Liver cirrhosis refers to severe scarring of the liver, which in around 60% of cases in England is caused by drinking excessive amounts of alcohol. However, in increasing numbers of individuals, liver cirrhosis is due to non-alcoholic fatty liver disease (NAFLD), which can occur in individuals who are overweight or diabetic. Other less common causes of liver cirrhosis include viral hepatitis and rare inflammatory or metabolic disorders.
Your liver can continue to function despite significant damage, which is why liver cirrhosis often does not cause any symptoms until your liver is severely damaged and begins to fail. If your liver is cirrhotic and the damage continues, it may lead to liver failure, at which time you may develop symptoms including: jaundice, fatigue, unintentional weight loss, a swollen tummy due to fluid build-up, and in severe cases, confusion and falling into a deep state of unconsciousness (coma). Symptoms of liver failure are very serious and you should seek immediate medical attention.
If you’re concerned about your liver health, see your GP. They will assess your risk factors and may send you for blood tests, including liver function tests (LFTs), and possibly an ultrasound of your liver.
Depending on your results, they may refer you to a see a doctor who specialises in treating liver problems (a hepatologist). Your hepatologist may send you for further blood tests to assess the function of your liver, as well as a liver Fibroscan®, which is a quick and harmless scan using ultrasound, which can rapidly rule out liver cirrhosis.
Unfortunately, liver cirrhosis can’t be reversed, so once the damage is done, it is permanent. However, there are lifestyle changes and treatments available to reduce the risk of it progressing to liver failure.
The outlook can still be good if your liver cirrhosis doesn’t progress. However, you will need regular monitoring to watch out for complications, including liver failure and the development of liver cancer.
If you have liver cirrhosis, you should be under the care of a hepatologist who can closely monitor your liver health.
Your best chance of reducing your risk of liver cirrhosis or slowing it down if you already have it, is to make significant lifestyle changes. This includes quitting drinking alcohol, losing excess body weight and controlling other conditions, such as high blood pressure, high cholesterol and diabetes.
If your liver cirrhosis is caused by viral hepatitis, there are very effective and well-tolerated tablet medications.
In its most advanced stages, when liver failure is not reversible, your doctor may recommend a liver transplant. However, liver cirrhosis doesn’t have to progress to liver failure. Early diagnosis and lifestyle changes are both essential and effective in slowing down the progression of the condition.
Dr Paul Kooner is a Consultant Hepatologist at Spire London East and Spire Harpenden hospitals. He has been a consultant hepatologist at the Royal London Hospital for the last 12 years with experience in all aspects of liver medicine. During this time he has led a regional hepatocellular carcinoma service and developed and led an outreach hepatology service to Queens Hospital.
Liver problems often cause few or no symptoms until they reach an advanced stage. His focus is on early detection of liver disease, which commonly has no symptoms, in order to reduce progression to liver cirrhosis.