Cirrhosis of the liver affects many individuals. The scarring that occurs can lead to liver failure. Several serious complications can result, some of which can be life-threatening. Treatment is now available to stop cirrhosis from getting worse.
What is cirrhosis?
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. In Anguilla, chronic alcoholism is the most common cause of cirrhosis. Excessive use of alcohol, over a number of years, is one sure way of getting cirrhosis. The liver is a remarkable organ and it tries to heal itself when it is damaged. When healing occurs scarring (fibrosis) occurs. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function. Advanced cirrhosis is life-threatening. The liver damage done by cirrhosis generally cannot be undone. If liver cirrhosis is diagnosed early and the cause is treated, further damage can be limited.
What causes cirrhosis?
A number of things can damage the liver. Some of the more common causes include the following:
• Chronic alcohol abuse
• Chronic viral hepatitis (hepatitis B, C and D)
• Fat accumulating in the liver
• Iron buildup in the body
• Inherited disorders of sugar metabolism (galactosemia or glycogen storage disease)
• Genetic digestive disorder
• Liver disease caused by your body’s immune system (autoimmune hepatitis)
• Destruction of the bile ducts (primary biliary cirrhosis)
• Medications, including methotrexate or isoniazid
What are some symptoms of cirrhosis?
In the early stages of cirrhosis the individual might not have any symptoms at all. As the condition progresses you might have a number of symptoms. As your liver becomes more damaged, you may:
• feel very tired and weak
• feel sick (nausea)
• lose your appetite
• lose weight and muscle mass
• get red patches on your palms and small, spider-like blood vessels on your skin (spider angiomas) above waist level
If cirrhosis gets worse, some of the symptoms and complications include:
• yellowing of the skin and white of the eyes (jaundice)
• vomiting blood
• itchy skin
• dark urine and tarry-looking stool
• bleeding or bruising easily
• swollen legs (oedema) or abdomen ‘stomach’ (ascites)
• loss of sex drive (libido)
How is cirrhosis diagnosed?
A detailed history and physical examination is carried out by your doctor. Your doctor will arrange for you to have a number of investigations. A liver biopsy might be needed to confirm the diagnosis. If tests show that you have cirrhosis, your doctor should refer you to see a doctor who specialises in liver problems (hepatologist).
Treatment
There is no cure for cirrhosis at this time. However, there are ways to manage the symptoms, and any complications, and slow its progression.
Treating the problem that led to cirrhosis can stop cirrhosis getting worse.
You may be advised to cut down or stop drinking alcohol, or to lose weight if you are overweight.
If your liver is severely damaged, a liver transplant may be the only treatment option. Unfortunately, liver transplant is not available in many countries including Anguilla.
How to prevent cirrhosis?
There are many ways you can prevent cirrhosis of the liver. These include the following:
Avoid excessive use of alcohol
In Anguilla, the number one way is to limit alcohol use. You are recommended to follow the general guidelines that are:
• men and women should not regularly drink more than 14 units of alcohol a week
• you should spread your drinking over 3 days, or more, if you drink as many as 14 units a week
Stop drinking alcohol immediately if you have alcohol-related cirrhosis. Drinking alcohol speeds up the rate at which cirrhosis progresses, regardless of the cause. If you have a drinking problem, it is important to get help. Your doctor can guide you to the best professionals.
Protecting yourself from hepatitis is another way to prevent cirrhosis
The hepatitis B virus is spread in blood and body fluids. The hepatitis C virus is usually spread in blood.
Common ways of spreading these viruses include having sex with an infected person without using a condom, or close contact with an infected person’s blood, such as sharing his/her toothbrush or sharing needles to inject drugs.
Vaccination for hepatitis B is also available to anyone who has an increased chance of getting hepatitis B.
There is no vaccine for hepatitis C at the moment.
Aim for a healthy weight
To reduce your chance of getting non-alcoholic fatty liver disease (NAFLD), which can lead to cirrhosis, make sure you have a healthy weight by eating a healthy, balanced diet – and exercising regularly.
Conclusion
Cirrhosis of the liver can be caused by a number of things, but prolonged excessive use of alcohol is the leading cause of cirrhosis in Anguilla. Symptoms might be mild in the early stages of the disease, but in the late stages many symptoms might occur and many complications can develop – some of which can result in death. A healthy lifestyle is a key part of preventing cirrhosis. If you think you might have cirrhosis seek professional help as soon as possible, as sometimes it is possible to halt the progression of the disease if it is diagnosed in its early stages.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-eight years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
