What is the Best Treatment for Liver Cirrhosis?

Liver cirrhosis is the late stage of chronic liver disease in which healthy liver tissue is gradually replaced by scar tissue due to long-term injury and inflammation. Please continue reading to learn about some of the treatment options for cirrhosis of the liver.

What causes liver cirrhosis?

Liver cirrhosis occurs when healthy tissue in the liver is injured and attempts to repair itself, forming scar tissue as a result. While scarring is the diseased liver’s attempt to save itself, too much of the scar tissue prevents the liver from functioning normally. The injury to the liver cells can be from chronic alcohol use, drug use, viral infections, or metabolic causes like nonalcoholic fatty liver disease. In addition to fatty liver caused by diabetes and obesity, alcohol-related liver disease and hepatitis B and C viral infections are some of the common causes of liver cirrhosis.

Less commonly, autoimmune liver diseases (autoimmune hepatitis, primary sclerosing cholangitis, primary biliary cholangitis), inherited liver diseases, other genetic disorders (cystic fibrosis, glycogen storage disorders, Wilson’s disease), toxins, and congestive heart failure can cause cirrhosis of the liver.

What is drug-induced hepatitis?

Drug-induced liver injury or drug-induced hepatitis is caused by drugs, including alcohol, herbal, and dietary supplements, causing inflammation of the liver. This condition can range from mild to severe. As serious as other causes of liver failure mentioned above are, drug-induced hepatitis is the most common cause of acute liver failure requiring hospitalization and, subsequently, liver transplant.

Certain over-the-counter and prescription medicines can cause drug-induced liver injury. While taking too much acetaminophen, the active ingredient of Tylenol and other combination drug products, can cause acute liver failure in many cases, NSAIDs (nonsteroidal anti-inflammatory drugs), such as ibuprofen and naproxen, can also cause drug-induced hepatitis. Keep in mind that genetic factors, alcohol intake, and other concurrent medications can increase the risk of liver injury. That’s why it is very important to read the drug product label carefully to make sure you don’t take over the daily recommended amount of certain medications, especially with acetaminophen (Tylenol) being a common active ingredient in many over-the-counter cough and cold products.

Below are other medications that can cause drug-induced hepatitis:

Anabolic steroids
Birth control pills
Antibiotics, such as anti-tuberculosis medicine like isoniazid, especially when being used with rifampin; other antibiotics that have been reported to cause liver injury include penicillins (amoxicillin-clavulanate) and antifungal agents like ketoconazole and tetracyclines
Antiviral, such as HIV therapy
Cholesterol-lowering drugs, such as statins
Certain anti-seizure medications
Immune system suppressants
Certain herbal supplements

Does liver cirrhosis lead to liver failure?

Liver cirrhosis is a progressive and irreversible disease that causes permanent scarring. In the early stages, the liver compensates for the scarring, and you do not have any symptoms of decreased liver function (this is called compensated cirrhosis). However, as the liver function declines further, symptoms develop (this is called decompensated cirrhosis). Ultimately, the condition progresses to end-stage liver disease and liver failure. Cirrhosis of the liver also increases your chances of developing hepatocellular carcinoma (liver cancer).

What are the symptoms of liver cirrhosis?

Signs and symptoms of early-stage cirrhosis include nausea, loss of appetite, upper abdominal pain, fatigue, malaise (feeling unwell), spider angiomas (visible blood vessels), and palmar erythema (redness of the palms).

In the advanced stages, cirrhosis of the liver can cause jaundice (yellowing of the skin and whites of the eyes), itchy skin, dark urine, light-colored stools, difficulty digesting fats, small yellow bumps on the skin or eyelids, unexplained weight loss, loss of muscle tissue bulk, tremors, difficulty with muscle control, confusion, mood changes, disorientation, and hormonal changes.

Compression of the portal vein that runs through the liver can lead to portal hypertension (high blood pressure) with signs and symptoms including peripheral oedema (swelling of the hands and feet), ascites (swelling of the abdomen), severe bleeding, blood in vomit due to oesophageal varices (enlarged veins in the esophagus), blood in the stool due to internal bleeding, low urine output due to chronic kidney failure, and shortness of breath or difficulty breathing due to chronic respiratory failure.

Can you heal a liver with cirrhosis?

You cannot heal a liver with cirrhosis. The damage caused by liver cirrhosis is irreversible and cannot be cured, and typically requires liver transplantation. However, if the cause of the liver disease is identified and treated early, it is possible to slow the progress of liver cirrhosis.

How do doctors diagnose cirrhosis of the liver?

Doctors can diagnose cirrhosis of the liver based on symptoms, medical history, physical exam, medical tests (blood tests, laboratory tests, imaging tests), and a liver biopsy.

What is the treatment for liver cirrhosis?

Treatment for cirrhosis of the liver consists of identifying and treating the underlying cause.

If cirrhosis is caused by alcohol consumption, doctors will advise you to stop drinking alcohol. For nonalcoholic fatty liver disease, treatment consists of managing metabolic risk factors such as high cholesterol, high blood sugar, and obesity. If the cause of liver cirrhosis is viral hepatitis (chronic hepatitis C or B), your physician may prescribe antiviral drugs to suppress or cure the infection. If liver cirrhosis is due to an autoimmune disease, corticosteroids and immunosuppressants can be used to manage it.

Sometimes, the only treatment option is medications to manage the symptoms of cirrhosis. Your provider will also recommend lifestyle changes to promote a healthy liver (eat a healthy diet, lose weight, and take precautions to prevent infection). The last resort in cirrhosis treatment is a liver transplant when the liver damage is extensive.

How long does it take to recover from cirrhosis of the liver?

Before permanent scarring develops, the liver’s ability to regenerate itself can restore functionality. It is possible to recover from liver damage caused by drinking alcohol, hepatitis infections, and nonalcoholic fatty liver disease over a period of several months to years and prevent further liver damage. However, once you develop cirrhosis and liver scarring, it is irreversible.

Do people with liver cirrhosis need a liver transplant?

Liver transplants are an option for severe cases of cirrhosis of the liver where the liver damage cannot be controlled with other treatments.

What is the life expectancy of a person with cirrhosis of the liver?

The life expectancy of a person with cirrhosis of the liver depends on the extent of the liver damage and the stage of liver cirrhosis. For patients with compensated cirrhosis (early-stage liver cirrhosis), the average life expectancy can be 12 years or more. In patients with decompensated cirrhosis (end-stage liver disease), the average life expectancy without liver transplantation is approximately 2 years.

What is the best natural medicine for cirrhosis of the liver?

Natural remedies such as Xiao-Chai-Hu-Tang (a Chinese herbal medicine), Minor Bupleurum Formula, silymarin, long pepper, and holy basil are sometimes used to treat chronic hepatitis, liver cirrhosis, and liver cancer. However, there is no scientific evidence that confirms these natural herbal supplements can benefit people with liver diseases. It is best to avoid these herbal remedies or use them with extreme caution because they can cause serious side effects and interact with other medications, leading to adverse reactions.

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