Cirrhosis – pronounced suh-ROH-sis

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.

Eating a Nutritious Diet

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.

Avoiding Alcohol and Other Substances

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.

Specific Complications

Treatment for cirrhosis also addresses specific complications.

• Edema and Ascites
  For edema (swelling caused by excessive fluid in the body) and ascites (buildup of fluid in the abdomen), 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.
• Portal Hypertension
  The doctor may prescribe a beta-blocker or nitrate for portal hypertension. Beta-blockers can lower the pressure in the varices (enlarged blood vessels) 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
  Hepatic encephalopathy (buildup of toxins in the brain) 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. Hepatic encephalopathy may improve as other complications of cirrhosis are controlled.
• Hepatorenal Failure
  Some people with cirrhosis who develop hepatorenal failure (kidney failure) must undergo regular hemodialysis treatments, a method in which blood is passed through a machine that purifies it and returns it to the body. Medications are also given to improve blood flow through the kidneys.
• Hepatitis
  Other treatments address the specific causes of cirrhosis. Treatment for cirrhosis caused by hepatitis depends on the specific type of hepatitis. For example, interferon and other antiviral drugs are prescribed for viral hepatitis, and autoimmune hepatitis requires corticosteroids and other drugs that suppress the immune system.

Medications are given to treat various symptoms of cirrhosis, such as itching and abdominal pain.

When is a Liver Transplant Indicated for Cirrhosis?

A liver transplant is considered when complications cannot be controlled by treatment. Liver transplantation is a major operation in which the diseased liver is removed and replaced with a healthy one from an organ donor.

A team of health professionals determines the risks and benefits of the procedure for each patient. Survival rates have improved over the past several years because of drugs that suppress the immune system and keep it from attacking and damaging the new liver.

The number of people who need a liver transplant far exceeds the number of available organs. A person needing a transplant must go through a complicated evaluation process before being added to a long transplant waiting list.

Generally, organs are given to people with the best chance of living the longest after a transplant. Survival after a transplant requires intensive follow-up and cooperation on the part of the patient and caregiver.

For More Information About Cirrhosis

American Liver Foundation
75 Maiden Lane, Suite 603
New York, NY 10038-4810
Phone: 1-800-GO-LIVER (465-4837) or 212-668-1000
Fax: 212-483-8179
Email: info@liverfoundation.org
Internet: www.liverfoundation.org

Hepatitis Foundation International
504 Blick Drive
Silver Spring, MD 20904-2901
Phone: 1-800-891-0707 or 301-622-4200
Fax: 301-622-4702
Email: hfi@comcast.net
Internet: www.hepfi.org

United Network for Organ Sharing
P.O. Box 2484
Richmond, VA 23218
Phone: 1-888-894-6361 or 804-782-4800
Fax: 804-782-4817
Internet: www.unos.org