You may also feel pain in other areas as the cirrhosis causes inflammation throughout the body. Gas pain? Stool issues? Sign up for the best tips to take care of your stomach.
ACG clinical guideline: alcoholic liver disease. Am J Gastroenterol. AME Medical Journal. Morgan TR. Treatment of alcoholic liver disease. Gastroenterol Hepatol. Cleveland Clinic. Cirrhosis of the liver. Updated November 1, Fairbanks KD. Alcoholic liver disease. Updated November 2, Your Privacy Rights. To change or withdraw your consent choices for VerywellHealth. At any time, you can update your settings through the "EU Privacy" link at the bottom of any page.
These choices will be signaled globally to our partners and will not affect browsing data. We and our partners process data to: Actively scan device characteristics for identification. I Accept Show Purposes. Table of Contents View All. Table of Contents. Recap In the early stages of alcoholic liver disease, you may have no symptoms. Recap Your prognosis is based on your individual lab results. It filters harmful substances from the blood and converts food and fluid into the nutrients and energy the body needs.
It also helps clot the blood. Causes of liver disease include viral hepatitis, autoimmune disorders, cancer, obesity, alcohol, drugs, toxins and genetics.
Changes that can occur with end-stage liver disease include:. Jaundice is a buildup of bile in the body that causes the skin and eyes to turn yellow. Bile contains a pigment called bilirubin that causes this yellow colour. Sometimes the buildup of bilirubin can be treated with a stent to keep the bile duct open. A buildup of bile can also cause itchiness. Itchiness can be very distressing and difficult to treat. These enlarged veins can rupture and pose an increased risk of bleeding.
Fluid buildup in the abdomen can develop and be uncomfortable. Fluid buildup may also cause nausea, loss of appetite, and abdominal and back pain. The person may also be at risk of developing an infection when this fluid is present. Bilirubin is a yellow chemical found in hemoglobin.
Your body builds new cells to replace broken down red blood cells and the old ones are processed in the liver. The breakdown of the old cells releases bilirubin. A healthy liver processes bilirubin out of the body. If the liver cannot successfully do this function, bilirubin builds up in the body and your skin or the whites or your eyes may look yellow. This is called jaundice.
Jaundice does not only occur in people with cirrhosis. Many healthy babies have jaundice during the first week of life. Jaundice can also be due to blood diseases, genetic conditions, blockages of bile ducts, infections like hepatitis A , and even some medications. When blood cannot flow through the portal vein into the liver it is forced to find new pathways, such as through the veins in the stomach and esophagus. These enlarged veins are called varices.
These small veins are not meant to carry so much blood. When overloaded with blood, these veins can balloon, leak blood or even rupture, causing life-threatening bleeding. Signs of bleeding varices include:. Doctors can view these varices by inserting an endoscope a thin flexible tube through your mouth, down to your esophagus and stomach.
Endoscopies are very important to avoid varices from bursting and bleeding. Doctors use endoscopies to check on the varices and, if needed, band them, or tie them off, to strangle the vein and keep them from bursting. Liver cancer is cancer that begins in the cells of your liver. While several types of cancer can form in the liver, the most common type of liver cancer is hepatocellular carcinoma , or HCC, which begins in the main type of liver cells hepatocytes.
Liver cancer is one of the leading causes of cancer-related deaths worldwide. Over the last 30 years, rates of liver cancer have tripled in the United States. While most other common cancers have seen improved survival rates during this time period, liver cancer death rates have doubled. It is very rare to develop HCC without first having cirrhosis. Because of this, when someone has been diagnosed with advanced fibrosis F3 or cirrhosis they should receive regular surveillance for liver cancer.
Finding and diagnosing liver cancer as soon as possible is essential. Early detection offers more potentially curative options, like resection where the cancer and surrounding liver tissue is removed and transplant.
Learn more in our liver cancer resource center. Liver transplantation is a surgical procedure performed to remove a diseased or injured liver from one person and replace it with a whole or a portion of a healthy liver from another person, called the donor. Since the liver is the only organ in the body able to regenerate, or grow back, a transplanted segment of a liver can grow to normal size within a few months.
Often, transplanted livers are from people who were registered donors who passed away. Since the liver has such regenerative ability, however, it is possible for a living person to donate a portion of his or her liver to someone in need of a transplant. To learn more about Liver Transplantation, click here. To learn more about living donor liver transplantation, please visit our new Living Donor Liver Transplantation Information Center. The best thing anyone can do for their health is to stay engaged in their healthcare.
Be an active member of your care team by regularly visiting your healthcare provider, undergoing routine surveillance when needed, making the most of your appointments by asking questions and learning more about your health.
When possible, provide your doctor a detailed family health history to determine your own risks for liver disease. There are genetic or hereditary liver diseases that can run in families. Sometimes our genes put us at a greater risk for developing lifestyle related liver disease like Nonalcoholic Fatty Liver Disease and Alcohol Related Liver Disease.
Being honest with our healthcare provider about your lifestyle is another important factor in determining risk for liver disease. Because your liver processes everything you eat, drink, breath, or absorb through our skin, it can be impacted by many different factors. Be sure your doctor knows how often you take each type of medication and review medications that may have been prescribed by another healthcare provider. It is best to ask your healthcare provider before you begin taking any medications to be sure you are making the best choice for your health.
Many medications can cause damage to the liver. Being open with your healthcare provider about your diet, exercise, and other lifestyle habits is very important! Your doctor can provide you the best care when they are aware of all the factors contributing to your health.
The Progression of Liver Disease. Your liver performs essential, life-sustaining functions. The Healthy Liver. Hepatitis Inflammation. Did you know that hepatitis simply means inflammation of the liver?
Fibrosis Scarring. How Fibrosis Develops When someone has liver disease, their liver enters into a very dangerous cycle. Cirrhosis Severe Scarring. The final stage of fibrosis is cirrhosis… Cirrhosis is where your liver is severely scarred and permanently damaged. Ascites The increased pressure of portal hypertension causes fluid to seep out and pool in the abdominal cavity.
Hepatic Encephalopathy Ammonia is a waste product made when our body digests protein. Eating can be a problem because there is less room for food. Even breathing can be a problem, especially when the person is lying down. But the most dangerous problem with ascites is infection, which can be life-threatening.
Ascites may go away with a low salt diet, and with diuretics water pills ordered by your provider. But sometimes a provider must actually drain the fluid from the belly using a special kind of needle. A liver that is working poorly may not be able to get rid of toxic substances like ammonia which comes from the intestines , and it may allow these substances to go into the brain and cause confusion. Besides confusion, toxins in the brain cause changes in sleep, mood, concentration, and memory.
If extremely serious, it can even cause a coma. These are all symptoms of hepatic encephalopathy. With encephalopathy, a persons may have problems driving, writing, calculating, and performing other activities of daily living. Signs of encephalopathy are trembling and hand "flapping.
A liver that is working poorly cannot get rid of bilirubin, a substance that produces a yellowing of the eyes and skin called jaundice.
Too much alcohol and some medicines can also lead to jaundice. The model for end-stage liver disease MELD score measures the severity of cirrhosis.
The MELD score was developed to predict the day survival of people with advanced cirrhosis. The MELD score is based on three blood tests:. MELD scores usually range between 6 and 40, with a score of 6 indicating the best likelihood of day survival. The diagnosis of cirrhosis is usually based on the presence of a risk factor for cirrhosis, such as alcohol use or obesity, and is confirmed by physical examination, blood tests, and imaging.
The doctor will ask about the person's medical history and symptoms and perform a thorough physical examination to observe for clinical signs of the disease. For example, on abdominal examination, the liver may feel hard or enlarged with signs of ascites. The doctor will order blood tests that may be helpful in evaluating the liver and increasing the suspicion of cirrhosis.
Patient with cirrhosis may have an upper endoscopy pronounced "en-dahs-cup-ee" periodically see figure at right. A thin tube with a camera can be inserted into the mouth to look for varices in the esophagus food tube and the stomach.
The endoscopy is repeated every few years to monitor for varices. To view the liver for signs of enlargement, reduced blood flow, or ascites, the doctor may order a computerized tomography CT scan, ultrasound, magnetic resonance imaging MRI , or liver scan. The doctor may look at the liver directly by inserting a laparoscope into the abdomen.
A laparoscope is an instrument with a camera that relays pictures to a computer screen. A liver biopsy can confirm the diagnosis of cirrhosis but is not always necessary. A biopsy is usually done if the result might have an impact on treatment. The biopsy is performed with a needle inserted between the ribs or into a vein in the neck.
Precautions are taken to minimize discomfort. A tiny sample of liver tissue is examined with a microscope for scarring or other signs of cirrhosis. Sometimes a cause of liver damage other than cirrhosis is found during biopsy.
Treatment for cirrhosis depends on the cause of the disease and whether complications are present. The goals of treatment are to slow the progression of scar tissue in the liver and prevent or treat the complications of the disease.
Hospitalization may be necessary for cirrhosis with complications. Because malnutrition is common in people with cirrhosis, a healthy diet is important in all stages of the disease. Health care providers recommend a meal plan that is well balanced. If ascites develops, a sodium-restricted diet is recommended. A person with cirrhosis should not eat raw shellfish, which can contain a bacterium that causes serious infection.
To improve nutrition, the doctor may add a liquid supplement taken by mouth or through a nasogastric tube-a tiny tube inserted through the nose and throat that reaches into the stomach.
People with cirrhosis are encouraged not to consume any alcohol or illicit substances, as both will cause more liver damage. Because many vitamins and medications-prescription and over-the-counter-can affect liver function, a doctor should be consulted before taking them. For edema and ascites, the doctor will recommend diuretics-medications that remove fluid from the body. Large amounts of ascitic fluid may be removed from the abdomen and checked for bacterial peritonitis.
Oral antibiotics may be prescribed to prevent infection. Severe infection with ascites will require intravenous IV antibiotics. The doctor may prescribe a beta-blocker or nitrate for portal hypertension. Beta-blockers can lower the pressure in the varices and reduce the risk of bleeding. Gastrointestinal bleeding requires an immediate upper endoscopy to look for esophageal varices.
The doctor may perform a band-ligation using a special device to compress the varices and stop the bleeding. People who have had varices in the past may need to take medicine to prevent future episodes. Hepatic encephalopathy is treated by cleansing the bowel with lactulose-a laxative given orally or in enemas.
Antibiotics are added to the treatment if necessary. Patients may be asked to reduce dietary protein intake.
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