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The liver is unable to perform its vital functions of metabolism, production of proteins, including blood clotting factors, and filtering of drugs and toxins. Many people think that only drinking excessive amounts of alcohol causes liver cirrhosis.

But there are a number of other ways that the liver can be damaged and lead to cirrhosis. Depending on the cause, cirrhosis can develop over months or years.

There is no cure

Treatment aims to halt liver damage, manage the symptoms and reduce the risk of complications, such as diabetes, osteoporosis (brittle bones), liver cancer and liver failure. Symptoms depend on the severity of the cirrhosis, but may include:

  • hormone disruptions that could cause a range of problems
  • including testicular atrophy (shrinking)
  • impotence in males or amenorrhoea (no periods) in women cognitive problems such as memory loss
  • confusion or concentration difficulties

Two of the most well-known causes of liver cirrhosis are long-term excessive alcohol consumption and virus infection.

However, there are a number of other conditions that can also lead to liver damage and cirrhosis. In fact, non-alcoholic (‘fatty liver’) is the most common cause of chronic liver disease in United States. A small proportion of patients with fatty liver can also develop cirrhosis.

Hepatitis B virus infection is an important cause of cirrhosis worldwide. Excessive and chronic alcohol consumption is the most common cause of liver cirrhosis. Cirrhosis from drinking alcohol can develop over many years.

It is important to remember that the amount of alcohol that will damage the liver can vary from person to person.

If a healthy woman drinks the same amount of alcohol as a healthy man, she has a higher risk of cirrhosis.

Children are particularly susceptible to damage from alcohol

Some people also have a genetic predisposition to alcohol-related liver injury. People with a medical condition, especially those affecting the liver, may have a higher risk of damage from alcohol.

If you already have hepatitis B or C, or cirrhosis of the liver (from any cause), you are at risk of making your condition worse if you drink alcohol.

Hepatitis is a general term meaning inflammation of the liver. Viral hepatitis is hepatitis caused by a virus like the hepatitis B or C virus. Chronic hepatitis C is a common cause of liver cirrhosis.

Hepatitis B can also cause cirrhosis

With either of these conditions, you increase your risk of developing cirrhosis if you drink alcohol. Non-alcoholic fatty liver disease (NAFLD) is a condition where fat accumulates in the liver. It now affects about 20 per cent of Americans.

It is becoming more common in children who are overweight or obese. NAFLD is associated with conditions such as:

  • type 2 diabetes. NAFLD can lead to inflammation of the liver
  • the formation of scar tissue
  • a condition called non-alcoholic steatohepatitis (NASH)
  • which can then lead to cirrhosis of the liver

NASH usually occurs in people who are obese, have diabetes or have high blood cholesterol and triglycerides, so controlling these conditions is recommended. People with NASH have a higher risk of liver damage if they have hepatitis C. The effect of alcohol is debated, but it is probably not recommended if there is significant liver scarring present.

Some inherited conditions damage the liver and this leads to the scarring that can contribute to cirrhosis. These conditions include:

  • – the body is unable to process galactose (a sugar) so it accumulates in the blood
  • can result in liver damage – can cause lung damage but can also affect liver function
  • lead to cirrhosis
  • liver failure

A number of other medical conditions that result in liver damage can cause cirrhosis, including: – certain types of cells of the immune system attack and damage the liver.

These uncommon conditions that can cause liver cirrhosis include autoimmune hepatitis, primary biliary cholangitis and primary sclerosing cholangitis (inflammation and scarring of the bile ducts). – can damage the liver because one of the liver’s main roles is to remove toxins from the blood. Prolonged exposure to environmental toxins such as arsenic can damage the liver and lead to cirrhosis.

– a tropical disease caused by a parasitic worm called Schistosoma. The worm is passed to humans from snails, and the disease is also known as bilharziasis. Chronic schistosomiasis causes damage to internal organs including the liver certain medications (such as amiodarone, which is used to manage heart arrhythmias) – in rare cases, may cause cirrhosis in susceptible people – can cause cirrhosis in about one third of cases (called ‘cryptogenic cirrhosis’.

Some of these are due to non-alcoholic fatty liver disease). Without medical treatment, cirrhosis of the liver can lead to a range of potentially life-threatening complications including: liver failure – loss of liver cells and disruption of blood flow through the liver by scar tissue can impair liver function impaired functioning of the brain caused by toxins that the liver has failed to remove (hepatic encephalopathy). primary liver cancer – the most common type of cancer caused by cirrhosis is hepatocellular carcinoma Tests used to diagnose liver cirrhosis may include:

  • imaging studies including ultrasound computed tomography (CT scan) or magnetic resonance imaging (MRI) )
  • this test uses an ultrasound-based technique to detect liver cirrhosis

This test is less accurate in people with obesity issues unless specially designed XL probes are used. liver biopsy, obtaining liver tissue for laboratory examination. Cirrhosis of the liver is incurable but, in some cases, treatment can help to reduce the likelihood that the condition will become worse.

Treatment options include:

  • for example
  • treating the underlying hepatitis (B or C) virus infection
  • or the removal of blood to lower iron levels in haemochromatosis – such as beta-blockers to reduce blood pressure
  • lower the risk of bleeding or diuretics to remove excess fluid – an option that may be considered in severe cases

Cirrhosis of the liver is a type of liver Symptoms of liver cirrhosis appetite loss nausea weight loss general tiredness spidery red veins on the skin (spider angiomas) easily bruised skin yellowing of the skin and eyes (jaundice) reddened palms (palmar erythema) itchy skin hair loss dark coloured urine fluid retention in the abdomen and legs internal bleeding presenting as dark-coloured stools or vomiting blood disturbed sleep patterns Causes of liver cirrhosis hepatitis C fatty liver disease Alcoholic liver cirrhosis Liver cirrhosis and hepatitis Liver cirrhosis and fatty liver obesity – 20 per cent of people with obesity have fatty liver disease high blood cholesterol and triglycerides Liver cirrhosis from inherited conditions haemochromatosis – the body accumulates iron, which can damage many organs, including the liver Wilson disease – the tissues of the body accumulate copper galactosaemia cystic fibrosis – mainly affects the lungs, but can also cause scarring of the liver alpha-1 antitrypsin deficiency Other causes of liver cirrhosis some autoimmune diseases exposure to poisons schistosomiasis unknown conditions Complications of liver cirrhosis bleeding from enlarged blood vessels (‘varices’) in the oesophagus or stomach build-up of fluid within the abdominal cavity (ascites) infection of the fluid found within the abdominal cavity (spontaneous bacterial peritonitis) osteoporosis (brittle bones) Diagnosis of liver cirrhosis medical history physical examination blood tests, including liver function tests urine tests transient elastography (Fibroscan TM Treatment of liver cirrhosis treating the underlying cause of liver damage making dietary and lifestyle changes – a nutritious low-fat, high-protein diet and exercise can help people to avoid malnutrition avoiding alcohol – alcohol damages the liver and harms remaining healthy tissue taking certain medications avoiding certain medications that can make the symptoms worse – such as non-steroidal anti-inflammatory drugs (NSAIDs), opiates or sedatives having regular medical check-ups – including scans to check for liver cancer having regular endoscopic procedures to check whether there are varicose veins within the oesophagus or stomach having a liver transplant Where to get help Your GP (doctor) Gastroenterologist Dietitian.

Key Points

  • Many people think that only drinking excessive amounts of alcohol causes liver cirrhosis
  • Depending on the cause, cirrhosis can develop over months or years
  • Two of the most well-known causes of liver cirrhosis are long-term excessive alcohol consumption and virus infection
  • In fact, non-alcoholic (‘fatty liver’) is the most common cause of chronic liver disease in United States
  • Hepatitis B virus infection is an important cause of cirrhosis worldwide