Cirrhosis is a progressive liver disease that results in the loss of normal liver function and the development of fibrous scar tissue. The disease is often caused by long-term liver damage due to factors such as chronic alcohol consumption, viral hepatitis, and non-alcoholic fatty liver disease.

As cirrhosis progresses, scar tissue replaces healthy liver tissue, which can lead to liver failure, liver cancer, and other complications. Some common symptoms of cirrhosis include fatigue, weakness, weight loss, abdominal pain and swelling, jaundice, and easy bruising and bleeding.

Diagnosis of cirrhosis typically involves a physical examination, blood tests, and imaging studies such as ultrasound, CT scan, or MRI to assess the extent of liver damage. In some cases, a liver biopsy may also be necessary to confirm the diagnosis.

Treatment for cirrhosis depends on the underlying cause and the extent of liver damage. In cases of alcohol-related cirrhosis, for example, quitting alcohol consumption is the most effective treatment. Other treatments may include medications to manage symptoms and complications, such as diuretics to reduce fluid buildup, beta blockers to control high blood pressure, and antiviral medications to treat viral hepatitis. In severe cases, a liver transplant may be necessary.

While cirrhosis is a serious and potentially life-threatening condition, early diagnosis and treatment can help slow the progression of the disease and improve the quality of life. Additionally, adopting a healthy lifestyle with a balanced diet and regular exercise, avoiding excessive alcohol consumption, and taking steps to prevent hepatitis infection can help reduce the risk of developing cirrhosis.

A wide range of diseases and conditions can damage the liver and lead to cirrhosis.

Some of the causes include:

• Chronic alcohol abuse
• Chronic viral hepatitis (hepatitis B, C and D)
• Fat accumulating in the liver (nonalcoholic fatty liver disease)
• Iron buildup in the body (hemochromatosis)
• Cystic fibrosis
• Copper accumulated in the liver (Wilson's disease)
• Poorly formed bile ducts (biliary atresia)
• Alpha-1 antitrypsin deficiency
• Inherited disorders of sugar metabolism (galactosemia or glycogen storage disease)
• Genetic digestive disorder (Alagille syndrome)
• Liver disease caused by your body's immune system (autoimmune hepatitis)
• Destruction of the bile ducts (primary biliary cirrhosis)
• Hardening and scarring of the bile ducts (primary sclerosing cholangitis
• Infection, such as syphilis or brucellosis
• Medications, including methotrexate or isoniazid

Reduce your risk of cirrhosis by taking these steps to care for your liver:

• Do not drink alcohol if you have cirrhosis. If you have liver disease, you should avoid alcohol.
• Eat a healthy diet. Choose a plant-based diet that's full of fruits and vegetables. Select whole grains and lean sources of protein. Reduce the amount of fatty and fried foods you eat.
• Maintain a healthy weight. An excess amount of body fat can damage your liver. Talk to your doctor about a weight-loss plan if you are obese or overweight.
• Reduce your risk of hepatitis. Sharing needles and having unprotected sex can increase your risk of hepatitis B and C. Ask your doctor about hepatitis vaccinations.

If you're concerned about your risk of liver cirrhosis, talk to your doctor about ways you can reduce your risk.

Treatment for cirrhosis depends on the cause and extent of your liver damage. The goals of treatment are to slow the progression of scar tissue in the liver and to prevent or treat symptoms and complications of cirrhosis. You may need to be hospitalized if you have severe liver damage.

Treatment for the underlying cause of cirrhosis

In early cirrhosis, it may be possible to minimize damage to the liver by treating the underlying cause. The options include:

• Treatment for alcohol dependency. People with cirrhosis caused by excessive alcohol use should try to stop drinking. If stopping alcohol use is difficult, your doctor may recommend a treatment program for alcohol addiction. If you have cirrhosis, it is critical to stop drinking since any amount of alcohol is toxic to the liver.
• Weight loss. People with cirrhosis caused by nonalcoholic fatty liver disease may become healthier if they lose weight and control their blood sugar levels.
• Medications to control hepatitis. Medications may limit further damage to liver cells caused by hepatitis B or C through specific treatment of these viruses.
• Medications to control other causes and symptoms of cirrhosis. Medications may slow the progression of certain types of liver cirrhosis. For example, for people with primary biliary cirrhosis that is diagnosed early, medication may significantly delay progression to cirrhosis.

Other medications can relieve certain symptoms, such as itching, fatigue and pain. Nutritional supplements may be prescribed to counter malnutrition associated with cirrhosis and to prevent weak bones (osteoporosis).

Treatment for complications of cirrhosis

Your doctor will work to treat any complications of cirrhosis, including:

• Excess fluid in your body. A low-sodium diet and medication to prevent fluid buildup in the body may help control ascites and swelling. More-severe fluid buildup may require procedures to drain the fluid or surgery to relieve pressure.
• Portal hypertension. Certain blood pressure medications may control increased pressure in the veins that supply the liver (portal hypertension) and prevent severe bleeding. Your doctor will perform an upper endoscopy at regular intervals to look for enlarged veins in the esophagus or stomach (varices) that may bleed.
• If you develop varices, you likely will need medication to reduce the risk of bleeding. If you have signs that the varices are bleeding or are likely to bleed, you may need a procedure (band ligation) to stop the bleeding or reduce the risk of further bleeding. In severe cases, you may need a small tube — a transjugular intrahepatic portosystemic shunt — placed in your vein to reduce blood pressure in your liver.
• Infections. You may receive antibiotics or other treatments for infections. Your doctor also is likely to recommend vaccinations for influenza, pneumonia and hepatitis.
• Increased liver cancer risk. Your doctor will likely recommend periodic blood tests and ultrasound exams to look for signs of liver cancer.
• Hepatic encephalopathy. You may be prescribed medications to help reduce the buildup of toxins in your blood due to poor liver function.

Liver transplant surgery

In advanced cases of cirrhosis, when the liver ceases to function, a liver transplant may be the only treatment option. A liver transplant is a procedure to replace your liver with a healthy liver from a deceased donor or with part of a liver from a living donor. Cirrhosis is one of the most common reasons for a liver transplant. Candidates for liver transplant have extensive testing to determine whether they are healthy enough to have a good outcome following surgery.

Historically, those with alcoholic cirrhosis have not been liver transplant candidates because of the risk that they will return to harmful drinking after transplant. Recent studies, however, suggest that carefully selected people with severe alcoholic cirrhosis have post-transplant survival rates similar to those of liver transplant recipients with other types of liver disease.

For transplant to be an option if you have alcoholic cirrhosis, you would need:

• To find a program that works with people who have alcoholic cirrhosis
• To meet the requirements of the program, which would include lifelong commitment to alcohol abstinence as well as other requirements of the specific transplant center

Potential future treatments

Scientists are working to expand current treatments for cirrhosis, but success has been limited. Because cirrhosis has numerous causes and complications, there are many potential avenues of approach. A combination of increased screening, lifestyle changes and new medications may improve outcomes for people with liver damage, if started early.

Researchers are working on therapies that will specifically target liver cells, helping to slow or even reverse the fibrosis that leads to cirrhosis. While no targeted therapy is quite ready, the framework for developing such treatments is in place, and progress is accelerating.