Why is cirrhosis of the liver irreversible

The American Liver Foundation reports that once alcohol-related cirrhosis occurs, even if you stop drinking, you cannot reverse this form of cirrhosis. Instead, doctors aim to slow down or halt the progression of the scarring process and help their patients avoid severe complications of the condition.

However, they can only achieve these goals if you seek treatment and abstain from further alcohol intake. Fibrosis can be reversed if detected early enough and the underlying liver disease that caused the development of fibrosis can be cured or treated. If fibrosis is left untreated, it can lead to cirrhosis and liver cancer. It is important to remember that the process of fibrosis progressing to cirrhosis happens over a long period of time.

The time it takes for fibrosis to progress is different for every disease and every person. Not everyone who develops fibrosis will progress to cirrhosis. Not everyone who gets cirrhosis will get cancer. Testing Options Until recently, liver biopsy was the only way doctors could determine the stage and degree of liver damage. Today, there are both blood and imaging tests that can determine liver damage.

This is a brief overview of different types of tests your doctor may discuss with you. Understanding Liver Biopsy Results Understanding the results of these different tests can be a challenge. Healthcare providers use different scales to define the stages of liver damage. Common scales used to grade a liver biopsy are explained here. Most scoring systems examine the impact of fibrosis on the portal vein which brings blood from the intestines and the location and number of septa connecting bands of scars.

If you have cirrhosis or are in the final stage before cirrhosis, please speak with your doctor about liver cancer screenings. This imaging test is not invasive. By measuring the stiffness of the liver your doctor can detect both scarring and fatty change in the liver. Your CAP score is a measurement of fatty change in your liver. Fatty change steatosis is when fat builds up in your liver cells. Your doctor will use your CAP score to grade how much fatty change has happened in the liver.

The table here shows ranges of CAP scores, the matching steatosis grade, and the amount of liver with fatty change. Reliability of Test Scores This table shows liver diseases, ranges of fibrosis results, and the matching fibrosis score. The ranges of fibrosis results in the table are estimates. Your actual fibrosis score may not match the fibrosis score in the table. If you have more than one liver disease you may not be able to use this table. Your fibrosis result may be overestimated if you have liver inflammation caused by recent illness or drinking alcohol, benign or cancerous tumors in your liver, or liver congestion when liver is too full of blood or other fluids.

Cirrhosis is where your liver is severely scarred and permanently damaged. While the word cirrhosis is most commonly heard when people discuss alcohol-induced liver disease , cirrhosis is caused by many forms of liver disease. While fibrosis is reversible there is a point where the damage becomes too great and the liver cannot repair itself.

There is no treatment that can cure cirrhosis. If possible, treating the underlying cause of cirrhosis may keep your cirrhosis from getting worse and help prevent liver failure. Successful treatment may slowly improve some of your liver scarring.

It is important to avoid things that could damage your liver further like alcohol, certain medications and fatty food. Treatment for someone with cirrhosis often means managing the symptoms of cirrhosis and preventing further damage to avoid liver failure. Doctors treat liver failure with a liver transplant.

Someone with cirrhosis is at a very high risk of developing liver cancer. It is very important to receive routine liver cancer surveillance if you have cirrhosis; most people who develop liver cancer have evidence of cirrhosis. Doctors also treat liver cancer with a transplant. It is important to note, people often live with cirrhosis for a long time before the option of liver transplant is discussed. There is a big difference between liver functioning and disease progression.

Our livers are resilient, continuing to function even when they become severely scarred. Because of this, some people may not experience symptoms or have elevated liver enzyme tests even though their liver is damaged. It is important to talk to your doctor about your risks for liver disease so you can receive imaging tests that may help diagnosis liver damage.

Compensated Cirrhosis v. Decompensated Cirrhosis Cirrhosis is often categorized as either compensated or decompensated. Their symptoms of the disease may be mild or nonexistent even though the liver is severely scarred. Someone with decompensated cirrhosis will feel and appear sick as their liver is struggling to function.

The liver has two sources that supply blood to the liver — the hepatic artery and the hepatic portal vein. The hepatic artery brings oxygen-rich blood into the liver. Blood coming from our digestive system enters the liver through the hepatic portal vein carrying nutrients, medications, or toxins. When someone has decompensated cirrhosis the scar tissue blocks the blood meant to flow through the portal vein causing an increase of pressure known as portal hypertension.

The blood unable to enter the liver must find new routes; because the blood is not entering the liver, nutrients, toxins and more from the digestive system does not get properly filtered.

Portal hypertension is responsible for symptoms like varices , ascites and encephalopathy. Hepatorenal syndrome can also occur when someone has decompensated cirrhosis.

The increased pressure of portal hypertension causes fluid to seep out and pool in the abdominal cavity. This is called ascites. Feldman M, et al. Overview of cirrhosis. Kellerman RD, et al. In: Conn's Current Therapy Goldberg E, et al. Cirrhosis in adults: Overview of complications, general management, and prognosis. American Gastroenterological Association. Alagille syndrome. National Organization for Rare Disorders. Cirrhosis in adults: Etiologies, clinical manifestations, and diagnosis. Liver cirrhosis.

American College of Gastroenterology. Merck Manual Professional Version. Hernaez R, et al. Acute-on-chronic liver failure: An update. Hepatitis B questions and answers for the public. Centers for Disease Control and Prevention.

Dove LM, et al. Liver transplantation in adults: Patient selection and pretransplantation evaluation. If a GP suspects cirrhosis, they'll check your medical history and do a physical examination to look for signs of long-term liver disease. If tests show that you have cirrhosis, a GP should refer you to see a doctor who specialises in liver problems hepatologist.

If you have complications from cirrhosis, or a high chance of getting complications, you may be referred to a specialist liver centre. There's no cure for cirrhosis at the moment. However, there are ways to manage the symptoms and any complications and slow its progression.

Treating the problem that led to cirrhosis for example, using anti-viral medicines to treat hepatitis C can stop cirrhosis getting worse. You may be advised to cut down or stop drinking alcohol, or to lose weight if you're overweight.

A GP can help you get support if you need help to stop drinking or to lose weight. If your liver is severely damaged, a liver transplant may be the only treatment option. Cirrhosis can also be caused by a problem affecting your bile ducts such as primary biliary cholangiti s or immune system such as autoimmune hepatitis , some inherited conditions, and the long-term use of certain medicines.