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Cirrhosis

Overview:

Cirrhosis is the end stage of chronic liver disease. It is characterized by the replacement of the normal liver with scar tissue. Common chronic liver diseases which can result in cirrhosis include alcoholism, viral hepatitis, fatty liver disease, and autoimmune forms of chronic liver disease.

Symptoms

Symptoms of cirrhosis result from the inability of the liver to perform its normal function. Scarring also prevents normal blood flow through the liver and excretion of bile into the intestine.  Patients often develop yellowing of the skin or eyes, known as jaundice. Fluid may accumulate in the abdominal cavity and lower extremities. Accumulation of blood toxins in the brain may result in confusion, a condition known as hepatic encephalopathy. Enlarged veins may develop in the esophagus and stomach known as varices. These can rupture and produce severe gastrointestinal bleeding. This may be evidenced by vomiting blood or passing bloody stools.

Testing

The diagnosis of cirrhosis is typically made on the basis of symptoms and the physical findings mentioned above. Patients will often have abnormal laboratory studies. Imaging studies of the abdomen such as ultrasound, CT Scan or MRI will show the typical characteristic changes of cirrhosis. A liver biopsy may be necessary to confirm the diagnosis of cirrhosis or to determine a specific underlying cause.

Treatment

Typically the liver damage from cirrhosis cannot be reversed. An underlying form of chronic liver disease should be identified, as specific therapy may be available to prevent further progression of liver disease.  Specific treatments for symptoms such as hepatic encephalopathy, ascites, and gastrointestinal bleeding are available. Please refer to these specific conditions for further information. Ultimately, patients with cirrhosis require liver transplantation to prevent death.

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