Cirrhosis
Cirrhosis is a late stage of progressive liver scarring (fibrosis). The liver of someone who has cirrhosis may become distorted (deformed or misshapen) and may have regenerative nodules (tumor-like growths). In advanced stages it is considered to be irreversible at which point the only treatment option may be liver transplantation. In early stages, it can be reversible if the cause of the cirrhosis is treated.
Because of long-term damage to the liver, scar tissue slowly replaces normal functioning liver tissue, progressively decreasing blood flow through the liver. As the normal liver tissue is lost, nutrients, hormones, drugs and poisons are not processed as well by the liver. In addition, production of protein and other substances produced by the liver slows down or stops altogether.
What are the symptoms of cirrhosis?
Symptoms of cirrhosis vary, depending on severity of the condition. Mild cirrhosis may have no symptoms at all. Although all patients may not experience the same symptoms, patients may experience:
- Loss of appetite
- Weight loss
- Weakness
- Fatigue
- Jaundice
- Itchy skin
- Signs of upper gastrointestinal bleeding, including blood in vomit or black stools
- Muscle cramps
- Abdominal distension (bloating) from ascites
- Confusion due to hepatic encephalopathy.
The symptoms of cirrhosis may resemble other medical conditions or problems. Always consult your child’s gastroenterologist for a diagnosis.
What causes cirrhosis?
The most common causes of cirrhosis in the United States are:
- Hepatitis C
- Alcoholic liver disease
- Nonalcoholic liver disease.
Other causes of liver cirrhosis can include:
- Chronic viral hepatitis B
- Hemochromatosis
- Nonalcoholic fatty liver disease
- Autoimmune hepatitis
- Primary and secondary liver cirrhosis
- Primary sclerosing cholangitis
- Medications (including methotrexate and isoniazid)
- Wilson disease
- Alpha-1 antitrypsin deficiency
- Celiac disease
- Granulomatous liver disease
- Idiopathic portal fibrosis
- Polycystic liver disease
- Infections (including brucelosis, syphilis, echinococcosis and schistosomiasis)
- Right-sided heart failure
- Hereditary hemorrhagic telangiectasia
- Veno-occlusive disease.
How is cirrhosis diagnosed?
Your child’s gastroenterologist will perform a complete medical history and physical examination to look for jaundice, dilated skin vessels, enlarged breast tissue in males, ascites, an enlarged spleen, reddening skin on the palms of the hands, digital (finger) clubbing and asterexis, which is sudden loss of muscle tone in an outstretched limb.
Diagnostic procedures used to diagnose cirrhosis may include:
- Liver function tests. A series of special blood tests that can determine if the liver is functioning properly. Learn more about blood tests.
- Liver biopsy. A procedure in which tissue samples from the liver are removed (with a needle or during surgery) for examination under a microscope. Learn more about liver biopsy.
- Cholangiography. X-ray examination of the bile ducts using an intravenous (IV) dye (contrast). Learn more about X-ray.
- Computed tomography scan (CT or CAT scan). A diagnostic imaging procedure using a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat and organs. CT scans are more detailed than general X-rays. Learn more about CT.
- Ultrasound (also called sonography). A diagnostic imaging technique, which uses high-frequency sound waves and a computer to create images of blood vessels, tissues and organs. Ultrasounds are used to view internal organs of the abdomen such as the liver, spleen and kidneys and to assess blood flow through various vessels. Learn more about ultrasound.
What is the treatment for cirrhosis?
Specific treatment for cirrhosis will be determined by your child’s gastroenterologist based on:
- The child’s age, overall health and medical history
- Extent of the disease
- The child’s tolerance for specific medications, procedures or therapies
- Expectations for the course of the disease
- The family’s opinion or preference.
Cirrhosis is a progressive liver disease, and damage sustained to the liver cannot be reversed. However, eating right, avoiding certain toxins like alcohol, taking certain vitamins and managing the complications of cirrhosis can delay or stop further liver damage. In severe cases of cirrhosis, a liver transplantation may be considered.
What is fibrosis?
Fibrosis is the growth of scar tissue due to infection, inflammation, injury or even healing. The overgrowth of scar tissue can occur in almost any organ. Fibrosis in the liver can inhibit the organ’s proper functioning. Liver fibrosis is usually the result of cirrhosis.