Let's learn more about cirrhosis: the silent enemy of the liver!

We talk about many organs in our body, don't we? Heart , kidneys... But do we think about the liver that much? The liver is like a big factory in our body. It does its job quietly. But when this liver starts to get damaged, the condition called cirrhosis is a bit more serious. This is not something that develops suddenly, but something that develops gradually over years. Today, we will talk about this simply, in a way that you can understand.

What exactly is cirrhosis?

Simply put, cirrhosis is when healthy liver cells are replaced by scar tissue. Think of it this way, just as a scar forms when we get a cut on our skin, when the liver is continuously damaged, it tries to heal itself. This scar tissue forms during this process. As this scarring builds up, the liver can no longer do its normal jobs, such as filtering toxins from the blood, making enzymes that help digest food, and storing energy.

The liver is a worker in our body. We cannot live without it. Therefore, it is very important to be aware of this condition.

What are the symptoms of cirrhosis?

The biggest problem here is that there are no symptoms in the early stages . Sometimes you may not notice anything until about 75% of the liver is damaged. But when the disease is a little more severe, you may start to notice some changes.

What are the main causes of cirrhosis?

Cirrhosis is always caused by another disease or problem that affects the liver. There are several main causes.

• Alcohol use disorder: This is the most common cause. Drinking too much alcohol over a long period of time can severely damage the liver.
• Metabolic fatty liver disease (MASLD): This was previously called non-alcoholic fatty liver disease. Conditions such as diabetes, obesity, high cholesterol, and high blood pressure can cause fat to build up in the liver, which can eventually lead to cirrhosis. This condition is now very common in Sri Lanka.
• Hepatitis B and C infections: These two viral infections can cause chronic inflammation of the liver and lead to cirrhosis.
• Other reasons:
• Some genetic diseases (e.g. Wilson's disease, hemochromatosis).
• Diseases that attack the liver due to problems with the immune system (Autoimmune hepatitis).
• Severe reactions to some medications.
• Blockage of the bile ducts.

How does a doctor detect this?

When you go to see your doctor, he or she will ask about your symptoms, alcohol use, and family medical history. Then they will examine your body, especially your abdomen.

In addition, the following tests can be performed:

• Blood tests: Check liver function, check liver enzyme levels, bilirubin levels, etc.
• Imaging tests: An ultrasound scan or MRI scan can check the condition of the liver, its size, and whether there is scar tissue.
• Liver Biopsy: Sometimes, to confirm the diagnosis and determine the exact extent of the damage, a very small piece of tissue from the liver is taken using a small needle and examined.

How is it treated?

Unfortunately, the damage to the liver caused by cirrhosis cannot be completely reversed. However, there are treatments to stop further damage and control complications. Treatment depends on the cause of the cirrhosis and the severity of the disease.

Main goals of treatment

1. Treating the cause:

• If it is due to alcohol: You should stop drinking alcohol completely . For this, your doctor will refer you to an appropriate counseling service or treatment program.
• If it is due to hepatitis: Antiviral drugs are given to control the virus.
• If fat is deposited , weight loss, exercise, diet control, and diabetes and cholesterol control are essential.

2. Treatment of complications:

• For ascites: Diuretics and a low-salt diet are recommended.
• Varicose veins: Treatment includes medication or bandaging through endoscopy to prevent bleeding.
• Encephalopathy: Medications are given to reduce toxins in the blood.

3. Liver Transplant:

If the liver fails completely (liver failure), the last option is a healthy liver transplant. Although this is a major operation, it can be the best solution to save your life.

How can you take care of yourself?

Along with treatment, changes in your lifestyle are very important.

• Stop drinking alcohol completely: Don't drink even a single drop.
• Eat a healthy diet: Reduce salt, oil, and sugar. Eat foods rich in protein like vegetables, fruits, legumes, lean meats, and fish. Avoid foods like raw shellfish.
• Exercise: Talk to your doctor and develop an exercise plan that suits you.
• Be careful with medications: Do not take any painkillers (e.g. Panadol, Aspirin, Ibuprofen) or any other medication, even herbal products, without consulting your doctor. These can be difficult for the liver to process and can worsen the condition.
• Get vaccinated: Since your immune system may be weakened, get vaccinated against hepatitis A, B, pneumonia, and the common cold (flu).

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