What is liver cirrhosis?
Liver cirrhosis means “fibrotic scarring of the liver”
When the liver is repeatedly injured by agents such as alcohol or Hepatitis B or Hepatitis C, the liver tries to repair itself by growing new liver cells. Up to a certain point, this repair is incomplete and the liver form fibrotic scars and become harder and shrunken.
What can cause liver cirrhosis?
In Singapore, the commonest cause of liver cirrhosis is chronic hepatitis B. While not every Hepatitis B carrier will become cirrhotic, approximately 20-40% may end up with cirrhosis if their condition is not monitored. Other causes include alcohol, hepatitis C, fatty liver with inflammation and rarer causes such as Autoimmune Liver Disease, Primary Biliary Cirrhosis, Wilson’s disease and primary sclerosing cholangitis.
What happens to patients who have liver cirrhosis?
Early liver cirrhosis does not cause problems as the liver has enough reserve capacity to cater to the needs of the body even though it is scarred.
As scarring progresses, liver insufficiency develops, and patient is prone to develop the following complications:
- Retention of water in abdomen and leg
- Delayed clotting and easy bruising
- Internal bleeding and esophageal varices
- Increased risks of infection
- Increased risks of mental confusion
- Increased risks of liver cancer
How do I know if I have liver cirrhosis?
In early or compensated cirrhosis, patients will not have symptoms and may feel normal. Patients may not even know to have liver cirrhosis. It is important that patients will be monitored by doctor even if they feel well. Ultrasound scan of the liver is the easiest way to diagnose cirrhosis.
In advanced cirrhosis, symptoms of significant liver damage may include:
- Tiredness, lethargy
- Jaundice (yellow color of white of eye)
- A distended, fluid-filled abdomen (ascites)
- Swelling of the legs
- Presence of reddish spidery spots on the chest and back (spider nevi)
- Sleep disturbance, personality changes and confusion
- Vomiting of fresh blood or passage of black tarry stools.
What should I do if I have liver cirrhosis?
It is important that you consult a specialist who will help you confirm the condition and establish the cause of it. Many of the causes, if diagnosed early, could be treated, and hence prevent further injury and deterioration.
What shall I do to prevent worsening?
- Avoid excessive water – if there is a water retention in abdomen and legs- water intake should be restricted to 1 litre per day
- Low salt diet – salt and soy sauce to prevent water retention
- Avoid taking unnecessary drugs which may further overload liver
- Prevent constipation which is a common cause of brain confusion in patients with liver cirrhosis.
- Any signs of infection or worsening of mental state or alertness should prompt early consultation with doctor.
- Dietary protein should be adequate but not excessive for those sensitive to brain confusion.
Risks of liver cancer
The risk of liver cancer is increased in liver cirrhosis. Six monthly ultrasound and blood test are recommended.
Can I recover from cirrhosis?
Cirrhosis can improve and even reverse in some situations. The main aim is to remove the cause of liver injury and to allow the liver to repair itself. With treatment, early cirrhosis can be arrested thus preventing further deterioration. Even when complications develop, many of these complications can be controlled and patients can be maintained at compensated stage (with relatively normal functions). For end-stage liver cirrhosis, liver transplantation provides a cure for cirrhosis patients.