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Cirrhosis - Treatment

Alternative Names

Liver cirrhosis; Cryptogenic chronic liver disease

Treatment:

All patients with cirrhosis can benefit from certain lifestyle changes, including:

  • Stop drinking alcohol.
  • Limit salt in the diet.
  • Eat a nutritious diet.
  • Get vaccinated for influenza, hepatitis A and hepatitis B, and pneumococcal pneumonia (if recommended by your doctor).
  • Tell your doctor about all prescription and nonprescription medications, and any herbs and supplements you take now or are thinking of taking.

Other treatment options are available for the complications of cirrhosis:

  • Bleeding varices -- upper endoscopy with banding and sclerosis
  • Excess abdominal fluid (ascites) -- take diuretics, restrict fluid and salt, and remove fluid (paracentesis)
  • Coagulopathy -- blood products or vitamin K
  • Confusion or encephalopathy -- lactulose medication and antibiotics
  • Infections -- antibiotics

A procedure called transjugular intrahepatic portosystemic shunt (TIPS) is sometimes needed for bleeding varices or ascites.

When cirrhosis progresses to end-stage liver disease, patients may be candidates for a liver transplant.

Support Groups:

You can often ease the stress of illness by joining a support group whose members share common experiences and problems. See liver disease - support group.

Expectations (prognosis):

Cirrhosis is caused by irreversible scarring of the liver. Once cirrhosis develops, it is not possible to heal the liver or return its function to normal. It is a serious condition that can lead to many complications.

A gastroenterologist or liver specialist (hepatologist) should help evaluate and manage complications. Cirrhosis may result in the need for a liver transplant.

Complications:

  • Bleeding disorders (coagulopathy)
  • Buildup of fluid in the abdomen (ascites) and infection of the fluid (bacterial peritonitis)
  • Enlarged veins in the esophagus, stomach, or intestines that bleed easily (esophageal varices)
  • Increased pressure in the blood vessels of the liver (portal hypertension)
  • Kidney failure (hepatorenal syndrome)
  • Liver cancer (hepatocellular carcinoma)
  • Mental confusion, change in the level of consciousness, or coma (hepatic encephalopathy)

Calling your health care provider:

Call your health care provider if:

  • You develop symptoms of cirrhosis

Call your provider, go to the emergency room, or call the local emergency number (such as 911) if you have:

  • Abdominal or chest pain
  • Abdominal swelling or ascites that is new or suddenly becomes worse
  • A fever (temperature greater than 101 °F)
  • Diarrhea
  • New confusion or a change in alertness, or it gets worse
  • Rectal bleeding, vomiting blood, or blood in the urine
  • Shortness of breath
  • Vomiting more than once a day
  • Yellowing skin or eyes (jaundice) that is new or suddenly becomes worse
  • Reviewed last on: 12/13/2010
  • George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

References

Garcia-Tsao G, Lim JK; Members of Veterans Affairs Hepatitis C Resource Center Program. Management and treatment of patients with cirrhosis and portal hypertension: recommendations from the Department of Veterans Affairs Hepatitis C Resource Center Program and the National Hepatitis C Program. Am J Gastroenterol. 2009;104:1802-1829.

Schuppan D, Afdhal NH. Liver cirrhosis. Lancet. 2008;371:838-851.

Mehta G, Rothstein KD. Health maintenance issues in cirrhosis. Med Clin North Am. 2009;93:901-915.

The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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