How To Fix A Liver That Is Getting Hard On A Woman

Overview

Cirrhosis of the liver causes scarring of the liver with visible bumpy nodules throughout the tissue. — Cirrhosis causes scaring and nodules to form throughout the liver.

What is cirrhosis of the liver?

Cirrhosis is a tardily-stage liver disease in which salubrious liver tissue is replaced with scar tissue and the liver is permanently damaged. Scar tissue keeps your liver from working properly.

Many types of liver diseases and conditions injure healthy liver cells, causing cell decease and inflammation. This is followed by jail cell repair and finally tissue scarring as a result of the repair procedure.

The scar tissue blocks the flow of blood through the liver and slows the liver'southward ability to process nutrients, hormones, drugs and natural toxins (poisons). It as well reduces the product of proteins and other substances fabricated by the liver. Cirrhosis eventually keeps the liver from working properly. Belatedly-stage cirrhosis is life-threatening.

A normal liver, brown to reddish-brown in color, has a smooth exterior surface.

How common is cirrhosis?

Scientists estimate that cirrhosis of the liver affects about ane in 400 adults in the U.S. It affects about i in 200 adults age 45 to 54, the historic period group most commonly affected by cirrhosis. Cirrhosis causes about 26,000 deaths each year in the U.S. and is the seventh leading crusade of death in the U.S. among adults 25 to 64 years of historic period.

Who gets cirrhosis, who is about at gamble?

You are more likely to become cirrhosis of the liver if you:

Utilize alcohol for many years.
Have viral hepatitis.
Have diabetes.
Have obesity.
Inject drugs using shared needles.
Have a history of liver illness.
Take unprotected sex.

Is cirrhosis cancer?

No, cirrhosis of the liver isn't cancer. Even so, most people who take liver cancer accept cirrhosis. If you accept cirrhosis, you have an increased risk of liver cancer. If yous have hepatitis B or hepatitis C, you have an increased risk of liver cancer because these diseases frequently lead to cirrhosis. Any cause of liver disease tin lead to cirrhosis, which increases your hazard of liver cancer. (Even if you have hepatitis B or fat liver disease without cirrhosis, you are at increased risk of liver cancer.)

Is cirrhosis a hereditary disease?

Cirrhosis itself is not an inherited (passed from parent to child) illness. However, some of the diseases that can cause liver damage that lead to cirrhosis are inherited diseases.

Can cirrhosis be reversed?

More often than not no. If you have been told you take cirrhosis, you lot accept a late-stage liver disease and the damage that is already done is permanent. In that location are many liver diseases and complications of liver diseases that tin can lead to cirrhosis. If your liver disease or complication is caught early and successfully managed, it may be possible to irksome or end the progression of disease.

Is cirrhosis fatal?

Having a diagnosis of cirrhosis of the liver doesn't mean yous have an immediately fatal status. Still, as cirrhosis continues, more scarring occurs and liver function continues to decline. Eventually, your failing liver may become a life-threatening status. Yet at that place'due south yet hope. You and your medical team will discuss if you are a candidate for a liver transplant. If so, you will begin the process of being placed on a national liver transplant recipient list.

Symptoms and Causes

What are the symptoms of cirrhosis?

The symptoms of cirrhosis depend on the stage of your disease. In the beginning stages, you may not have any symptoms. If yous practise accept symptoms, some are general and could easily be mistaken for symptoms of many other diseases and illnesses.

Early on symptoms and signs of cirrhosis include:

Loss of appetite.
Feeling weak or tired.
Nausea.
Fever.
Unexpected weight loss.

Every bit liver function gets worse, other more commonly recognized symptoms of cirrhosis appear including:

Easy bruising and bleeding.
Yellow tint to your pare or the whites of your eyes (jaundice).
Itchy skin.
Swelling (edema) in your legs, feet and ankles.
Fluid buildup in your belly/abdomen (ascites).
Brownish or orange color to your urine.
Light-colored stools.
Confusion, difficulty thinking, retention loss, personality changes.
Claret in your stool.
Redness in the palms of your hands.
Spider-like blood vessels that surroundings small-scale, blood-red spots on your skin (telangiectasias).
In men: loss of sex bulldoze, enlarged breasts (gynecomastia), shrunken testicles.
In women: premature menopause (no longer having your menstrual period).

Is cirrhosis painful?

Yeah, cirrhosis can be painful, specially as the disease worsens. Hurting is reported past upwardly to 82% of people who have cirrhosis and more half of these individuals say their hurting is long-lasting (chronic).

Virtually people with liver disease study abdominal pain. Pain in your liver itself can feel like a dull throbbing hurting or a stabbing sensation in your right upper abdomen just nether your ribs. Full general abdominal pain and discomfort can likewise exist related to swelling from fluid retention and enlargement of your spleen and liver caused past cirrhosis.

Pain can come both from the diseases that pb to cirrhosis and/or cirrhosis can make the hurting from existing diseases worse. For instance, if yous accept not-alcoholic fatty liver disease and have obesity, you may also have osteoarthritis and cirrhosis makes your os and joint pain worse. Cirrhosis also causes an inflammatory state in your entire torso. Inflammation and your body's reaction to inflammation can cause general pain.

What causes cirrhosis?

The most mutual causes of cirrhosis of the liver are:

Booze abuse (alcohol-related liver disease caused by long-term [chronic] utilise of alcohol).
Chronic viral infections of the liver (hepatitis B and hepatitis C).
Fatty liver associated with obesity and diabetes and not booze. This condition is called non-alcoholic steatohepatitis.

Anything that amercement the liver can lead to cirrhosis. Other causes include:

Inherited diseases:
- Blastoff-one antitrypsin deficiency (build-upwards of an abnormal protein in the liver)
- Hemochromatosis (excess atomic number 26 stored in the liver).
- Wilson affliction (excess copper stored in the liver).
- Cystic fibrosis (pasty, thick mucus builds up in the liver).
- Glycogen storage diseases (liver can't store or pause down glycogen, a grade of carbohydrate).
- Alagille syndrome (built-in with fewer than normal number of bile ducts; affects bile flow and causes jaundice).
Autoimmune hepatitis (your body's own immune system attacks good for you liver tissue causing damage).
Diseases that harm or cake bile ducts in the liver (tubes that behave bile from the liver to other parts of digestive system; bile helps digest fats):
- Primary biliary cholangitis (bile ducts become injured, then inflamed, so permanently damaged).
- Primary sclerosing cholangitis (inflammation of the bile ducts leads to scarring and narrowing of the ducts and buildup of bile in the liver).
- Blocked bile duct (can cause infections, backup of products in the liver).
- Biliary atresia (infants are built-in with poorly formed or blocked bile ducts, causing damage, scarring, loss of liver tissue and cirrhosis).
Chronic heart failure (causes fluid to dorsum up in your liver, swelling in other areas of your body and other symptoms).
Rare diseases, such as amyloidosis, in which abnormal deposits in the liver of an abnormal protein called amyloid disrupts normal liver function.

Changes from liver diseases that lead to cirrhosis are gradual. Liver cells are injured and if injury – from whatever crusade – continues, liver cells get-go to die. Over fourth dimension, scar tissue replaces the damaged liver cells and the liver can't function properly.

What are the complications of cirrhosis?

At that place are many complications of cirrhosis of the liver. Considering cirrhosis develops over many years, some of these complications may be your outset noticeable signs and symptoms of the disease.

Portal hypertension: This is the almost common serious complexity. Portal hypertension is an increase in the pressure level in your portal vein (the large claret vessel that carries blood from the digestive organs to the liver). This increase in pressure is acquired past a blockage of claret flow through your liver as a result of cirrhosis. When blood flow through veins is partially blocked, veins in your esophagus, stomach or intestines tin become enlarged (a condition called varices). As the force per unit area in these veins builds, the veins can bleed or fifty-fifty outburst, causing severe internal haemorrhage.

Boosted complications of portal hypertension include:

Swelling (edema) in your legs, ankles or feet.
Buildup of fluids in your belly (called ascites).
Swelling/enlargement of your spleen (splenomegaly).
Formation and dilation (expansion) of blood vessels in the lungs (hepatopulmonary syndrome), leading to depression levels of oxygen in the claret and body and shortness of breath.
Failure of kidney part as a outcome of having portal hypertension equally a complication of cirrhosis (hepatorenal syndrome). This is a type of kidney failure.
Confusion, difficulty thinking, changes in your behavior, even coma. This occur when toxins from your intestines aren't removed by your damaged liver and circulate in the bloodstream and buildup in your brain (a condition chosen hepatic encephalopathy).

Hypersplenism: Hypersplenism is an overactive spleen. This condition causes quick and premature destruction of claret cells.

Infections: Cirrhosis increases your risk of getting and fighting serious infections, such as bacterial peritonitis (infection of the tissue that lines the inner wall of your abdomen).

Malnutrition : Your liver processes nutrients. A damaged liver makes this more difficult and leads to weight loss and general weakness.

Liver cancer: Most people who develop liver cancer have cirrhosis of the liver.

Liver failure: Many diseases and conditions crusade liver failure including cirrhosis of the liver. As its proper name implies, liver failure occurs when your liver isn't working well enough to perform its many functions.

Diagnosis and Tests

How is cirrhosis of the liver diagnosed?

Your healthcare provider will first ask about your medical history and over-the-counter and prescription drug use. They will also ask near any supplements or herbal products you lot may accept. Your provider may suspect y'all accept cirrhosis if you have a long history of alcohol abuse, injectable drug abuse or accept had hepatitis B or C and accept the symptoms listed in this commodity.

To diagnosis cirrhosis, your provider volition perform a physical examination and may club one or more of the following tests:

Physical test: Your doctor volition examine you, looking for the signs and symptoms of cirrhosis including: the red, spider-like blood vessels on your skin; yellowing of your pare or whites of your eyes; bruises on your skin; redness on your palms; swelling, tenderness or pain in your abdomen; enlarged firmer-feeling, bumpy texture to the lower edge of your liver (the part of your liver below the rib cage that can be felt).
Blood tests: If your medico suspects cirrhosis, your blood will be checked for signs of liver illness. Signs of liver impairment include:
- Lower than normal levels of albumin and blood clotting factors (lower levels means your liver has lost its ability to make these proteins).
- Raised levels of liver enzymes (suggests inflammation).
- College level of iron (may indicate hemochromatosis).
- Presence of autoantibodies (may indicate autoimmune hepatitis or primary biliary cirrhosis).
- Raised bilirubin level (suggests liver isn't working properly to remove bilirubin from the blood).
- High white blood prison cell count (indicates an infection).
- Loftier creatinine level (a sign of kidney disease that suggests late-stage cirrhosis).
- Lower levels of sodium (is an indicator of cirrhosis).
- Raised level of blastoff-fetoprotein (indicates presence of liver cancer).

In addition, other blood work will include a complete blood count to look for signs of infection and anemia caused past internal bleeding and a viral hepatitis test to bank check for hepatitis B or C.

Imaging tests: Imaging test show the size, shape and texture of the liver. These tests tin can likewise make up one's mind the amount of scarring, the corporeality of fat you take in your liver and fluid in your abdomen. Imaging tests of your liver that could be ordered include computerized tomography (CT) scan, abdominal ultrasound and magnetic resonance imaging (MRI). A special ultrasound, called a transient elastography, measures the fatty content and amount of stiffness in your liver. Two dissimilar types of endoscopies might exist ordered: an endoscopic retrograde cholangiopancreatography to notice bile duct problems, and/or upper endoscopy to observe enlarged veins (varices) or bleeding in your esophagus, tummy or intestines.
Biopsy: A sample of liver tissue (biopsy) is removed from your liver and examined under the microscope. A liver biopsy can confirm a diagnosis of cirrhosis, decide other causes or extent of liver harm or enlargement or diagnosis liver cancer.

Are at that place stages of cirrhosis?

If you lot take been diagnosed with cirrhosis of the liver, yous are already beyond the early stages of liver disease. Having cirrhosis ways your liver has scar tissue in it because information technology has been damaged.

Liver specialists and researchers have developed many different scoring systems to predict outcome and to guide handling for chronic liver disease. Some specific liver diseases also have their ain scoring systems. However, not every liver affliction has a scoring organization and at that place'south no scoring system if you lot happen to accept more than ane liver disease at the same time.

For these reasons, perhaps it's easier to talk near cirrhosis according to a classification organization you are more likely to hear from your healthcare provider. He or she may refer to you having either compensated cirrhosis or decompensated cirrhosis.

Compensated cirrhosis means you have cirrhosis but you don't yet accept noticeable symptoms (yous are asymptomatic). Your lab work and imaging findings may not exist abnormal. A liver biopsy may be the only manner to confirm a diagnosis of cirrhosis. Median survival in patients with compensated cirrhosis is approximately nine to 12 years. (Median is the middle signal in set of numbers, so an equal number of individuals survived less than 9 to 12 years as the number of individuals who survived over this time range.)

Decompensated cirrhosis means your cirrhosis has worsened to the point that yous accept noticeable symptoms. Your healthcare provider recognizes your status based on your history, physical and lab findings. You accept at least ane complexity, which includes jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome, variceal bleeding or liver cancer. You are usually admitted to the hospital for care. Median survival in patients with decompensated cirrhosis is approximately 2 years.

Management and Treatment

Is there a cure for cirrhosis of the liver?

No, there is no cure for cirrhosis. The impairment already done to your liver is permanent. All the same, depending on the underlying cause of your cirrhosis, in that location may be actions you can have to keep your cirrhosis from getting worse. These actions include:

Stop drinking alcohol.
Treat chronic hepatitis (if you take it).
Avert medications that stress the liver.
Consume a good for you, well-counterbalanced, depression-fat diet, such as the Mediterranean diet.

Follow other tips listed under the Prevention department in this article.

What are the goals of cirrhosis treatment?

The goals of treatment for cirrhosis of the liver are to:

Slow further damage to your liver.
Prevent and care for symptoms.
Prevent and treat complications.

How is cirrhosis of the liver treated?

Treatment depends on what's causing your cirrhosis and how much damage exists.

Although there is no cure for cirrhosis, treatments can delay or stop its progress and reduce complications.

Treatments for the causes of cirrhosis are every bit follows:

Alcohol-related liver disease: If you've adult cirrhosis from alcohol abuse, terminate drinking alcohol. If you need assistance, enquire your healthcare provider for recommendations for booze addiction treatment programs.
Hepatitis B or C: Several approved antiviral medications are available to treat hepatitis types B and C.
Nonalcoholic fat liver disease: Management of nonalcoholic fat liver disease includes losing weight, following a salubrious diet, getting physical exercise and following your provider'due south instructions for managing your diabetes.
Inherited liver diseases: Handling depends on the specific inherited affliction. Treatments are aimed at treating symptoms and managing complications. Treatment of alpha-1 antitrypsin deficiency may include medicine to reduce swelling in your abdomen and legs, antibiotics to treat infections and other medicines for complications. For hemochromatosis, treatment is to remove blood to reduce the level of iron in your blood. For Wilson disease, handling is medicines to remove copper from your body and zinc to prevent absorption of cooper. For cystic fibrosis, medications are prescribed to improve lung function, methods to articulate mucous and handling of complications. Treatment for glycogen storage diseases that involve the liver is to keep glucose at the right level.
Autoimmune hepatitis: Handling includes medications to suppress your immune system.
Diseases that damage or block bile ducts in the liver: Treatments include medications such as ursodiol (Actigall®) or surgery to open narrowed or blocked bile ducts.
Heart failure: Treatment depends on the cause and phase of your heart failure. Medications include drugs to treat high blood force per unit area, reduce cholesterol, remove excess fluids (edema) from your trunk and improve eye pumping function. Other treatments include implantation of devices to help pump blood or monitor heart rhythm, surgeries to unblock arteries or replace or repair heart valves and transplant surgery to supersede your heart.
Medications that may be contributing to cirrhosis: Your provider will review all of your medications to determine if any are causing bug for your liver and if so, stop the drug, lower the dosage or change to a dissimilar drug if possible.

How are the complications of cirrhosis treated?

Portal hypertension: Portal hypertension is mainly the effect of chronic stop-stage liver affliction. Treatment consists of treating its many complications. Treatments of portal hypertension include:

Giving beta blockers or nitrates to lower claret force per unit area in your veins.
Cut off claret flow through the varices to stop or reduce further bleeding with procedure using tiny elastic bands (band ligation) or with sclerotherapy.
Redirecting claret from the portal vein to reduce pressure in the portal vein and to control variceal bleeding. This is achieved using either one of two techniques – distal splenorenal shunt or transjugular intrahepatic portosystemic shunt.
Prescribing lactulose to blot toxins in the blood that result from hepatic encephalopathy, which cause symptoms including confusion and other mental changes.
Draining excess fluid in your abdomen (ascites) in a process called paracentesis or taking a diuretic medication to decrease actress fluids (edema) in your legs and other areas of your torso.

Bacterial peritonitis: Antibiotics and infusion of a poly peptide (albumin) will exist prescribed. Typically patients are admitted to the hospital for handling and monitoring. Following a diagnosis of bacterial peritonitis, an oral antibiotic will be prescribed for daily apply to prevent recurrence of infection.

Liver cancer: Treatment depends on the stage of your cancer and other factors. One or more treatments may be tried. Options include surgery to remove part of your liver or your whole liver (to be replaced with a new liver equally part of a liver transplantation) and nonsurgical tumor-destroying methods including ablation, chemotherapy, targeted therapy (drugs zero in on cancer genes or tissue), immunotherapy and radiations bead therapy (inject bead that give off radiation into the claret vessels that feed the tumor).

Kidney failure: Treatment may include medication, dialysis and kidney transplant, depending on the cause and extent of failure.

Liver failure: Handling depends on if you accept acute or chronic failure. For chronic liver failure, diet and lifestyle changes include stopping alcohol and medications that harm the liver; eating less red meat, cheese and eggs; losing weight; controlling high blood pressure level and diabetes and cutting downward on salt.

Acute treatments for liver failure include intravenous fluids to maintain blood pressure, laxatives to aid affluent toxins from the body and claret glucose monitoring.

If yous have either acute or chronic liver failure, your liver specialist may recommend a liver transplant. Liver transplants can come from a living or deceased donor. Only a portion of the donor liver needs to be transplanted. The liver is the only homo organ capable of growing dorsum.

Many tests are required of both you (the liver transplant recipient) and the person altruistic a portion of their liver or the cadaver liver (liver from a deceased person). If your doctors determine that yous demand a liver transplant, you volition be placed on a national liver transplant waiting listing, which lists patients by blood blazon, body size and severity of terminate-phase liver illness.

Prevention

How can I prevent cirrhosis of the liver?

Nutrient and potable problems:

Don't corruption booze. If yous do drink alcohol, limit how much y'all drink and how often. If yous drink more than two drinks a day if you are a man or more than one if you are a woman, you are increasing your run a risk. A drink is a drinking glass of wine or a 12-ounce can of beer or a one.5 ounce serving of hard liquor. If you lot accept liver disease, you should non drink alcohol at all.
Consume a well-balanced, low-fat diet, such equally the Mediterranean diet. A well-balanced healthy diet consists of fruits, vegetables, lean proteins and whole grains.
Don't eat raw seafood, especially oysters and clams. These foods can comprise a leaner that can cause serious affliction.
Cut dorsum on the amount of salt in your nutrition. Use other seasonings to flavor your foods.

Healthy trunk habits:

Maintain a good for you weight. Excess body fatty tin damage your liver. Inquire your healthcare provider for a weight loss programme if yous are overweight.
Practice regularly.
Encounter your healthcare provider regularly for check-ups. Follow medical recommendations to control obesity, diabetes, hypertension (high blood pressure level) and cholesterol (high bad cholesterol [LDL] and/or low good cholesterol [HDL]) and high triglycerides.
Quit smoking if you smoke.

Healthy liver practices:

Avoid high-risk behaviors that can lead to infection with hepatitis B or C, such as sharing needles for illegal drug utilise or having unprotected sexual practice.
Get vaccinated against hepatitis B. If yous already have hepatitis, enquire your provider if drug treatment is appropriate for you.
Get your annual flu shot and ask if a pneumonia vaccine makes sense for you (people with cirrhosis are more likely to get infections).
Avoid nonsteroidal anti-inflammatory drugs (such as ibuprofen [Advil®, Motrin®] indomethacin [Indocin®] celecoxib [Celebrex®] and aspirin) and loftier doses of acetaminophen (Tylenol®). Acetaminophen can be taken safely at a dose upwards to 2,000 mg daily. These drugs can cause or worsen liver role.
Take all medications and keep all appointments every bit recommended by your healthcare provider.

Outlook / Prognosis

What tin can I look if I accept cirrhosis?

Harm already done to your liver is permanent. But your liver is a big organ. If function of your liver is still working, you might be able to wearisome the progression of disease, depending on its cause. For instance, if your cirrhosis is caused by alcohol abuse, you need to cease drinking immediately. If you lot have obesity or diabetes, you lot will need to lose weight and manage your blood carbohydrate and then you can lower the damage acquired by fat liver disease.

You lot and your healthcare provider or team volition work together to determine what'due south causing your cirrhosis and what complications may have resulted from your cirrhosis and care for them accordingly.

What's the life expectancy for people with cirrhosis?

Life expectancy depends on several factors including the cause and severity of your cirrhosis, your response to treatments, presence of cirrhosis complications, your age and whatever other existing general health problems. Ask your liver specialist about your life expectancy since every person is unique, with unique overall health issues and specific liver wellness bug.

If your cirrhosis is advanced, liver transplantation may exist an option. Yous and your doctors will discuss if this is an option for y'all.

What's a Child-Turcotte-Pugh score and MELD score?

A Child-Turcotte-Pugh (CTP) score, also known only as the Child-Pugh score, is a clinical score that tells your doctors how severe your liver disease is and forecasts your expected survival rate. The scoring system provides a score on the presence of v clinical measures (the lab values of bilirubin, serum albumin and prothrombin fourth dimension; presence of ascites and hepatic encephalopathy) and the degree of severity of each of these measures.

Child-Turcotte-Pugh Score
Class Condition	Severity of Liver Illness	Two-Year Survival Charge per unit
Class A	Mild	85%
Class B	Moderate	60%
Class C	Severe	35%

The Model for End-stage Liver Illness (MELD) score is a score that is used to rank the urgency for a liver transplant. The worse your liver function is, the higher your MELD score and the higher your position is on the transplant list. The Pediatric End-stage Liver Disease (PELD) score is similar to MELD but is a scoring system for children under the age of 12.

Living With

When should I call 911 or get to the emergency room?

If y'all have cirrhosis and experience the following, phone call 911:

Your poop (stools) are black and tarry or contain claret (may be maroon or bright reddish in color).
You are vomiting blood.
The whites of your eyes are turning yellow.
You take difficulty breathing.
You take abdominal swelling.
You lot have muscle tremors or shakiness.
You are confused, irritable, disoriented, sleepy, forgetful or "foggy."
You have a change in your level of consciousness or alertness; you pass out.

What blazon of healthcare providers will care for my cirrhosis?

Depending on the stage of your cirrhosis, different healthcare providers may be involved in your intendance. Healthcare professionals likely to be office of your care team include:

Your master intendance provider.
Gastroenterologist (doctor who specializes in weather condition of your digestive tract).
Hepatologist (medico who specializes in conditions of your liver).
Nephrologist (doctor who specializes in atmospheric condition of your kidney).
Dietitian.
Members of a liver transplant team include: hepatologist, transplant surgeon, anesthesiologist, infectious affliction specialist, nephrologist, dietitian, transplant chemist, concrete and occupational therapist, case manager/social worker and nurses.

A note from Cleveland Dispensary

Cirrhosis of the liver is a belatedly-stage consequence of liver disease and its complications. Cirrhosis causes your liver to non function properly. Your liver plays a vital office in many of the processes and functions that continue you live.

Although scarring from liver disease causes permanent damage, it's still possible to live a long life. Depending on the underlying cause, information technology'due south possible to irksome or stop cirrhosis from worsening. Many of the causes and complications that lead to cirrhosis are treatable or manageable. If you beverage alcohol, stop. If you have nonalcoholic fatty liver disease, lose weight and command your metabolic take a chance factors. If you take diabetes, make sure y'all are post-obit your healthcare provider'southward direction recommendations. Take all medications for all your medical weather as directed past your healthcare team. Get vaccinated for hepatitis A and B.

If you take end-stage cirrhosis, don't lose hope. You and your healthcare squad will piece of work together to closely manage your condition and put you lot on a wait list for a donor liver.