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Massachusetts General Hospital Liver Center specialists are authorities in the diagnosis and management of all forms of acute and chronic liver disease.
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The Massachusetts General Hospital Transplant Center has performed more adult and pediatric liver transplants than any other center in New England, and has maintained some of the best graft and patient survivals in the country.
Chronic Liver Disease/Cirrhosis
What is cirrhosis?
Cirrhosis is when scar tissue replaces healthy liver tissue. This stops the liver from working normally.
Cirrhosis is a long-term (chronic) liver disease. The damage to your liver builds up over time.
The liver is your body’s largest internal organ. It lies up under your ribs on the right side of your belly or abdomen.
The liver does many important things including:
- Removes waste from the body, such as toxins and medicines
- Makes bile to help digest food
- Stores sugar that the body uses for energy
- Makes new proteins
When you have cirrhosis, scar tissue slows the flow of blood through the liver. Over time the liver can’t work the way it should.
In severe cases the liver gets so badly damaged that it stops working. This is called liver failure.
What causes cirrhosis?
The most common causes of cirrhosis are:
- Hepatitis and other viruses
- Alcohol abuse
- Non-alcoholic fatty liver disease
Other less common causes of cirrhosis may include:
- Autoimmune disorders, where the body’s infection-fighting system (immune system) attacks healthy tissue
- Blocked or damaged tubes (bile ducts) that carry bile from the liver to the intestine
- Use of certain medicines
- Exposure to certain toxic chemicals
- Repeated episodes of heart failure with blood buildup in the liver
- Parasite infections
Some diseases passed from parent to child (inherited diseases) may also cause cirrhosis. These may include:
- Alpha1-antitrypsin deficiency
- High blood galactose levels
- Glycogen storage diseases
- Cystic fibrosis
- Hereditary buildup of too much copper (Wilson disease) or iron (hemochromatosis) in the body
What are the symptoms of cirrhosis?
Your symptoms may vary, depending on how severe your cirrhosis is. Mild cirrhosis may not cause any symptoms at all.
Symptoms may include:
- Fluid buildup in the belly or abdomen (ascites)
- Vomiting blood, often from bleeding in the blood vessels in the food pipe (esophagus)
- Yellowing of the skin and eyes (jaundice)
- Kidney failure
- Muscle loss
- Loss of appetite
- Easy bruising
- Spider-like veins in the skin
- Low energy and weakness (fatigue)
- Weight loss
- Confusion as toxins build up in the blood
The symptoms of cirrhosis may look like other health problems. Always see your health care provider to be sure.
How is cirrhosis diagnosed?
Your health care provider will look at your past health. He or she will give you a physical exam.
You may also have tests including:
- Blood tests. These will include liver function tests to see if the liver is working the way it should. You may also have tests to see if your blood is able to clot.
- Liver biopsy. Small tissue samples are taken from the liver (with a needle or during surgery). The samples are checked under a microscope to find out the type of liver disease.
Your health care provider may want you to have imaging tests including:
- CT scan (computed tomography). A CT scan is more detailed than a standard X-ray. It can show detailed images of any part of the body, including the bones, muscles, fat, and organs. It uses X-rays and computer technology to make horizontal images (often called slices) of the body.
- MRI (magnetic resonance imaging). This test makes detailed pictures of organs and structures inside your body. It uses a magnetic field and pulses of radio wave energy. A dye may be shot (injected) into your vein. The dye helps the liver and other organs to be seen more clearly on the scan.
- Ultrasound. This shows your internal organs as they work. It checks how blood is flowing through different blood vessels. It uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs.
How is cirrhosis treated?
Cirrhosis is a progressive liver disease that happens over time. The damage to your liver can’t be reversed.
The goal of treatment is to slow down the buildup of scar tissue and prevent or treat other health problems.
In many cases you may be able to delay or stop any more liver damage.
Your treatment may include:
- Eating a healthy diet
- Not having alcohol or illegal drugs
- Managing any health problems that happen because of cirrhosis
Talk to your health care provider before taking prescription medicines, over-the-counter medicines, or vitamins.
If you have severe cirrhosis, treatment can’t control other problems. A liver transplant may be needed.
What are the complications of cirrhosis?
Cirrhosis can cause other health problems such as:
- Portal hypertension. The portal vein carries blood from your intestines and spleen to your liver. Cirrhosis slows the normal flow of blood. That raises the pressure in the portal vein. This is called portal hypertension.
- Enlarged blood vessels. Portal hypertension may cause enlarged blood vessels in the stomach (called gastropathy) or the food pipe or esophagus (called varices). These blood vessels are more likely to burst due to thin walls and higher pressure. If they burst, severe bleeding can occur. Seek medical attention right away.
- Easy bruising and severe bleeding. This happens when the liver stops making proteins that are needed for your blood to clot.
- Type 2 diabetes.When you have cirrhosis your body does not use insulin properly (insulin resistance). The pancreas tries to keep up with the need for insulin by making more, but blood sugar (glucose) builds up. This causes type 2 diabetes.
- Liver cancer.
Key points about cirrhosis
- Cirrhosis is when scar tissue replaces healthy liver tissue. This stops the liver from working normally.
- Cirrhosis is a long-term (chronic) liver disease.
- The most common causes are hepatitis and other viruses, and alcohol abuse. Other medical problems can also cause it.
- The damage to the liver can’t be reversed.
- The goal of treatment is to slow down the buildup of scar tissue and prevent or treat any problems that occur.
- In severe cases a liver transplant may be needed.
Next stepsTips to help you get the most from a visit to your health care provider:
- Before your visit, write down questions you want answered.
- Bring someone with you to help you ask questions and remember what your provider tells you.
- At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
- If you have a follow-up appointment, write down the date, time, and purpose for that visit.
- Know how you can contact your provider if you have questions.