Can You Reverse Cirrhosis Of The Liver?
Liver cirrhosis is a chronic progression of fibrosis (scarring) of healthy liver tissue leading to functional deterioration of liver. Liver is supposed to have over 500 functions including protein synthesis, destruction of old RBCs, detoxification and metabolism of chemicals and drugs along with hormone regulation and digestion of fats assisted by the production of bile, to name a few. Liver cirrhosis is caused by chronic liver damage caused by various conditions or diseases. The diseases that commonly affect liver are chronic hepatitis, chronic alcoholism and non-alcoholic liver disease. In the initial stage, liver damage is reversible and liver repairs itself, but in the advanced stages the liver function is compromised and liver cirrhosis is irreversible. Liver cirrhosis in itself is irreversible as it is the advanced stage of liver damage. It can only be prevented from further progression into liver failure and ultimate death.
Symptoms and Causes of Liver Cirrhosis
In the initial stages, cirrhosis is without any signs or symptoms until and unless it has progressed into severe liver damage. The signs and symptoms when present include weakness, lethargy, easy bruising and bleeding, pruritis, jaundice, ascites, nausea, vomiting, weight loss, loss of appetite, swelling of legs, enlarged veins in the esophagus and upper abdomen, confusion, excessive sleepiness/drowsiness and coma.
There are various causes of liver cirrhosis, but the most common causes include chronic alcoholism, chronic viral disease (hepatitis B and C, HIV) and/or fatty liver. Other causes of liver cirrhosis may include hemochromatosis, Wilson’s disease, cystic fibrosis, biliary atresia, glycogen storage disease, Alagille syndrome, autoimmune hepatitis, primary biliary cirrhosis, infection (schistosomiasis), primary sclerosing cholangitis and/or medications such as methotrexate.
Complications of Cirrhosis
The most common cause of liver cirrhosis are chronic alcoholism and chronic viral diseases (hepatitis B, hepatitis C and HIV), so it is best to stay healthy by eating hygienic/healthy food, immunizations and moderation of alcohol. Liver cirrhosis can have drastic effect on blood flow through the body and can lead to portal hypertension along with functional debility. It can lead to swelling in the abdomen and legs causing edema of legs and ascites, splenomegaly and easy bleeding. Other complications may include infections in the body, increased chances of liver cancer, malnutrition, bone disease, hepatic encephalopathy, diabetes, and acute-on-chronic liver failure. The inability of diseased liver to metabolize various medications may lead to toxicity.
Diagnosis and Treatment
The diagnosis of cirrhosis is based on medical history, physical examination, clinical findings along with lab findings that will show abnormal liver function tests and other complete blood tests, imaging such as ultrasound, elastography, abdominal CT, liver/bile duct MRI, endoscopy and the most definitive test is liver biopsy.
The most definitive treatment of liver cirrhosis includes liver transplant. There is no specific treatment to cure liver injury caused by liver cirrhosis and once progressed it cannot be reversed. However, treating the underlying cause may prevent further progression of the disease avoiding liver failure and death. The main aim of cirrhosis treatment is prevention of further liver damage and prevention of complications. This includes treating the underlying cause. Alcoholic cirrhosis can be prevented from worsening by alcohol abstinence and prescription medications such as naltrexone and acamprosate and attending support programs such as AA (alcoholics anonymous). Cirrhosis related to viral hepatitis is treated with antiviral drugs and also with interferons. Autoimmune hepatitis is treated with corticosteroids; primary biliary cirrhosis is treated with ursodiol that slows liver damage. Wilson’s disease is treated with penicillamine, which chelates excess copper stores in the body.
Liver cirrhosis can be further prevented from progression by eating a healthy and well balanced diet and avoiding foods and drinks causing liver damage. Salt intake is minimized in liver cirrhosis as it increases fluid buildup in the body. Hemodialysis is considered when the waste byproducts are not being excreted from the body.
Vaccinations against hepatitis A and B, flu and pneumonia are necessary for better protection as cirrhosis compromises immunity. A doctor should be consulted before taking any OTC medications as they might cause further liver damage.
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