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Home > Help Desk > Health Concern > Section A > Liver Cirrhosis
Liver Cirrhosis
Liver Cirrhosis is a condition of severe damage to the liver that impairs its ability to function normally. In the United States, the most common cause of liver cirrhosis is chronic alcoholism. Liver cirrhosis may also result from chronic viral infection of the liver ( hepatitis types B, C, and D) and a number of inherited diseases, such as cystic fibrosis, hemochromatosis, and Wilson’s disease. If severe, liver cirrhosis may lead to liver failure and death. In the Western world, liver cirrhosis is the third leading cause of death in people aged 45 to 65 (after cardiovascular disease and cancer). Liver cirrhosis may also cause a dangerous brain abnormality called portal-systemic encephalopathy (PSE), which may lead to coma. Another form of cirrhosis, primary biliary cirrhosis (PBC), damages the bile ducts connecting the liver and gallbladder, and occurs primarily in women over 35 years of age. The cause of PBC is not known.
What are the symptoms of liver cirrhosis?
Many people with cirrhosis have no symptoms for years. Others may have weakness, loss of appetite, malaise, and weight loss. With blocked bile flow, it is common for people with cirrhosis to have jaundice, itching, and fatty yellow skin nodules. Later in the disease, there may be massive bleeding inside the throat, brain abnormalities due to accumulation of ammonia in the blood, liver failure, and death.
How is it treated?
Conventional treatment is supportive, since cure is unlikely: withdrawal of alcohol and other toxic agents, correction of nutritional deficiencies, and treatment of complications as they arise. A number of experimental drugs are being investigated for reversal of liver damage, but few have proven effective. Liver transplantation for patients with advanced disease has dramatically increased the life expectancy associated with liver cirrhosis.
Dietary changes that may be helpful:
Adequate protein intake is essential for people with alcoholic liver cirrhosis, because this condition often results in significant protein, as well as calorie, deficiency. However, people with liver cirrhosis may be unable to tolerate normal amounts of dietary protein because the cirrhotic liver is less able to detoxify ammonia, a major product of protein digestion. Ammonia toxicity contributes to PSE. The amount of protein that can be tolerated by people with cirrhosis varies considerably. In these people, there is only a small margin of safety when treating protein deficiency. Extreme caution must be exercised when changing their protein intake. A doctor familiar with this disease should closely supervise any changes in dietary protein intake by people with cirrhosis.
Some people with cirrhosis and impaired bile flow (such as in Wilson’s disease or PBC) may have an excess amount of copper accumulate in the liver. If laboratory tests confirm copper excess, most doctors would recommend avoiding foods rich in copper (such as chocolate, shellfish, and liver) along with medical treatment to reduce copper stores.
Lifestyle changes that may be helpful:
Alcoholism is the leading cause of liver cirrhosis in the Western world. Drinking too much alcohol also impairs the absorption and accelerates loss of several nutrients. Therefore, avoidance of alcohol is strongly recommended for people with liver cirrhosis. Alcohol is directly toxic to the liver. In people with alcohol-induced liver cirrhosis, even moderate alcohol consumption increases the risk of portal hypertension, a dangerous blood pressure abnormality in the liver’s circulation.
Nutritional supplements that may be helpful:
Large amounts of S-adenosylmethionine (SAMe) may improve survival and liver function in alcoholic liver cirrhosis.
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