What is Liver cirrhosis?
Liver cirrhosis is scarring of the liver that involves the formation of fibrous or scar tissue related to the
destruction of the normal liver architecture. It is the result of long-standing injury most commonly
due to alcohol in excess but there are a number of other important causes (see below).
The loss of liver cells and the destruction of the normal architecture prevent the liver from functioning
normally. It plays an important part in digestion of food but it also has a major role in metabolising
drugs and making proteins, including those that help the blood to clot.
Cirrhosis is so serious that only 30% of patients with this problem will survive five years after
diagnosis and the outlook is worse if the cause is alcohol and the patient continues to drink.

Symptoms
Patients with cirrhosis may have few or no symptoms and signs in the early stages. Some of the
symptoms may be nonspecific, that is, they don't suggest that the liver is their cause. As the disease
worsens, some may experience the follwing symptoms:
 Yellowing of the skin (jaundice)
 Lack of energy (fatigue)
 Weakness
 Loss of appetite
 Itchy skin
 Easy bruising from decreased production of blood clotting factors by the diseased liver.
 Weight loss or sudden weight gain
 Fever
 A dark tint to the urine

Causes
In the western world, hepatitis C, fatty liver and alcohol abuse are the most common causes, but
anything that damages the liver can cause cirrhosis:
• Fatty liver related to obesity and diabetes.
• Chronic viral infections of the liver incuding hepatitis B, C and D
• Repeated bouts of heart failure with fluid backing up into the liver.
• Blockage of the bile duct, which carries bile formed in the liver to the intestines where it helps in the
digestion of fats. In babies, this can be caused by biliary atresia in which bile ducts are absent or
damaged, causing bile to back up in the liver. In adults, bile ducts may become inflamed, blocked or
scarred, due to another liver disease called primary biliary cirrhosis.
• Certain inherited diseases such as:
o Cystic fibrosis.
o Glycogen storage diseases, in which the body is unable to process glycogen, a form of sugar that is
converted to glucose and serves as a source of energy for the body.
o Alpha 1 antitrypsin deficiency, an absence of a specific enzyme in the liver.
o Diseases caused by abnormal liver function, such as hemochromatosis, a condition in which excessive
iron is absorbed and deposited into the liver and other organs, and Wilson's disease, caused by the
abnormal storage of copper in the liver.
Less common causes of cirrhosis include unusual reactions to some drugs and prolonged exposure to
toxins, as well as chronic heart failure (cardiac cirrhosis). In certain parts of the world (i.e. Northern
Africa), infection of the liver with a parasite is the most common cause of liver disease and cirrhosis.

Dignosis
The cirrhosis is diagnosed on the basis of symptoms, laboratory tests, the medical history, and a
physical examination. During a physical exam, the doctor may observe changes in how your liver feels
or how large it is.
If looking at the liver is necessary to check for signs of disease, the doctor might order a computerized
axial tomography (CAT) scan, ultrasound, magnetic resonance imaging (MRI), or a scan of the liver
using a radioisotope (a harmless radioactive substance that highlights the liver). Or the doctor might
look at the liver using a laparoscope, an instrument that is inserted through the abdomen and relays
ictures back to a computer screen.
A liver biopsy will confirm the diagnosis. For a biopsy, your doctor uses a needle to take a tiny sample
of tissue from liver, then examines it under the microscope for scarring or other signs of disease.
In some cases, cirrhosis is diagnosed during surgery when the doctor is able to see the entire liver. The
liver also can be inspected through a laparoscope, a viewing device that is inserted through a tiny
incision in the abdomen.

Treatment and prevention
Treatment depends on the causes and stage of the cirrhosis. It can stop or delay the progress of the
cirrhosis and treating complications. Stopping or reversing the process requires removal of the cause, as
in the following cases:
Alcoholic cirrhosis: abstain from alcohol and intake of an adequate wholesome diet.
Cirrhosis caused by viral hepatitis: experimental approaches that include the use of interferon to
improve immune responses to viral infection or corticosteroids to help destroy the virus.
Cirrhotic patients with jaundice: use supplemental fat soluble vitamins may be helpful.
Certain types of cirrhosis caused by chronic hepatitis: corticosteroids are indicated.
Wilson's disease: removal of excessive copper.
Hemochromatosis: removal of excess iron.
When complications cannot be controlled or when the liver becomes so damaged from scarring that it
completely stops functioning, a liver transplant is necessary. In liver transplantation surgery, a diseased
liver is removed and replaced with a healthy one. About 80 to 90 percent of patients survive liver
transplantation.
There are several ways to reduce your risk of cirrhosis: • Avoid excessive drinking. It is best to limit
how much you drink and how often. Two drinks a day for men and one drinks for women. Avoid
alcohol completely if you have liver diseases.
• Eat a well-balanced, low-fat diet and take vitamins.
• Get vaccinated against hepatitis if in a high-risk group.
• Avoid high-risk sexual behavior such as unprotected sexual contact with multiple partners.
• Be careful around synthetic chemicals, such as cleaning products and pesticides. If you come into
contact with toxic chemicals often, wear protective clothing and follow product directions.