World Liver Day is observed annually on April 19th to raise awareness about liver health and highlight the importance of preventing and managing liver diseases, including liver cirrhosis. The day aims to educate people about the risk factors, causes, and consequences of liver diseases, as well as promote early detection, proper management, and healthy lifestyle choices to maintain liver health.
Liver cirrhosis is a significant global health concern, and the day serves as a reminder to take steps to prevent liver diseases, such as avoiding excessive alcohol consumption, maintaining a healthy diet and weight, getting vaccinated against viral hepatitis, and seeking timely medical care for liver-related symptoms. It also encourages individuals to support liver health research, spread awareness, and provide support to those affected by liver cirrhosis or other liver diseases.
It’s important to understand the symptoms and causes of liver cirrhosis and liver health to prevent liver disease and improve the overall well-being of individuals worldwide.
Dr Anubhav Jain, Consultant, Gastroenterology, Paras Health, Gurugram, says, “Liver cirrhosis is scarring of liver caused by long term damage it is sometime called end stage liver disease because it happens after other stages of liver damage like hepatitis scarring prevents normal working of liver and can lead to life threatening complication.”
Liver cirrhosis: How does it happen?
Your liver tries to repair itself, each time it is injured. “The cause of liver injury may be excessive alcohol consumption, chronic hepatitis, non-alcoholic fatty steatosis, etc. In the process of repairing itself, the liver forms scar tissue. When more and more scar tissue forms, cirrhosis gets worse, and this makes it tough for the liver to do its job. Advanced liver cirrhosis needs immediate medical intervention as it is life-threatening. A liver transplant may become inevitable in severe cases. The damaged liver is replaced with a healthy one from a donor in a liver transplant procedure. In fact, cirrhosis is the reason behind most liver transplants,” says Dr Aakaar Kapoor, CEO and Lead Medical Advisor, City X-Ray & Scan Clinic Partner, City Imaging and Clinical Labs.
As the liver tissue becomes scarred, it loses its ability to function properly, leading to complications such as jaundice, ascites, portal hypertension, and hepatic encephalopathy. These complications can be life-threatening if left untreated.
Dr Abhai Singh, Senior Consultant, Gastroenterologist, Primus Super Speciality Hospital, New Delhi, says, “Cirrhosis of the liver is a chronic liver disease caused by causes such as alcoholism, hepatitis B and C infections, non-alcoholic fatty liver disease, obesity, and toxicity exposure. Fatigue, weakness, jaundice, itchy skin, and stomach discomfort or swelling are all possible symptoms.”
Risk factors
Primary risk factors for cirrhosis of the liver include excessive alcohol consumption or alcohol abuse. “Obesity or being overweight can also raise your risk of conditions that may lead to cirrhosis. These conditions may include nonalcoholic fatty liver disease and nonalcoholic steatohepatitis. Therefore, obesity is one of the risk factors for cirrhosis. In addition, having viral hepatitis can also lead to this condition. Chronic hepatitis is the world’s leading cause of liver disease, although not everyone with the condition will develop cirrhosis,” adds Dr Kapoor.
Symptoms
Dr Jain shares the symptoms of liver cirrhosis:
- Feeling weak and tired
- Nausea
- Loss of appetite
- Loss of muscle mass
- Red patches over skin
If cirrhosis gets advanced then:
- Jaundice
- Blood vomiting or black stools
- Itchy skin
- Dark coloured urine
- Easy bleeding /bruising
- Leg edema or tummy ascites
- Loss of libido
Causes:
- Obesity or diabetes
- Chronic alcohol use
- Chronic untreated viral liver infection like Hepatitis B and C
- Immune disease like autoimmune hepatitis
- Disease affecting bile ducts like primary biliary cholangitis
Stages of liver cirrhosis
- Hepatitis
- Compensated cirrhosis
- Decompensated cirrhosis
A medical history, physical exam, blood tests, imaging studies, and a liver biopsy are used to make a diagnosis. It is critical to identify and manage risk factors early in order to avoid or limit the course of liver cirrhosis, which can lead to major consequences such as liver failure, liver cancer, and even death.
Diagnosis
Radiology testing such as Computed Tomography (CT scan), Ultrasound, or Magnetic Resonance Imaging (MRI) are generally used for the diagnosis of liver cirrhosis. In some cases, a needle biopsy of the liver is also done to diagnose the condition. A new imaging technique called Elastography can also diagnose the condition. The technique can be performed with ultrasound or MRI.
“For better risk stratification, prognosis, and treatment decision-making, an accurate diagnosis of liver fibrosis is necessary. Liver biopsy is the gold standard for assessing liver fibrosis, is invasive, costly, and impractical for surveillance and treatment response monitoring. Fibroscan is a non-invasive painless test, without patient discomfort, and can be performed at the point of care. Its results are instantaneous; therefore clinicians can use them to make decisions during patients’ visits. Compared to a liver biopsy, it is less expansive and has not been associated with any side effects,” opines Dr Kapoor. The reports generated from Fibroscan would include a CAP score for grading of fatty liver, along with Young’s modulus in Kilopascal for assessing the stiffness of the liver.
According to research, there is no cure for cirrhosis yet, but your doctor may treat your symptoms caused by the condition by recommending medication, lifestyle changes, or transjugular intrahepatic portosystemic shunt (TIPS). Liver transplantation is also an option for some patients, but it may have some complications.
Treatment options depend on the underlying cause of the disease, but may include lifestyle changes, medications, and in some cases, liver transplantation.
Prevention of liver cirrhosis involves avoiding alcohol abuse, maintaining a healthy weight, and getting vaccinated against viral hepatitis. Early detection and treatment of the disease can improve outcomes and prevent complications.
Liver cirrhosis is a serious medical condition that can affect anyone’s life drastically. The good news is that with advancements in medical science and diagnostic technology, it can be treated as well as managed if taken care of on time. “The liver is a vital organ that processes nutrients and removes toxins from circulation, among many other functions. Therefore, it plays a significant role in the normal functioning of the body and must be taken care of,” signs off Dr Kapoor.
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