Educational Articles

Liver is an organ that is located in the right upper region of the abdomen. It weighs approximately 3 pounds, and measures about 10 inches in length. Its many vital functions include production of clotting factors, lipids, and bile; as well as metabolism of medications and removal of harmful toxins.

Cirrhosis is a condition that occurs as a result of injury and inflammation of liver cells. Common conditions that lead to the damage of the liver include hepatitis B and C, obesity, and over consumption of alcohol. Other causes include inherited and autoimmune disorders. Over time, persistent and recurrent injury of the liver from these conditions lead to the loss of liver cells. This eventually results in cirrhosis, a condition in which the liver is mostly replaced by scar tissue.

Common early symptoms associated with cirrhosis include fatigue, weakness, and lack of appetite. As the disease progresses, there may be a bleeding tendency, particularly in the veins of the esophagus; collection of fluid in the abdomen called ascites; yellowing of the skin or jaundice, and even confusion and coma. One of the most worrisome complications of cirrhosis may be the development of liver cancer.

A careful review of medical history and physical exam are very useful in making the diagnosis of cirrhosis. Routine blood test including complete blood count (CBC), blood chemistry, and coagulation test are also very helpful. Abdominal sonogram and CT scan can further assist in making the diagnosis of cirrhosis. Although often not necessary, the liver biopsy can help in making the diagnosis of cirrhosis in difficult cases.

The management of cirrhosis first involves the treatment, or removal of underlying causes of liver injury. For example, patients with hepatitis B and C are often treated with anti-viral medications. Dietary measures are advised in individuals with fatty liver; and abstinence is recommended for patients with alcoholic cirrhosis. 

For various complications related to cirrhosis, specific problem needs to be addressed individually. For example, patients with ascites or swelling of the extremeties are treated with dietary salt restriction and diuretics, medications that facilitate excretion of salt and water. Bleeding from veins in the esophagus are treated with beta-blockers that lowers the pressure in the venous system around the liver; and upper endoscopy with banding of the veins in the esophagus. Individuals with altered level of consciousness and coma may be treated with antibiotic, laxative, or shunting of blood flow in the liver. When the cirrhosis becomes far advanced and its complications too difficult to manage, transplantation of the liver may be considered.