What is cirrhosis?

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Cirrhosis is a late stage of liver disease characterized by extensive scarring (fibrosis) of the liver tissue. It results from chronic liver damage, which can be caused by a variety of factors, including long-term alcohol abuse, chronic viral hepatitis (such as hepatitis B or C), fatty liver disease, and other conditions that lead to ongoing liver inflammation and injury.

Key Features of Cirrhosis

Liver Scarring: In cirrhosis, healthy liver tissue is gradually replaced by scar tissue. This scar tissue disrupts the normal structure of the liver, blocking the flow of blood through the liver and impairing its ability to function properly.
Liver Dysfunction: As the liver becomes more scarred, its ability to perform vital functions diminishes. The liver is responsible for processing nutrients, detoxifying harmful substances, producing bile for digestion, and manufacturing proteins important for blood clotting. Cirrhosis severely compromises these functions.
Complications of Cirrhosis:
- Portal Hypertension: Scar tissue obstructs blood flow through the liver, leading to increased pressure in the portal vein (which carries blood from the digestive organs to the liver). This can cause enlarged veins (varices) in the esophagus and stomach, which are prone to bleeding.
- Ascites: Accumulation of fluid in the abdomen, known as ascites, is a common complication of cirrhosis, resulting from the liver’s impaired ability to regulate fluid balance.
- Hepatic Encephalopathy: The buildup of toxins in the blood due to reduced liver function can affect brain function, leading to confusion, memory loss, and in severe cases, coma.
- Jaundice: The liver’s reduced ability to process bilirubin (a byproduct of red blood cell breakdown) can cause jaundice, characterized by yellowing of the skin and eyes.
- Increased Risk of Liver Cancer: Cirrhosis is a major risk factor for hepatocellular carcinoma, the most common type of liver cancer.
Causes of Cirrhosis:
- Chronic Alcoholism: Prolonged alcohol abuse is a leading cause of cirrhosis, as it continuously damages liver cells.
- Chronic Viral Hepatitis: Hepatitis B and C infections can cause long-term liver inflammation that leads to cirrhosis.
- Non-Alcoholic Steatohepatitis (NASH): A severe form of non-alcoholic fatty liver disease (NAFLD) that involves inflammation and scarring.
- Genetic Disorders: Conditions like hemochromatosis (excess iron accumulation) and Wilson’s disease (copper accumulation) can also cause cirrhosis.
Diagnosis and Monitoring:
- Imaging Tests: Ultrasound, CT scans, and MRIs can show the structure of the liver and the extent of scarring.
- Liver Biopsy: A small sample of liver tissue may be taken to confirm the diagnosis and assess the severity of cirrhosis.
- Blood Tests: Liver function tests, including measurements of bilirubin, albumin, and liver enzymes, help assess how well the liver is functioning.
Treatment:
- Managing Complications: Treatment focuses on managing symptoms and complications, such as reducing portal hypertension, preventing variceal bleeding, and treating infections.
- Lifestyle Changes: Abstinence from alcohol, maintaining a healthy diet, and managing underlying conditions like hepatitis can slow the progression of cirrhosis.
- Liver Transplantation: For patients with advanced cirrhosis, liver transplantation may be the only viable option.

Prognosis

Cirrhosis is a progressive condition, and without treatment, it can lead to liver failure, life-threatening complications, and death. However, early detection and management of the underlying causes can slow or even halt its progression.

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