I'm Dr. Sumera Ilyas, a transplant hepatologist at Mayo Clinic. In this video, we'll cover the basics of cirrhosis. What is it? Who gets it? The symptoms, diagnosis and treatment. Whether you're looking for answers for yourself or someone you love, we're here to give you the best information available. Put simply, cirrhosis is scarring of the liver. Any time an organ is injured, it tries to repair itself. And when this happens, scar tissue forms. As more scar tissue forms in the liver, it becomes harder for it to function. Cirrhosis is usually a result of liver damage from conditions such as hepatitis B or C, or chronic alcohol use. The damage done by cirrhosis typically cannot be undone. But if caught early enough and depending on the cause, there is a chance of slowing it with treatment. And even in the most severe cases, liver transplants and new treatments provide those suffering from cirrhosis with hope.
Any kind of disease or condition that harms the liver can lead to cirrhosis over time. About 2% of American adults have liver disease, and therefore are at risk of developing cirrhosis. However, those who drink too much alcohol, those who are overweight and those with viral hepatitis are at a greater risk. Not everyone with these risk factors develops cirrhosis. These are the leading causes of liver disease. A wide range of other conditions and diseases can cause cirrhosis as well. Some include inflammation and scarring of the bile ducts, known as primary sclerosing cholangitis; iron buildup in the body - what we call hemochromatosis; Copper accumulation in the liver, which is a rare condition called Wilson's disease; and inflammation from the body's own immune system harming liver cells, known as autoimmune hepatitis.
Often, cirrhosis shows no signs or symptoms until liver damage is extensive. When symptoms do occur, they may first include fatigue, weakness and weight loss, nausea, bruising or bleeding easily, swelling in your legs, feet or ankles, itchy skin, redness on the palms of your hands, and spider-like blood vessels on your skin. During later stages, you might develop jaundice, which is yellowing of the eyes or skin; gastrointestinal bleeding; abdominal swelling from fluid building up in the belly; and confusion or drowsiness. If you notice any of these symptoms, you should speak to your doctor.
Since you may not have any symptoms in the early stages of the disease, cirrhosis is often detected through routine blood tests or checkups. If your doctor find something suspicious, further blood tests may be necessary. These can help identify how extensive your cirrhosis is by checking for liver malfunction, liver damage, or screening for causes of cirrhosis such as hepatitis viruses. Based on the results, your doctor maybe able to diagnose the underlying cause of cirrhosis. They may also recommend imaging tests like an MR elastogram that checks for scarring in the liver, or an MRI of the abdomen, CT scan or an ultrasound. A biopsy may also be required to identify the severity, extent and cause of liver damage.
Although the damage caused by cirrhosis is not reversible, treatment can slow the progression of the disease, alleviate symptoms, and prevent complications. In cases of early cirrhosis, it is possible to minimize damage to the liver by tackling the underlying causes. For instance, treating alcohol addiction, losing weight, and using medications to treat viral hepatitis and other conditions can limit damage to the liver. Once the liver stops functioning, an organ transplant may be an option. During a transplant, surgeons remove the damaged liver and replace it with a healthy working liver. In fact, cirrhosis is one of the most common reasons for a liver transplant. You and your medical team will need to assess if you are an appropriate candidate through a transplant evaluation. Surgery is a big undertaking, one that brings its own risks and complications. And it should always be a decision between you, your family, and your doctors.
If you're concerned about your risk of cirrhosis, talk to your doctor. Life with cirrhosis can be challenging, but with the right information, the right medical team and the right treatment, there's reason to be encouraged. Health professionals learn more and more every day about the conditions and diseases that damage our livers. Studies investigating new treatments that can slow and even reverse the scarring that leads to cirrhosis are currently underway. For those with cirrhosis, the future is brighter than ever before. If you'd like to learn even more about cirrhosis, watch our other related videos or visit mayoclinic.org. We wish you well.