Liver Diseases

Cirrhosis

Cirrhosis is the end result of a variety of chronic liver diseases, such as hepatitis or fatty liver disease. In this condition, the normal liver cells have been replaced by scar tissue and fibrosis. Blood flow to the liver may also be partially blocked, leading to even more damage. In end stage cirrhosis, the liver cells are no longer able to heal themselves and are permanently damaged.

A healthy liver has a variety of functions, such as eliminating toxins, processing medications, producing nutrients and proteins, and fighting infections. In a person with cirrhosis, these functions can no longer take place in a normal fashion. That is why people with cirrhosis may have a variety of serious symptoms. Symptoms may range from excessive bleeding, buildup of fluid in the abdomen (called ascites), weakness and confusion (called hepatic encephalopathy), weight loss and overall poor nutrition, to enlarged blood vessels in the esophagus (esophageal varices). Some of these are life threatening complications. Cirrhosis also increases the risk for liver cancer.

Diagnosis and Treatment

When a person believes they may have cirrhosis, it is very important that they make an appointment with a hepatologist.

Diagnosing cirrhosis requires a thorough evaluation of a person's medical history, including how much alcohol is regularly consumed and risk factors for hepatitis. Blood testing to examine how well the liver is functioning is generally the next step. Further testing, such as a liver biopsy, an ultrasound or CT scan, are usually performed as well.

Treatment for cirrhosis begins with the complete elimination of alcohol and/or other substances that harm the liver. Because people with cirrhosis also have many nutritional problems, a healthy balanced diet with low salt is very important. These important steps should be taken by all individuals with cirrhosis. It is also important to discuss all medications (including over the counter medications and multivitamins) with the doctor, because they can all affect liver function.

Other medications and treatment options depend on whether or not there are complications from cirrhosis. Medications to reduce the amount of fluid in the abdomen or legs may be needed. Antibiotics are given if the fluid in the abdomen gets infected. If hepatic encephalopathy develops, medications to eliminate the toxin called ammonia are given. Medications called beta blockers are prescribed to lower the pressure of esophageal varices and prevent bleeding.

A liver transplant is also an option for patients with end-stage cirrhosis. There are certain requirements to qualify for transplant, and not everyone can be a candidate. Complete abstinence from alcohol and illicit drugs, and strong family support are important factors taken into consideration, as are the patient's other medical issues.

The hepatologists at NewYork-Presbyterian Brooklyn Methodist Hospital treat patients with cirrhosis with a variety of medications to prevent complications. They may also perform life-saving emergent procedures, such as esophageal banding.

As a member of the NewYork-Presbyterian Healthcare System, the Liver Center at NewYork-Presbyterian Brooklyn Methodist Hospital is also actively involved in the liver transplant program. Our hepatologists have trained at major transplant centers and are experts in evaluation for liver transplant. They work with surgeons, support staff, nutritionists and family members to provide the best treatment options both before and after transplant.