Liver cirrhosis

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What is it about ?

Cirrhosis is a disease of the liver in which healthy liver cells are replaced by connective tissue, a kind of scar tissue. As a result, the liver shrinks, loses its smooth surface and no longer functions as it should.

Causes of cirrhosis of the liver

Cirrhosis of the liver is caused by prolonged inflammation of the liver. The most common causes are:

Accumulation of fat in the liver (fatty liver)

Excessive alcohol consumption, diabetes and being overweight can cause fatty liver disease (fatty liver disease). A distinction is made between alcoholic fatty liver disease and non-alcoholic fatty liver disease. Fatty liver disease is reversible, but can lead to cirrhosis of the liver if its cause is not addressed. Hepatic cirrhosis is not reversible.

Consequences of cirrhosis of the liver

Decreased liver function

The liver is our chemical factory:

  • It absorbs nutrients in the blood and transforms them into essential components for our body.
  • It produces bile, which is essential for the digestion of fats.
  • It is involved in the metabolism of alcohol.
  • It breaks down toxic substances, such as drugs, and eliminates them from the body.

People with cirrhosis of the liver develop deficiencies in several important substances for our body. Various mechanisms are responsible. For example, they eat less and their bodies digest and absorb food less well. Cirrhosis also has an impact on the way the body processes drugs.

Other consequences of cirrhosis of the liver
  • hypertension in the portal vein;
    • The portal vein is a large blood vessel that carries blood from the intestines to the liver.
    • With cirrhosis of the liver, this blood flow is prevented, often resulting in increased blood pressure in the portal vein.
  • varicose veins of the esophagus;
    • because of hypertension in the portal vein, the blood seeks an exit to other blood vessels.
    • As a result, varicose veins can form in the esophagus. These varicose veins can cause life-threatening bleeding.
  • accumulation of fluid (edema) in the belly;
    • The increased pressure on the portal vein contributes to the accumulation of fluid in the belly.
  • confusion ;
    • The buildup of wastes in the blood (ammonia) can cause confusion in people with cirrhosis of the liver.
  • kidney function disorder;
    • People with cirrhosis of the liver can develop kidney failure.
  • liver cancer.
    • People with cirrhosis of the liver have a greater risk of liver cancer.

What is its frequency?

In Belgium, around 8 in 1,000 people suffer from cirrhosis of the liver.1

The cause is excessive alcohol consumption in more than 1 in 2 people. The second cause is hepatitis C.

How to recognize it?

Cirrhosis of the liver often goes unnoticed for a long time. The damage to the liver is already severe when the first complaints appear. The main symptoms are:

  • tired ;
  • loss of appetite ;
  • itching;
  • jaundice (yellowish discoloration of the whites of the eyes and skin);
  • swelling of the belly;
  • red coloring of the palms of the hands;
  • formation of small spider-shaped blood vessels on the skin;
  • breast development and impotence in men;
  • swollen veins on the stomach;
  • muscle wasting ;
  • weightloss.

How is the diagnosis made?

  • a physical examination is not sufficient to establish the diagnosis. The doctor will systematically give you a blood test and an abdomen ultrasound.
  • If he suspects cirrhosis of the liver on the basis of these tests, the doctor will refer you to a specialist (hepatologist) for liver biopsy. The examination is done under local anesthesia and consists of removing, using a long needle, a piece of tissue for microscopic examination.
  • The specialist will insert a small camera into the stomach (gastroscopy) in order to visualize possible varicose veins in the esophagus.
  • Occasionally, an MRI or CT scan of the abdomen is performed or the hardness of the liver is examined by means of a elastography.

It is the combination of all the results that determines the diagnosis.

What can you do ?

Accumulation of fat in the liver (fatty liver)

The number one cause of cirrhosis of the liver is fatty liver disease due to excessive alcohol consumption, being overweight, or conditions such as diabetes. Fortunately, fatty liver disease is reversible, except when it is in its final stage.

  • Moderate your alcohol intake or stop drinking it altogether.
  • Try to lose weight if you are overweight.
  • If you have diabetes, stick to your diet.
Cirrhosis of the liver (hepatic cirrhosis)
  • Stop alcohol altogether. This stopping improves the prognosis in patients with hepatic cirrhosis, although it does not negate the risk of liver cancer.
  • Eat enough and in a balanced way, because cirrhosis of the liver goes hand in hand with undernutrition.
  • When you want to take a medicine, always discuss it with your doctor beforehand.
  • Try to be physically active every day.

What can your doctor do?

Unfortunately, cirrhosis of the liver cannot be cured. Treatment is aimed at slowing the process of hepatic cirrhosis, fighting symptoms and avoiding complications.

  • If you have hypertension in the portal vein, your doctor will prescribe medicines that lower blood pressure (antihypertensives).
    • If treatment does not work and the high blood pressure causes complications, a small tube can be placed between the portal vein and the veins that draw blood from the liver (TIPS). This procedure relieves pressure in the portal vein.
  • If you have varicose veins in your esophagus, a elastic can be placed to encircle them (ligature).
  • If you have fluid in your stomach, your doctor will prescribe diuretics.
    • You will also need to limit your salt intake.
    • Sometimes it is necessary to puncture the fluid in the stomach with a needle.
  • If you are confused about having high ammonia levels, a laxative can be given to you to eliminate it.
  • As a last resort, you can benefit from a liver transplant. This can be considered in the final stage of cirrhosis of the liver.

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