Thomas Kerr, M.D., Ph.D. Answers Questions On: Liver Cirrhosis

Cirrhosis is scarring of the liver. Over time inflammation and scarring can damage the liver so it’s not able to perform its important metabolic and toxin-removal functions. Liver cirrhosis can also lead to a number of other complications including liver cancer and the need for a liver transplant.

If we can identify and treat the underlying liver conditions early, cirrhosis can often be entirely avoided. If cirrhosis develops, successfully treatment can often result in the liver remaining stable for years.

In patients with cirrhosis, including those who are stable, we will monitor for cirrhosis-related complications, such as risk for internal bleeding and cancer.

There’s a misconception that liver cirrhosis comes only from alcohol abuse, but cirrhosis actually has many causes. It’s usually the result of years of smoldering liver inflammation and/or underlying chronic liver disease.

In addition to viral hepatitis and alcohol, cirrhosis can be caused by fatty liver disease – which is very common in the U.S. – as well as iron overload (hemochromatosis), copper overload, and immune conditions that affect the liver and bile ducts.

Cirrhosis can cause abdominal swelling and pain, gastrointestinal bleeding, jaundice (yellowing of the skin and whites of the eyes), and clouded thinking. If an individual has cirrhosis, and notices any of these, they should contact their physician.

People with a chronic liver condition that is otherwise unexplained often benefit from seeing a liver specialist for a consultation.

In some cases, cirrhosis is evident based on blood work and ultrasound, MRI, or CT imaging of the liver. In other cases, a liver biopsy or a specialized ultrasound (to measure liver stiffness) is required.

In some cases, cirrhosis is so mild and stable that it needs only periodic monitoring. Depending on the cause of the cirrhosis, there often are things we can do to slow – and sometimes entirely stop – its progress by treating the underlying condition.

For example, we’re now able to cure the hepatitis C virus in more than 95 percent of patients. Hepatitis B medicines are also exceedingly effective. Avoiding alcohol and maintaining a healthy weight can also help some patients keep their cirrhosis in check.

If cirrhosis progresses and becomes more symptomatic, it may be time to consider liver transplantation – and we work with patients to decide if that’s the best option.