Liver cirrhosis is a serious condition, and while a complete cure is often not possible, effective management strategies and lifestyle adjustments can significantly improve your quality of life and slow disease progression. The approach to managing cirrhosis depends heavily on its underlying cause. Although cirrhosis is typically not curable in the traditional sense, there are numerous ways to manage its symptoms, handle potential complications, and prevent the condition from worsening.
Lifestyle Changes to Manage Cirrhosis
Making appropriate lifestyle changes is crucial when you have cirrhosis. These adjustments play a vital role in reducing further liver damage and minimizing complications. Key changes include:
- Complete Alcohol Abstinence: Regardless of the cause of your cirrhosis, avoiding alcohol is paramount. Alcohol puts significant stress on the liver and can drastically accelerate liver damage.
- Smoking Cessation: If you smoke, quitting is essential. Smoking exacerbates liver damage and increases the risk of complications. Resources are available to help you quit smoking effectively.
- Weight Management: If you are overweight or obese, losing weight is strongly recommended. Excess weight can contribute to fatty liver disease, which can worsen cirrhosis. Aim for a healthy weight through a balanced diet and regular exercise.
- Regular Exercise: Engaging in regular physical activity helps maintain muscle mass, which is often affected by cirrhosis, and improves overall health. Consult your doctor to determine a safe and effective exercise plan for you.
- Hygiene Practices: Good hygiene is important to minimize the risk of infections, as people with cirrhosis are more susceptible to them. Wash your hands frequently and practice safe food handling.
- Vaccinations: Talk to your doctor about necessary vaccinations. These may include annual flu shots, pneumococcal vaccine, and travel vaccines, as infections can be more serious in people with cirrhosis.
- Medication Review: Always inform your doctor or pharmacist about all medications you are taking, including over-the-counter and prescription drugs. Cirrhosis can alter how some medications are processed by your body, requiring dosage adjustments or alternative medications.
Dietary Changes for Liver Health
Malnutrition is a common concern for individuals with cirrhosis. Therefore, adopting a healthy, balanced diet is vital to ensure you receive all the necessary nutrients. Key dietary adjustments include:
- Sodium Restriction: Limiting salt intake can help manage fluid retention, a common complication of cirrhosis that leads to swelling in the legs, feet, and abdomen.
- Increased Calorie and Protein Intake: Liver damage can impair glycogen storage, the body’s energy reserve. This can lead to muscle loss and weakness as the body breaks down muscle tissue for energy. Increasing your calorie and protein intake can help combat this.
- Frequent Small Meals: Eating healthy snacks between meals or having three to four smaller meals throughout the day, rather than one or two large meals, can help maintain energy levels and prevent muscle loss.
Medical Treatments for Cirrhosis
The medical treatment for cirrhosis is tailored to the underlying cause of the liver damage. For instance, if viral hepatitis is the cause, antiviral medications may be prescribed. Additionally, medications can help manage the symptoms and complications of cirrhosis:
- Diuretics: These medications, often used in conjunction with a low-sodium diet, help reduce fluid buildup (edema) in the body.
- Medications for Portal Hypertension: Medications can help manage high blood pressure in the portal vein, which carries blood to the liver, a condition known as portal hypertension.
- Prescription Creams: These can alleviate skin itching, a common symptom of cirrhosis.
Managing Cirrhosis Complications
As cirrhosis progresses, it can lead to complications that require specific treatments. These complications arise when the liver’s function becomes severely impaired (decompensated cirrhosis).
Addressing Swollen or Bleeding Veins (Varices)
Advanced cirrhosis can cause veins in the esophagus (esophageal varices) or stomach (gastric varices) to swell. These varices are prone to bleeding.
An endoscopy may be performed to diagnose varices. To prevent bleeding, or manage active bleeding, treatments include:
- Beta Blockers: Medications like propranolol can reduce blood pressure in the portal vein, decreasing the risk of variceal bleeding.
- Endoscopic Variceal Band Ligation: This procedure involves placing bands around the swollen veins to stop or prevent bleeding.
- Urgent Treatment for Bleeding Varices: Vomiting blood or blood in the stool may indicate variceal hemorrhage, requiring immediate medical attention at the nearest emergency department. Treatments to stop bleeding include medications and endoscopic procedures.
For more detailed information on managing varices, resources from organizations like The British Liver Trust are invaluable.
Managing Fluid Accumulation (Ascites and Edema)
Fluid buildup in the abdomen (ascites) and legs/ankles (peripheral edema) is a frequent complication of advanced cirrhosis. Management strategies include:
- Strict Sodium Restriction: Completely eliminating added salt from your diet is crucial.
- Diuretics: Medications like spironolactone or furosemide help the body eliminate excess fluid.
- Antibiotics for Infected Ascites: If ascites fluid becomes infected (spontaneous bacterial peritonitis), antibiotics are necessary.
- Therapeutic Paracentesis: In severe cases of ascites, fluid may need to be drained from the abdomen using a needle or tube.
Addressing Encephalopathy
Hepatic encephalopathy is a condition where cirrhosis affects brain function due to the liver’s inability to remove toxins from the blood. Symptoms include confusion, drowsiness, and difficulty concentrating.
The primary treatment for encephalopathy is:
- Lactulose: This syrup acts as a laxative, helping to remove toxins from the body.
- Rifaximin: This antibiotic may be prescribed to reduce toxin-producing bacteria in the gut.
Managing Bleeding Risks
Cirrhosis can impair the liver’s production of clotting factors, increasing the risk of bleeding. Precautions and treatments include:
- Medications or Plasma: These may be given to prevent or treat bleeding episodes.
- Pre-Procedure Planning: Inform your doctor about your cirrhosis and bleeding risk before any surgery, including dental procedures.
Liver Transplantation: A Potential Option
In cases of severe, decompensated cirrhosis, a liver transplant may be the only viable treatment option. This major surgery involves replacing the diseased liver with a healthy donor liver.
Important considerations regarding liver transplantation:
- Waiting List: There is often a significant waiting time for a suitable donor liver.
- Alcohol-Related Cirrhosis: Liver transplantation may not be an option for individuals with alcohol-related cirrhosis who continue to drink.
Organizations like the British Liver Trust provide comprehensive information about liver transplantation.
Cirrhosis and Diabetes
If you have type 2 diabetes and develop cirrhosis, managing diabetes can become more challenging. Cirrhosis can increase insulin resistance, making blood sugar control more difficult. Careful monitoring and multiple medications may be necessary to manage both conditions effectively.
Liver Cancer Risk in Cirrhosis
Cirrhosis significantly increases the risk of liver cancer, particularly hepatocellular carcinoma (HCC). Regular screening for liver cancer is crucial. This typically involves:
- Ultrasound Scans: Usually performed every 6 months.
- Blood Tests: May be conducted alongside ultrasound scans to screen for HCC.
Early detection of liver cancer improves treatment outcomes.
This information provides a comprehensive overview of managing liver cirrhosis. While the term “cure” might not fully capture the reality of living with cirrhosis, proactive management, lifestyle adjustments, and medical treatments can lead to a better quality of life and help slow the progression of this condition. Always consult with your healthcare provider for personalized advice and treatment strategies.
Page last reviewed: 29 June 2020
Next review due: 29 June 2023
