray and/or biopsy of liver.

APPROPRIATE HEALTH CARE

• Treatment methods may include drug treatment, dietary restrictions, rest and other supportive measures.
• Psychotherapy or counseling (for alcoholism).
• Liver transplantation (sometimes). (See Liver Transplantation in Surgery section.)

POSSIBLE COMPLICATIONS

• Life-threatening hemorrhage, especially from the esophagus and stomach.
• Liver cancer.
• Body poisoning and coma from a buildup of ammonia and other body waste.
• Sexual impotence.

PROBABLE OUTCOME--Cirrhosis can be arrested if the underlying cause can be removed. Liver damage is irreversible, but symptoms can be relieved or controlled. A near-normal life is possible if treated early and treatment succeeds. If the underlying cause is not removed, liver scarring will continue, resulting in death from liver failure.

How To Treat

GENERAL MEASURES--

• If cirrhosis is caused by alcoholism, stop drinking. Ask for help from family, friends and community agencies. Contact an Alcoholics Anonymous group in your community.
• Weigh daily and keep a record. Notify your doctor if there is a sudden weight gain.
• See Resources for Additional Information.

MEDICATION--Your doctor may prescribe:

• Iron supplements for anemia resulting from hemorrhage or poor nutrition.
• Diuretics to reduce fluid retention.
• Antibiotics, such as neomycin, to reduce ammonia buildup.

ACTIVITY--

• Maintain as active a life as possible.
• Elevate swollen feet and legs when resting.

DIET--Eat a nutritionally balanced diet with appropriate vitamins and minerals. Eating frequent small meals may help.

Call Your Doctor If

• You have symptoms of cirrhosis.
• The following occurs during treatment: Vomiting blood or passing black stool. Mental confusion or coma. Fever or other signs of infection (redness, swelling, tenderness or pain).