Cirrhosis -- Treatment
How Do I Know If I Have It?
A patient's history and symptoms, along with the
results of a physical examination, are usually enough to
determine a case of cirrhosis. Once the diagnosis has
been made, the physician may order one or more liver
function tests, which use blood samples to identify
specific liver diseases and assess the organ's overall
health. The doctor may also require a liver biopsy, or
tissue sample, and blood tests to ascertain the cause of
the cirrhosis. In a liver biopsy, a needle is inserted
into the liver to draw out a fragment of tissue, which
is then sent to a lab for analysis.
What Are the Treatments?
The best way to treat cirrhosis is to correct the
underlying cause. This could involve giving up alcohol,
seeking treatment for viral hepatitis or an inherited
disorder, or eliminating certain substances from your
diet or environment. Some conditions cannot be cured,
but medications can put them into remission.
Specific remedies for cirrhosis depend on the
underlying cause and its stage of development. Besides
halting the progress of the disease, conventional
treatment also aims at correcting any complications,
such as internal bleeding, which in themselves can be
disabling or life-threatening.
If your cirrhosis is caused by alcoholism, you simply
must stop drinking — immediately and completely. If
you continue to drink after you have been diagnosed with
cirrhosis, you have less than a 40% chance of living
longer than five more years. If you stop drinking,
however, those chances increase to 60%-70%.
Corking the bottle is also the best way to remedy
alcoholic hepatitis and alcohol-induced fatty liver.
Both of these conditions usually clear up when the
patient stops drinking long enough for the liver to
heal. Conventional treatment of cirrhosis caused by
chronic viral hepatitis emphasizes rest, proper
nutrition, and possibly the use of the drug interferon.
There are new medications, such as ribivarin or
lamivudine, which if used in combination with interferon
for some types of viral hepatitis can improve chances
for a cure. Some types of hepatitis, however, cannot be
For Wilson's disease, doctors generally prescribe
medications that rid the body of accumulated copper. It
may be necessary to continue these medications for life.
In the case of hemochromatosis, the best way to dispose
of excess iron is to draw blood from the patient once or
twice a week. This may be kept up for as long as two
years, or until the iron level reaches its normal range.
Treatment then continues every two to four months.
Severe cirrhosis may require a liver transplant — a
serious procedure usually regarded as a last resort.
Transplants are not appropriate for everyone: Some
patients are too old, too young, or too sick for the
procedure. And people whose cirrhosis is due to alcohol
abuse must demonstrate a prolonged period of abstinence
before the operation. Doctors generally are hesitant to
transplant a liver if the patient is just going to abuse
As with any form of major surgery, liver transplants
can be risky. The new liver may not function properly,
or the body may reject the transplanted organ. There's
also the danger that infection will set in after
surgery. Still, the procedure has a promising success
rate overall. In the U.S., 60%-75% of adult patients and
90% of children survive the operation. Transplant
patients live an average of five to 10 years after
Good nutrition often plays a vital role in the
treatment of cirrhosis. Although parts of the liver that
have given way to scar tissue can't be restored, a
balanced diet — including plenty of fruits,
vegetables, grains, milk, and protein — can help
promote regeneration among cells in the intact portion.
Adults with the disease need to monitor their intake of
protein. Too little protein can slow cell regeneration,
and too much can raise the amount of ammonia in your
bloodstream, possibly leading to mental impairment.
Check with a doctor or nutritionist for the amount of
protein that's right for you.
Because the liver must filter and refine substances
that are introduced into the body, patients with
cirrhosis are often told to seek medical advice before
taking large doses of vitamins or other dietary
supplements. Cirrhosis patients should also avoid eating
uncooked shellfish, which are sometimes harvested in
polluted estuaries and may carry organisms that cause
hepatitis or other diseases.
D. Vogin, MD, August 2002.