Written by Dr Yiannis Kallis for Doctify
Liver health is incredibly important – but how can you tell if yours is damaged? What are the symptoms and how can this be treated? Here to tell us is Gastroenterologist, Dr Yiannis Kallis.
What is cirrhosis?
Cirrhosis refers to extensive scarring and damage to the liver. This usually only develops gradually over many years and it can be caused by a number of different types of liver injury.
There are typically very few if any symptoms associated with the accumulation of liver scar tissue and damage and many people are unaware that they may have cirrhosis.
Once a person has cirrhosis, they are at risk of progressing to liver failure or of developing other serious complications such as primary liver cancer. The prevalence of cirrhosis has markedly increased over the last three decades. It is now the second most common cause of early mortality in adults in the UK.
What are the symptoms of cirrhosis?
Chronic liver disease is normally silent so there are typically few if any symptoms.
- Unexplained weight loss,
- Tiredness
- Muscle weakness
These can occur in the later stages, but these symptoms are often subtle and are non-specific (i.e. they can occur for many other reasons).
The symptoms of liver failure are more obvious, and include:
- Jaundice
- Fluid accumulation in the abdomen (ascites)
- Recurrent infection and confusion/drowsiness (hepatic encephalopathy)
However, these are very end-stage symptoms and they may not be reversible. It is thus vital that cirrhosis is detected at an earlier stage.
When should you see your doctor?
It is worth seeing your doctor about your liver if you think you may be at risk of having liver disease. It is also important to consult your doctor if you have ever had a liver abnormality picked up on a blood test or on a scan in the past.
Your GP may then recommend onward referral to a liver specialist for further investigation and treatment.
Who is most likely to suffer from cirrhosis?
Chronic liver diseases characteristically progress to cirrhosis over periods as long as 15-30 years, though in some situations it can be shorter than this. The liver has a remarkable capacity to repair itself and to regenerate so a person can have no outward symptoms and have normal liver function despite ongoing liver injury.
Anyone can suffer from chronic liver disease leading to cirrhosis but there are some common and important risk factors to look out for.
What are the most common causes of cirrhosis?
The most common cause of cirrhosis in the UK, and in many other parts of the world, is excess alcohol consumption. Your risk of developing chronic liver disease is directly proportional to how much you are regularly drinking and how long you are drinking for.
Many patients with alcohol related liver damage are not alcoholics, and any type of alcohol containing drink (e.g. beer, wine, spirits) can cause damage if consumed to excess. In the UK, the recommended safe limit of alcohol consumption is 14 units a week for both men and women. This equates to approximately one and a half bottles of wine or five pints of beer.
Another important cause of chronic liver disease is fatty liver. This is the disease that is most on the increase and it is closely linked with obesity, diabetes and high cholesterol.
Chronic viral hepatitis is another relevant cause of cirrhosis and there are a number of risk factors, including previous blood transfusions or using contaminated needles or other medical devices. There are parts of the world where hepatitis B and hepatitis C are very prevalent, so one of the most important risk factors may be the country in which you were born and raised.
There are other less common causes of liver damage such as autoimmune diseases, inflammatory bile duct disorders, and rarer inherited metabolic conditions.
How can you check if you have cirrhosis?
Routine blood tests may show abnormalities of liver function or indicate liver inflammation, and if this is the case then further investigation is certainly required. Derangements in liver blood tests (LFTs) are actually often found by chance during medical work up for other conditions.
Blood tests will not definitely tell you, however, whether you are starting to accumulate scar tissue (fibrosis) in your liver that could lead to cirrhosis over time. There are specific scans that can non-invasively measure this. The most widely used is called a Fibroscan, which is a modified type of ultrasound machine.
Your GP may be able to refer you for one directly. A hepatologist (liver specialist) can perform this for you.
Are there preventative measures you can take?
It is important to screen for chronic viral hepatitis if you could be at risk, as there are very successful treatments available now available for this.
Moderating alcohol consumption to within the recommended limits, reducing weight by following a sensible balanced diet together with taking regular exercise, will all help your liver, as well as making you fitter and healthier overall.
