Scarring of the liver, occurring in the late stages of various liver disorders
- More common over the age of 40
- More common in males
- In some cases, the underlying cause is inherited
- Long-term excessive alcohol consumption is a risk factor
In cirrhosis, normal liver tissue is destroyed and replaced by fibrous scar tissue. The condition may be caused by several different disorders, including viral infections and excessive alcohol consumption. The liver damage is usually irreversible and prevents the liver from functioning properly. Some people with cirrhosis may feel well for years despite having severe liver damage. However, with time they may develop complications, such as liver failure and liver cancer.
In developed countries, cirrhosis is the third most common cause of death in people aged between 45 and 65, after coronary artery disease and cancer. Cirrhosis is much more common in men than in women in the UK and accounts for about 3,000 deaths a year.
What are the causes?
There are various causes of cirrhosis. Worldwide, the most common cause is infection with a hepatitis virus, particularly the hepatitis B and C viruses (see Chronic hepatitis). However, in developed countries, cirrhosis is most frequently caused by excessive alcohol consumption (see Alcohol-related liver disease). Another cause is the autoimmune disorder primary biliary cirrhosis, which is more common in women than in men. Bile, a liquid produced by the liver to aid digestion, normally leaves the liver through the bile ducts. In primary biliary cirrhosis, the bile ducts become inflamed, blocking the flow of bile from the liver. This causes bile to build up, damaging the liver tissue. Cirrhosis may also be caused by sclerosing cholangitis, a condition in which the bile ducts inside the liver become inflamed. The cause of this condition is not known, although it can be associated with the inflammatory bowel diseases ulcerative colitis and Crohn’s disease. Cirrhosis may also develop after bile duct surgery or as a result of a blockage of the bile ducts by gallstones. In addition, certain inherited disorders, such as haemochromatosis, may cause cirrhosis to develop.
What are the symptoms?
Often, cirrhosis produces no symptoms and is detected during a routine examination for another condition. If there are symptoms, they may include:
Poor appetite and weight loss.
Yellowing of the skin and the whites of the eyes (see Jaundice).
After some time, life-threatening complications may develop. For example, cirrhosis can lead to high blood pres-sure in veins in the oesophagus, which causes them to be fragile and to bleed easily (see Portal hypertension and varices). Malnutrition may also develop from being unable to absorb fats and certain vitamins. Eventually, cirrhosis can lead to liver cancer or liver failure. The symptoms of liver failure include a swollen, fluid-filled abdomen and visible spider-like blood vessels in the skin, known as spider naevi. A failing liver may also result in abnormal bleeding and easy bruising. This is as a result of reduced production of blood clotting factors in the liver.
What might be done?
If your doctor suspects that you have cirrhosis from your symptoms, he or she will take blood samples to assess liver function and look for hepatitis viruses. You may also have ultrasound scanning, CT scanning, or MRI to assess the liver. To confirm the diagnosis, you may have a liver biopsy, in which a small sample of tissue is removed from your liver for microscopic examination.
Damage to the liver caused by cirrhosis is usually irreversible. However, if the underlying cause can be treated, further deterioration may be prevented. Whatever the cause of the cirrhosis, you should not drink alcohol. Nutritional deficiencies can be corrected by taking supplements and altering your diet. If the condition worsens but you are otherwise in good health, you may be suitable for a liver transplant.
What is the prognosis?
The outlook for cirrhosis is extremely variable and depends on the degree of liver damage, whether complications have developed, and whether further damage can be prevented. If the condition is mild, people may live for many years. About 9 in 10 people survive for more than a year after a liver transplant.
From the 2010 revision of the Complete Home Medical Guide © Dorling Kindersley Limited.
The subjects, conditions and treatments covered in this encyclopaedia are for information only and may not be covered by your insurance product should you make a claim.