Health Topics for Digestive System

James A. Clifton Center for Digestive Diseases

Cancers of the Digestive System

Liver Failure Clinic

Liver Service

Cirrhosis

Cirrhosis is a disease of the liver in which scar tissue replaces normal healthy liver cells. The scarring cannot be repaired. If the scarring continues, it may become so severe that it keeps the liver from doing its normal functions. The liver is the largest organ in the body. It has many functions, including:

• processing healthful nutrients such as proteins, glucose, and vitamins
• making bile, which helps the body absorb fat and fat-soluble vitamins
• getting rid of toxins including alcohol, nicotine, and drugs
• making proteins that are needed for clotting blood and
• recycling blood -- taking the iron from old red blood cells and sending it to the bone marrow to make new red blood cells

There are many causes of cirrhosis. Long-term alcohol abuse and chronic hepatitis are the most common causes. Inherited diseases, long-term exposure to toxic chemicals, and certain medicines may also cause hepatitis. The symptoms of cirrhosis are many and varied. At first there may not be any symptoms. Or the symptoms may be very mild such as being tired, easy bruising, or loss of appetite. As cirrhosis gets worse the following symptoms may be present:

• nausea or vomiting
• itching
• weight loss
• spider angiomas on skin (groups of small spider web-like veins)
• low-grade fever
• abdominal pain
• ankle swelling
• jaundice or yellow color to skin and eyes
• loss of body hair
• palms of hands may be reddish and blotchy
• pain in the right upper abdomen and
• abdominal swelling caused by fluid build-up in the abdomen

A damaged liver from cirrhosis affects every body process such as digestion, hormones and circulation. As cirrhosis becomes worse, it can cause bleeding, especially from the esophagus or food pipe, or the stomach, infections, and damage to the brain. A long-term effect of cirrhosis is liver cancer.

If the healthcare provider suspects cirrhosis, the person will be examined. Often the liver can be felt in the upper left part of the abdomen. It may be larger than normal and feel hard. As the damage to the liver gets worse, the liver will start to get smaller. The provider will check to see if there is fluid built up in the abdomen. Blood tests can check the function of the liver. Special x-rays and tests can be done. But, the one test that can definitely diagnose cirrhosis is a liver biopsy. The liver biopsy can usually be done on an outpatient basis. For this test a needle is put through the abdomen into the liver, and a small piece of the liver is taken for a biopsy.

The most important treatment for cirrhosis caused by alcohol is to stop drinking all alcohol. No one with cirrhosis should drink, as it can cause more liver scarring. People with cirrhosis from alcohol are usually malnourished. They require increased calories and a healthy diet that includes fresh fruits and vegetables, and whole grains. There are drugs that are being tested that may eventually help improve cirrhosis.

The provider may suggest other lifestyle changes a person with cirrhosis may need to make. These changes could include: supplements, avoiding foods high in iron, nutritional drinks like Ensure, and limiting salt, fluids, and exercise. The provider may also suggest being vaccinated for flu and pneumonia. It is up to the provider to decide if these changes need to be followed.

Prevention of cirrhosis is possible. It includes:

• limit the use of alcohol, no more than 1 drink a day for women and 2 drinks a day for men
• do not share syringes
• avoid drugs that can damage the liver
• safe sex, avoid multiple partners
• immunization for hepatitis A and B
• do not take acetaminophen (such as Tylenol) when drinking and
• get regular liver tests when taking drugs that are toxic to the liver

Long-term survival is possible from cirrhosis as long as the damage is not too severe. If the cirrhosis is severe a liver transplant may be suggested. A liver transplant usually will not be done on anyone who cannot give up alcohol completely. Often liver transplants are not covered by health insurance.

Last Reviewed 2005

Disclaimer: This content is reviewed periodically and is subject to change as new health information becomes available. The information provided is intended to be informative and educational and is not a replacement for professional medical evaluation, advice, diagnosis or treatment by a healthcare professional.

HIL File DIGE3496.rf2 VRS# 5401 Data Version 7.0 Copyright 1998, 2000, 2002 McKesson Health Solutions LLC. All rights reserved.