Cirrhosis is a late-stage form of liver disease. In the early phases of liver disease, some people may not encounter any symptoms. Alcohol use disorder, hepatitis, and fatty liver disease are all contributing factors to alcoholic cirrhosis.
The approach to treatment for cirrhosis is based on the underlying cause of the condition and the extent of liver damage. Patients whose conditions progress to liver failure may require a liver transplant.
Chronic heavy drinking can lead to all sorts of complications with your liver, including alcoholic cirrhosis, liver disease, and liver cancer. Below, we will take a closer look at the symptoms and causes of cirrhosis, as well as treatment options for alcohol-related liver disease and how to get help to stop any amount of drinking any amount of alcohol.
What Is Alcoholic Cirrhosis of the Liver?
Alcoholic liver disease is an umbrella term for a spectrum of disorders. Alcoholic cirrhosis refers to the end-stage of liver disease that happens when healthy liver tissue is replaced with scar tissue, which permanently damages the liver. Scar tissue is detrimental to proper liver function. (1)
According to the National Institutes of Health, liver diseases and conditions can damage healthy liver cells, resulting in cell death and inflammation. When this happens, cells go to work to repair the damage, and tissue scarring is a result of the repair process.
When scar tissue builds up in the liver, it obstructs blood flow, which can impede the organ’s ability to metabolize nutrients, hormones, drugs, and toxins. (2) Furthermore, scar tissue build-up can lower the liver’s ability to generate proteins and other essential substances.
Cirrhosis can eventually impair the liver’s ability to function normally. In advanced stages, cirrhosis of the liver can be life-threatening.
Signs and Symptoms of Cirrhosis
According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), there are often no symptoms of cirrhosis until the later stages of liver disease, once the liver has already sustained damage. (3)
Some early symptoms of cirrhosis might include:
- Feeling more tired or weaker than usual
- Loss of appetite
- Unintended weight loss and malnutrition
- Nausea and vomiting
- Mild abdominal pain
- Loss of sex drive
As the condition progresses and liver function worsens, the following symptoms may appear: (3)
- Easily bleeding and bruising
- Edema, or swollen legs, ankles, and/or feet
- Bloating from a build-up of fluid in the abdomen, known as ascites
- Severe itchy skin
- Yellowing of the skin and whites of the eyes, known as jaundice
- Spider blood vessels
- Confusion
- Slurred speech
- Memory loss
- Personality changes
Causes and Risk Factors of Alcoholic Cirrhosis
The NIDDK says that there are several different causes of the condition. The most common causes in the early stages are:
- Alcoholic liver disease
- Nonalcoholic fatty liver disease
- Chronic hepatitis C
- Chronic hepatitis B
- Bile duct destruction caused by primary biliary cholangitis (4)
- Wilson’s disease is a liver injury where copper builds up in the liver
Long-Term Complications of Cirrhosis
Some of the most common complications of cirrhosis include:
- High blood pressure: Portal hypertension, or high blood pressure that’s isolated in the veins that provide blood to the liver, is a common complication of cirrhosis.
- Enlarged spleen: Spleen swelling can also be caused by portal hypertension trapping white blood cells and platelets.
- A reduction in the number of white blood cells and platelets present in the bloodstream is often one of the first signs of cirrhosis.
- Bleeding: When someone has portal hypertension, blood flow can be redirected to smaller veins, which can burst from the increased pressure, often resulting in severe bleeding. The condition can also cause the veins in the gastrointestinal system or esophagus to enlarge or explode, which is known as varices. This condition can be life-threatening if the veins bleed.
- Ascites: This is the accumulation of fluid in the abdomen, which can cause swelling and discomfort. Severe ascites can also lead to respiratory problems and increase the risk of infection. (5)
- Infections: People with cirrhosis have a harder time fighting infections. Bacterial peritonitis, which is a severe infection, may develop as a result of ascites. (6)
- A build-up of toxins in the brain: When the liver becomes damaged from cirrhosis, it can’t properly clear toxins from the blood. When these toxins build up in the brain, they can cause mental confusion and delayed processing. This condition is called hepatic encephalopathy. As time progresses, this condition may worsen and eventually lead to a state of unresponsiveness or coma.
- Bone disease: People with cirrhosis may lose bone strength more easily, putting them at an increased risk of fractures and bone disease.
- Increased risk of liver cancer: Cirrhosis is a leading factor in the development of liver cancer.
- Liver failure: Most often, chronic liver failure is the result of cirrhosis.
Liver Cirrhosis Diagnosis and Testing
Liver cirrhosis, particularly when related to alcohol consumption and binge drinking, is diagnosed through a combination of medical evaluations, tests, and exams. These diagnostic measures are super important for understanding the extent of liver damage and implementing appropriate interventions.
- Medical History and Physical Examination: The diagnosis of alcoholic cirrhosis begins with a comprehensive medical history and physical examination. Healthcare providers inquire about alcohol consumption, overall health, and any symptoms that may suggest liver dysfunction. Physical examinations may reveal signs such as abdominal swelling, jaundice, or spider-like blood vessels on the skin.
- Liver Function Tests: Liver function tests play a key role in assessing the health of the liver. Blood tests measure various enzymes, proteins, and substances produced or processed by the liver. Elevations in certain markers may indicate liver damage and dysfunction. Common liver function tests include alanine aminotransferase (ALT), aspartate aminotransferase (AST), and bilirubin levels. (7)
- Imaging Studies: Imaging studies provide visual insights into the structure of the liver and can reveal cirrhosis-related changes. Common imaging modalities include ultrasound, CT scans, and MRI. These tests help identify liver scarring, nodules, and changes in liver size.
- FibroScan or Transient Elastography: FibroScan, also known as transient elastography, is a specialized test that measures liver stiffness. This non-invasive procedure assesses the degree of liver fibrosis or scarring. It provides valuable information about the progression of cirrhosis without the need for a liver biopsy. (8)
- Liver Biopsy: In some cases, a liver biopsy may be recommended to confirm the diagnosis and assess the severity of cirrhosis. During a liver biopsy, a small sample of liver tissue is obtained using a needle. The sample is then examined under a microscope to identify signs of cirrhosis, inflammation, and other liver conditions.
- Ascites Fluid Analysis: Ascites, the accumulation of fluid in the abdominal cavity, is a common complication of cirrhosis. Analyzing the fluid obtained through a procedure called paracentesis can help determine the cause of ascites and provide additional information about liver function.
- Additional Blood Tests: Additional blood tests may be conducted to assess overall health and identify potential complications of cirrhosis. These tests may include blood clotting assessments, complete blood count (CBC), and tests for viral hepatitis.
- Evaluation of Alcohol Use Disorder: Since alcoholic cirrhosis is closely linked to excessive alcohol consumption, healthcare providers assess the presence of alcohol use disorder. Discussions about alcohol consumption habits, patterns, and potential interventions are integral to the overall diagnosis and treatment plan.
Treatment Options for Alcoholic Cirrhosis
There are several different treatment options for cirrhosis, which all depend on the severity of the disease and the extent of the liver damage.
Some of the treatment options that healthcare providers commonly use include:
- Stopping alcohol consumption: Liver damage can often be reversed by quitting drinking alcohol.
- Nutritional counseling: Malnutrition is common in people with cirrhosis, and nutritional support may be necessary to improve liver function and promote overall health. A balanced diet with adequate protein, vitamins, and minerals is key. Especially if there is a history of chronic liver disease.
- Medication: People with more advanced stages of liver disease and with more damage to the liver may be prescribed medications to reduce inflammation or treat infections. Some procedures can drain the fluid build-up in the abdomen.
- Liver transplant: The most severe cases of alcoholic cirrhosis require a liver transplant. This involves surgically removing the damaged liver and replacing it with a healthy liver from a donor.
It’s important to note that early intervention is key when it comes to treating alcoholic cirrhosis of the liver. So if you have been experiencing any of the symptoms we’ve gone over in this article, seek medical attention immediately to prevent further liver damage and improve your chances of recovery.
Prevention Strategies for Alcoholic Cirrhosis
Alcoholic cirrhosis is a serious condition that affects heavy drinkers, but preventive measures can significantly reduce the risk of its development. Implementing effective strategies is crucial for promoting liver health and preventing the progression of liver disease.
- Moderate Alcohol Consumption: The primary preventive measure for alcoholic cirrhosis is moderating alcohol intake. Following established guidelines for moderate alcohol consumption can help protect the liver. For men, moderate drinking is defined as up to two drinks per day, while for women, it is up to one drink per day. (9) Abstaining from alcohol in the short term is advisable for individuals with a history of liver disease or those at risk for developing cirrhosis.
- Regular Liver Health Checkups: Routine liver health checkups are essential for early detection and intervention. Regular monitoring, including liver function tests and imaging studies, enables healthcare professionals to assess liver health and identify any signs of developing cirrhosis. Timely intervention can significantly impact the prognosis.
- Maintaining a Healthy Diet: Nutrient-rich, well-balanced diets support overall health, including liver function. Diets high in fruits, vegetables, and whole grains, while low in processed foods and saturated fats, contribute to liver health. Adequate hydration or helpful supplements are also good for supporting liver function and preventing dehydration-related stress on the liver.
- Weight Management and Exercise: Maintaining a healthy weight through regular exercise is vital for preventing liver disease. Obesity is a risk factor for cirrhosis, and engaging in physical activity helps manage weight, improve metabolism, and enhance overall well-being. Exercise also supports the body’s natural detoxification processes.
- Vaccination Against Hepatitis: Vaccination against hepatitis viruses, particularly hepatitis B and C, is an essential preventive measure. (10) Chronic hepatitis infections significantly contribute to the development of cirrhosis. Ensuring immunization against these viruses helps protect the liver and reduce the risk of cirrhosis.
- Avoiding Risky Behaviors: Practices such as unsafe drug use and unprotected sex can expose individuals to hepatitis infections, accelerating the progression of liver disease. Avoiding risky behaviors contributes to overall liver health and complements other preventive measures.
Prognosis and Living with Liver Cirrhosis
Understanding the prognosis and learning to manage day-to-day life are crucial aspects for individuals living with liver cirrhosis. Navigating the challenges of this condition requires a comprehensive approach to enhance the quality of life.
- Long-Term Outlook: The prognosis for individuals with liver cirrhosis varies depending on the severity of the condition, the presence of underlying health issues, and adherence to treatment plans. Early detection and intervention can slow the progression of cirrhosis and improve outcomes. Regular medical follow-ups are essential for monitoring liver function and addressing emerging issues promptly.
- Treatment Plans and Medications: Individuals with cirrhosis often require specific treatment plans to manage symptoms and address underlying causes. Medications may be prescribed to alleviate complications such as fluid retention, portal hypertension, or hepatic encephalopathy. Adherence to prescribed medications and lifestyle modifications is crucial for optimizing outcomes. (11)
- Lifestyle Modifications: Adopting lifestyle changes is fundamental for individuals with liver cirrhosis. Abstinence from alcohol is non-negotiable for those with alcoholic cirrhosis. Following a liver-friendly diet, engaging in regular exercise, and avoiding harmful substances contribute to overall well-being and support liver health.
- Monitoring and Early Intervention: Regular medical checkups, including liver function tests and imaging studies, are necessary to monitor the progression of cirrhosis. Early intervention for emerging complications, such as varices or infections, can prevent exacerbations and improve overall health.
- Nutritional Support: Malnutrition is a common concern in individuals with cirrhosis. Working with healthcare professionals, including dietitians, to ensure adequate nutrition is essential. Specialized dietary plans may be recommended to address nutritional deficiencies and promote optimal health.
- Emotional and Social Support: Living with liver cirrhosis can be emotionally challenging. Seeking emotional and social support from healthcare providers, support groups, and loved ones is crucial. Addressing the psychological impact of cirrhosis is integral to enhancing the overall quality of life.
- Advanced Care Planning: Individuals with advanced cirrhosis should engage in advanced care planning discussions with healthcare providers and family members. Discussing preferences for end-of-life care, addressing potential transplant considerations, and ensuring comprehensive support contribute to a more informed and empowered approach to managing the condition.
- Liver Transplant Consideration: In advanced stages of cirrhosis, liver transplantation may be a consideration. Evaluating eligibility and discussing the potential benefits and risks of transplantation with healthcare providers is an important aspect of long-term management.
Navigating Alcoholic Cirrhosis Treatment with Zinnia Health
If you’re having a hard time controlling your alcohol consumption, you’re not alone. Zinnia Health is here for you. Our experienced team of addiction counselors and other healthcare providers will work one-on-one with you to develop a customized treatment plan. Contact us today to learn more.
Citations
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5513682/
- https://www.msdmanuals.com/home/liver-and-gallbladder-disorders/fibrosis-and-cirrhosis-of-the-liver/cirrhosis-of-the-liver
- https://liverfoundation.org/liver-diseases/complications-of-liver-disease/cirrhosis/
- https://www.ncbi.nlm.nih.gov/books/NBK459209/
- https://www.ncbi.nlm.nih.gov/books/NBK470482/
- https://www.ncbi.nlm.nih.gov/books/NBK448208/
- https://www.mayoclinic.org/tests-procedures/liver-function-tests/about/pac-20394595
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3594956/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6713002/
- https://pubmed.ncbi.nlm.nih.gov/16381231/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7603526/
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