Many people believe that cirrhosis is caused by drinking large amounts of alcohol, but there are actually a number of other factors that also contribute to this condition. While there is no cure for cirrhosis, early treatment and self-care can slow down or prevent subsequent liver damage.

The body’s largest internal organ, the liver performs many important functions. It produces proteins, hormones and blood cells. It stores nutrients and removes toxins produced in the body or received from external sources. The liver also works in conjunction with other organs, such as the heart, kidneys, pancreas and gallbladder.

One condition that can affect the liver’s ability to function well is cirrhosis. The symptoms of cirrhosis may include general tiredness, fatigue, loss of appetite, nausea, weight loss, confusion, poor concentration and forgetfulness. In the advanced stage, there may also be some itching of the skin and yellow discoloration in the skin and eyes.

Cirrhosis may also affect blood flow, leading to high blood pressure and low platelets, easy bleeding, enlarged spleen, swelling in the legs, build-up of fluid in the abdominal cavity, red spots on the skin and bloody stool from ruptured varicose veins in the esophagus or stomach.

Cirrhosis is caused when the liver becomes damaged due to inflammation. After repeated episodes of inflammation, healthy cells are replaced by scar tissue. As the normal liver tissue is lost, cirrhosis develops.

We know that long-term excessive alcohol consumption causes cirrhosis, but it is by no means the only cause. Cirrhosis can also be attributed to several other factors, including infections caused by viral hepatitis (such as hepatitis B and C), bacteria, fungi and parasites. Long-term exposure to certain medications and toxins can also lead to cirrhosis, while other contributing factors include autoimmune hepatitis and fatty liver.

To confirm the diagnosis of cirrhosis, the doctor will assess the history of the symptoms and conduct tests that may include a blood test, CT scan, ultrasound, liver and liver stiffness measurement, or a biopsy to take a tissue sample.

The treatment of cirrhosis aims to reduce the inflammation that causes the scarring of the liver. Treatment options depend on the cause and severity of the liver damage. The doctor will choose an appropriate treatment plan for each patient. However, the patients themselves and their carers play an important role in an efficient treatment strategy.

In order to limit additional liver damage and prevent complications of cirrhosis, patients are recommended to:

• Avoid all substances that increase damage to the liver, including alcohol
• Reduce body weight to prevent fatty liver from developing
• Avoid medications that damage the liver
• Consume sufficient protein because the body needs protein for maintenance (choose lean protein such as fish, soy, etc.)
• Avoid adding salt to meals because it may increase the swelling
• Avoid constipation because it causes a poisoning of the system
• Avoid medications and herbs that may harm the liver
• Observe the symptoms and seek medical attention urgently if the symptoms or signs worsen
• Have regular medical check-ups.

Although cirrhosis of the liver is incurable, treatment can help to reduce the likelihood that the condition will become worse. Practicing self-care as outlined above and taking any additional medical advice will slow down or prevent liver damage.

By Dr. Orapin Tanapanpanit, gastroenterologist and hepatologist, Digestive Disease Center, Bumrungrad Hospital