What Is Non-Alcoholic Cirrhosis Of Liver?
- 10 Mins Read
- Health Conditions
- Written by: Dr. Pramod Mane
- Reviewed by: Dr Lynda Odoh
- Cirrhosis is the late stage of scarring of the liver caused by other liver diseases.
- A lot of complications can result from cirrhosis, such as hypertension, malnutrition, etc.
- In addition to a range of blood tests, liver biopsy, CT scans, and MRI are the major tests that are recommended for the identification of cirrhosis.
- Cirrhosis can be prevented or kept in check by taking precautions and maintaining a healthy lifestyle.
- The last stage of treatment includes liver transplant.
The liver is one of the most important organs in our body, performing 500-odd functions, the most important of which are to do with digestion, blood filtration, waste secretion, blood sugar regulation, and blood-clotting to prevent excessive blood loss.
While it keeps our body free of diseases by removing toxins, the liver itself is vulnerable to diseases if we have a bad lifestyle and ignore the risks and warning signs of liver trouble. Cirrhosis is one of the worst things that can happen to the liver, and it can happen even without alcohol. Non-alcoholic cirrhosis of the liver is the last stage of Non-Alcoholic Fatty Liver Disease, and NAFLD has become a leading cause of chronic liver disease globally.
We have to understand that anyone, including teetotallers, can be at risk of non-alcoholic cirrhosis unless they take steps to reverse NAFLD before it can get to the irreversible stage of cirrhosis.
What does liver cirrhosis mean?
Cirrhosis simply means scarring. Cirrhosis is a late-stage liver disease, in which healthy liver tissue is mostly replaced with scar tissue and the liver is permanently damaged. Scar tissue keeps your liver from working properly.
Many types of liver diseases and conditions injure healthy liver cells, causing cell death and inflammation. This is followed by cell repair and finally tissue scarring as a result of the repair process.
The scar tissue blocks blood flow through the liver and slows the liver’s ability to process nutrients, hormones, drugs, and natural toxins. It also reduces the production of proteins and other substances made by the liver. Cirrhosis eventually keeps the liver from working properly. Late-stage cirrhosis is life-threatening, as it can lead to complete liver failure.
Non-alcoholic cirrhosis symptoms
The symptoms of cirrhosis depend on the stage of your disease. In the early stages, you may not have any symptoms. If you do have symptoms, some are general and could easily be mistaken for symptoms of many other illnesses.
Early symptoms and signs of cirrhosis include:
As liver function gets worse, other more commonly recognized symptoms of cirrhosis appear, including:
- Easy bruising and bleeding
- Yellow tint to the skin or whites of the eyes (jaundice)
- Itchy skin
- Swelling (edema) in legs, feet, and ankles
- Fluid build-up in your belly/abdomen (ascites)
- Brownish or orange color to your urine
- Light-colored stools
- Confusion, difficulty thinking, memory loss, and personality changes
- Blood in the stool
- Redness in the palms
- Spider-like blood vessels surround small, red spots on the skin
- In men: loss of sex drive, enlarged breasts, shrunken testicles
- In women: premature menopause(permanent end of menstruation)
Non-alcoholic liver cirrhosis causes
- Fatty liver disease associated with obesity and diabetes, and not alcohol. This condition is called non-alcoholic steatohepatitis.
- Chronic viral infections of the liver (Hepatitis Band Hepatitis C)
- Inherited diseases:
- Hemochromatosis(excess iron stored in the liver)
- Wilson’s disease(excess copper stored in the liver)
- Cystic fibrosis(sticky, thick mucus builds up in the liver)
- Glycogen storage diseases(the liver can’t store or break down glycogen, a form of sugar)
- Autoimmune hepatitis(your body’s immune system attacks healthy liver tissue, causing damage)
- Diseases that damage or block bile ducts in the liver (tubes that carry bile from the liver to other parts of the digestive system; bile helps digest fats)
- Chronic heart failure(causes fluid to back up in your liver, swelling in other areas of your body, and other symptoms)
Changes from liver diseases that lead to cirrhosis are gradual. Liver cells are injured, and if that injury — from whatever cause — continues, liver cells start to die. Over time, scar tissue replaces the damaged liver cells and the liver can’t function properly.
Complications of cirrhosis in non-drinkers
There are many complications of cirrhosis in non-drinkers. Because cirrhosis develops over many years, some of these complications may be your first noticeable signs and symptoms of the disease. They are:
- Portal hypertension: This is the most common of the serious complications arising from liver cirrhosis. Portal hypertension is an increase in the pressure in your portal vein (the large blood vessel that carries blood from the digestive organs to the liver). This increase in pressure is caused by a blockage of blood flow through your liver as a result of cirrhosis. As the pressure in the veins builds, the veins can bleed or even burst, causing severe internal bleeding.
Additional complications of portal hypertension include:
- Swelling (edema) in legs, ankles, or feet
- Build-up of fluids in the abdomen (called ascites)
- Swelling/enlargement of the spleen (splenomegaly)
- Formation and dilation (expansion) of blood vessels in the lungs, leading to low levels of oxygen in the blood and body and shortness of breath
- Failure of kidney function as a result of having portal hypertension as a complication of cirrhosis. This is a type of kidney failure
- Confusion, difficulty thinking, changes in behavior, even coma. This occurs when toxins from the intestines aren’t removed by the damaged liver and circulate in the bloodstream and reach the brain
- Malnutrition: The liver processes nutrients. A damaged liver makes this more difficult and leads to weight loss and general weakness.
- Liver cancer: Most people who develop liver cancer have reached the stage of liver cirrhosis, including non-alcoholic liver cirrhosis.
- Liver failure: Many diseases and conditions cause liver failure, including cirrhosis of the liver. As its name implies, liver failure occurs when your liver isn’t working well enough to perform its many vital functions.
Diagnosis of non-alcoholic cirrhosis
To diagnose liver cirrhosis, your doctor will perform a physical exam and may order one or more of the following tests:
- Physical exam: Your doctor will examine you, looking for the signs and symptoms of cirrhosis, including the red, spider-like blood vessels on your skin; yellowing of your skin or whites of your eyes; bruises on your skin; redness on your palms; swelling, tenderness or pain in your abdomen; bumpy texture to the lower edge of your liver (the part of your liver below the rib cage that can be felt).
- Blood tests: If your doctor suspects cirrhosis, your blood will be checked for signs of liver disease. Signs of liver damage include:
- Lower than normal levels of albumin and blood-clotting factors (lower levels mean your liver has lost its ability to make these proteins)
- Raised levels of liver enzymes (suggests inflammation)
- Higher level of iron (may indicate hemochromatosis)
- Presence of autoantibodies (may indicate autoimmune hepatitis or primary biliary cirrhosis)
- Raised bilirubin level (suggests liver isn’t working properly to remove bilirubin from the blood)
- High white blood cell count (indicates an infection)
- High creatinine level (a sign of kidney disease that suggests late-stage cirrhosis)
- Lower levels of sodium (an indicator of cirrhosis)
- A complete blood count to look for signs of infection and anemia caused by internal bleeding and a viral hepatitis test to check for Hepatitis B or C
- Imaging tests: Imaging tests show the size, shape, and texture of the liver. These tests can also determine the amount of scarring, the amount of fat you have in your liver, and the fluid in your abdomen. Imaging tests of your liver that could be ordered include computerized tomography (CT) scan, abdominal ultrasound, and magnetic resonance imaging (MRI). Ultrasound measures the fat content and amount of stiffness in your liver. Endoscopies might be required to detect bile duct problems, and/or to detect enlarged veins or bleeding in your esophagus, stomach, or intestines.
- Biopsy: A sample of liver tissue is removed from your liver and examined under the microscope. A liver biopsy can confirm a diagnosis of cirrhosis, determine other causes or extent of liver damage or enlargement, or diagnose liver cancer.
Stages of non-alcoholic cirrhosis of the liver
If you have been diagnosed with non-alcoholic cirrhosis of the liver, you’re already beyond the early stages of liver disease. Having cirrhosis means your liver has scar tissue in it because it has been damaged irreparably.
Compensated cirrhosis means you have cirrhosis but you don’t yet have noticeable symptoms (you are asymptomatic). Your lab work and imaging findings may not be abnormal. A liver biopsy may be the only way to confirm a diagnosis of cirrhosis.
Decompensated cirrhosis means your cirrhosis has worsened to the point that you have noticeable symptoms. Your doctor recognizes your condition based on your history, and physical and laboratory findings. You have at least one complication, which includes jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome, variceal bleeding, or liver cancer. You’re usually admitted to the hospital for care.
Ways to manage non-alcoholic cirrhosis of the liver
There’s no permanent cure for cirrhosis, be it alcoholic or non-alcoholic. The damage already done to your liver is irreversible. However, depending on the underlying cause of your cirrhosis, there may be actions you can take to keep your cirrhosis from getting worse.
These actions include:
- Never touching alcohol in any form
- Treating chronic hepatitis (if you have it)
- Avoiding medications that stress the liver
- Eating a healthy, well-balanced, low-fat diet, such as the Mediterranean diet, but minus the wine
Treatment for non-alcoholic cirrhosis of the liver
Treatment depends on what’s causing your cirrhosis and how much damage exists. Although there’s no cure for cirrhosis, treatments can delay or stop its progress and reduce complications.
Treatments for the causes of cirrhosis are as follows:
- Hepatitis B or C: Several approved antiviral medications are available to treat Hepatitis B and C.
- Non-Alcoholic Fatty Liver Disease: Management of NAFLD includes losing weight, following a healthy diet, getting physical exercise, and managing diabetes (if you have it).
- Inherited liver diseases: Treatment depends on the specific inherited disease. Treatments are aimed at treating symptoms and managing complications.
- Autoimmune hepatitis: Treatment includes medications to suppress your immune system.
- Heart failure: Treatment depends on the cause and stage of your heart failure. Medications include drugs to treat high blood pressure, reduce cholesterol, remove excess fluids (edema) from your body and improve heart pumping function. Other treatments include the implantation of devices to help pump blood or monitor heart rhythm, surgeries to unblock arteries or replace or repair heart valves, and transplant surgery to replace your heart.
- Medications that may be contributing to cirrhosis: Your doctor will review all of your medications to determine if any are causing problems for your liver and if so, stop the drug, lower the dosage, or change to a different drug if possible.
- Liver transplant: If you develop severe cirrhosis and your liver mostly stops working, you may need to be put on the waiting list for a liver transplant; or, it may be possible to have a transplant using a section of liver removed from a living donor. As the liver can regenerate itself, both the transplanted section and the remaining section of the donor’s liver can regrow to normal size.
Prevention of non-alcoholic cirrhosis of the liver
Food and drinks
- Eat a well-balanced, low-fat diet. A healthy diet consists of fruits, vegetables, lean proteins, and whole grains.
- Don’t eat raw seafood, especially oysters and clams. These foods can contain bacteria that can cause serious illness and stress the liver.
- Cut back on the amount of salt in your diet. Use other seasonings to flavor your foods.
- Maintain a healthy weight. Excess body fat can damage your liver. Ask your doctor for a weight loss plan if you are overweight.
- Exercise regularly, for 30 minutes a day and 5 days a week.
- See your doctor regularly for check-ups. Follow medical recommendations to control obesity, diabetes, hypertension(high blood pressure) and cholesterol (high bad cholesterol [LDL] and/or low good cholesterol [HDL]), and high triglycerides.
- Quit smoking, if you smoke.
Cirrhosis (scarring) from liver disease causes permanent damage, but it’s still possible to live a long life. Depending on the underlying cause, it’s possible to slow or stop cirrhosis from worsening. Many of the causes and complications that lead to cirrhosis are treatable or manageable.
Identify your risks of Non-Alcoholic Fatty Liver Disease and do everything to reverse NAFLD, including losing weight and improving your diet. If you have diabetes, follow your doctor’s advice strictly. Get vaccinated for Hepatitis A and B. These can help you prevent non-alcoholic cirrhosis.
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