Liver

Cirrhosis

Late-stage liver scarring from chronic damage, leading to liver failure and portal hypertension.

Overview

Cirrhosis is late-stage liver scarring (fibrosis) caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. Each time the liver is injured, it tries to repair itself, forming scar tissue. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function.

Causes

Chronic alcohol abuse (most common in India)
Chronic Hepatitis B or C infection
Non-alcoholic fatty liver disease (NAFLD/NASH)
Autoimmune hepatitis
Primary biliary cholangitis
Hemochromatosis (iron overload)
Wilson's disease (copper accumulation)
Cryptogenic (unknown cause)

Risk Factors

Heavy alcohol consumption (>60g/day for men, >40g/day for women)
Chronic viral hepatitis B or C
Obesity and metabolic syndrome
Type 2 diabetes
Family history of liver disease
Exposure to hepatotoxic drugs

Symptoms

Fatigue and weakness

Easy bruising and bleeding

Jaundice (yellow skin/eyes)

Ascites (fluid in abdomen)

Swelling in legs (edema)

Spider angiomas on skin

Confusion (hepatic encephalopathy)

Loss of appetite and weight loss

Diagnosis

Liver function tests (LFT)
Complete blood count (low platelets)
Fibroscan (transient elastography)
Ultrasound abdomen with Doppler
CT/MRI for complications
Upper GI endoscopy for varices
Liver biopsy (gold standard, rarely needed now)

Treatment Options

1Lifestyle modification (alcohol cessation)

2Antiviral therapy for Hepatitis B/C

3Diuretics for ascites

4Beta-blockers for portal hypertension

5Endoscopic variceal banding

6TIPS procedure

7Liver transplantation

Surgical Treatment

Surgical options include: TIPS (Transjugular Intrahepatic Portosystemic Shunt) for portal hypertension, shunt surgery for variceal bleeding, liver resection for HCC in cirrhosis, and liver transplantation for end-stage disease.

Recovery

Cirrhosis management is lifelong. Compensated cirrhosis patients can live well with proper management. Decompensated cirrhosis requires close monitoring. Liver transplant offers definitive cure for eligible patients.

Prevention

Limit alcohol intake or abstain completely
Get vaccinated for Hepatitis B
Practice safe sex and avoid sharing needles
Maintain healthy weight
Manage diabetes and metabolic syndrome
Regular liver health screening if at risk

Frequently Asked Questions

Can cirrhosis be reversed?

Early fibrosis can be reversed if the cause is removed (e.g., stopping alcohol, treating hepatitis). True cirrhosis (advanced scarring) is generally irreversible, but progression can be halted and complications managed.

What is the life expectancy with cirrhosis?

Compensated cirrhosis (no complications): 10-12+ years. Decompensated cirrhosis: variable, depending on MELD score and treatment. Liver transplant can offer normal life expectancy.

When is liver transplant needed?

Transplant is considered when cirrhosis becomes decompensated (ascites, variceal bleeding, hepatic encephalopathy, jaundice) or when liver cancer develops in cirrhosis that cannot be treated otherwise.

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