Cirrhosis

About Cirrhosis

Cirrhosis is advanced scarring fibrosis of the liver, estimated to affect more than 100 million people worldwide. It is the end stage of chronic liver disease. The leading causes are hepatitis B and C, alcohol related liver disease, and nonalcoholic fatty liver disease NAFLD, now called MASLD. NAFLD is increasingly the leading cause in developed countries due to obesity and diabetes epidemics. Other causes include autoimmune hepatitis, primary biliary cholangitis, hemochromatosis, Wilson disease, and certain medications. Cirrhosis develops over years to decades. Early compensated cirrhosis may be asymptomatic. Decompensated cirrhosis presents with jaundice yellow skin and eyes, ascites abdominal fluid accumulation, hepatic encephalopathy confusion from toxin buildup, variceal bleeding bleeding from enlarged esophageal veins, peripheral edema, easy bruising, and fatigue. Complications include hepatocellular carcinoma liver cancer, spontaneous bacterial peritonitis, hepatorenal syndrome, and death. Diagnosis involves blood tests liver function panel, imaging ultrasound, CT, MRI with FibroScan showing liver stiffness, and sometimes liver biopsy. Treatment focuses on addressing the underlying cause antivirals for hepatitis B and C, alcohol cessation, weight loss for NAFLD, managing complications lactulose for encephalopathy, beta blockers and endoscopic banding for varices, diuretics and paracentesis for ascites. Liver transplantation is the definitive treatment for end stage disease, with 5 year survival of roughly 75 percent or more. Vomiting blood, black tarry stools, or sudden confusion in someone with cirrhosis is a medical emergency; call your local emergency number.