What is cirrhosis ?
1111Normal liver has a smooth surface and is soft to feel. Cirrhosis is the scarring of the liver — hard scar tissue replaces soft healthy tissue. As cirrhosis becomes worse, the liver is not able to perform its functions and there occurs an increase in resistance to the flow of blood through the liver (portal hypertension).

What causes cirrhosis ?
Cirrhosis is caused by chronic (long-term) liver diseases that damage the liver. It usually takes many years for liver damage to lead to cirrhosis. Recognizing liver diseases early and treating them can thus prevent development of cirrhosis. Common causes of cirrhosis are alcohol, hepatitis B, hepatitis C, fatty liver disease and certain genetic diseases.

How does alcohol damage the liver ?
Chronic alcohol use is the leading cause of cirrhosis in India. Excess alcohol causes the liver to swell, which over time can lead to cirrhosis. Even small quantities of alcohol if taken over a prolonged period of time can lead to significant liver damage.

What infections cause cirrhosis ?
Chronic hepatitis B and C viruses are important causes of cirrhosis in India. One may get hepatitis B and C viruses by blood transfusion, infected needles and razors, sexual transmission and vertical transmission from mother to child. These viruses cause persistent infection of the liver that leads to cirrhosis over time. About one in four people with chronic hepatitis B or C may develop cirrhosis. Early detection of these viruses and successful treatment can prevent the development of cirrhosis.

Can fat in the liver cause cirrhosis ?
People who are overweight, have diabetes, or high cholesterol can accumulate fat in the liver. This is known as fatty liver. In some people fatty liver can progress to cirrhosis. Such patients are also at risk of developing liver cancer.

What other diseases can cause cirrhosis ?
Certain rare diseases of the bile ducts can lead to cirrhosis. In these diseases there is obstruction of bile flow to the small intestine. The bile backs up in the liver causing the liver to swell and can lead to cirrhosis. These diseases are known as primary sclerosing cholangitis and primary biliary cirrhosis. Some genetic diseases can lead to cirrhosis. These diseases include Wilson disease, hemochromatosis, glycogen storage diseases, alpha-1 antitrypsin deficiency, and autoimmune hepatitis.

What are symptoms of cirrhosis in its early stage ?
There are usually no symptoms of cirrhosis in its early stage. Patients feel healthy and unless certain blood tests and other investigations are done, it may not be possible to detect cirrhosis at all. Almost 80 percent of the liver needs to be damaged before a patient develop symptoms.

What are the symptoms of advanced cirrhosis?
Symptoms of advanced cirrhosis include loss of appetite, tiredness, nausea, weight loss, abdominal pain, and severe itching. Other severe complications include:
Jaundice, a yellow discoloration of the skin and eyes
Bruising and bleeding easily (nose, gums and skin)
Excess water build up leading swelling of the legs (edema) and abdomen (ascites)
Mental confusion
Vomiting of blood

How is cirrhosis diagnosed ?
Cirrhosis is diagnosed by symptoms, medical history, blood tests, and physical examination. Scans of the liver – ultrasound or CT scan are often required. A liver biopsy may be needed to find out the exact cause of cirrhosis and to check how much of the liver has been damaged. During a biopsy, a small piece of liver tissue is removed with a needle passed into the liver. This tissue is then studied in the laboratory.

How is cirrhosis treated ?
Treatment options for cirrhosis depend on the cause and the level of liver damage. Depending on the disease causing cirrhosis, medications or lifestyle changes may be used for treatment. The goals of treatment are to prevent further liver damage and reduce complications. When cirrhosis cannot be treated, the liver will not be able to work and a liver transplant may be needed. Doctors will determine whether a liver transplant is the best treatment option.

What is the best way to manage cirrhosis ?
It is possible to prevent further liver damage with proper management of cirrhosis.
Maintain a healthy lifestyle (eat a healthy diet and exercise regularly).
Limit salt in your diet to prevent or reduce fluid buildup.
Stop drinking alcohol completely.
Talk to your doctor about all of the medications, vitamins and supplements you take.
Talk to your doctor about hepatitis A and hepatitis B vaccinations.
You may require regular blood tests to assess the condition of your liver periodically.
You may need regular ultrasound scans to detect cancers that develop in cirrhotic livers. Liver cancers if detected early, when they are small,
and be treated effectively.
Do not take herbal therapies or other alternative medicines for cirrhosis before consulting your doctor. Some of these medications can actually
cause more harm to the liver.