Liver Cirrhosis (Liver Scarring) - FAQ

A: The ability for the liver to regenerate is significantly reduced once liver cirrhosis (advanced fibrosis) occurs.

A: Cirrhosis of the liver is not cancer. However, most people who have liver cancer have cirrhosis. If you have cirrhosis, you have an increased risk of liver cancer.

A: People with early-stage cirrhosis of the liver usually do not have symptoms. Often, cirrhosis is first detected through a routine blood test or checkup. To confirm a diagnosis, a combination of laboratory and imaging tests is usually done. If you suspect you may have liver cirrhosis, do consult with a liver specialist as soon as you can.

A: Life expectancy depends on several factors including the cause and severity of your cirrhosis, your response to treatments, presence of cirrhosis complications, your age and any other existing general health problems.

Consult a liver specialist about your prognosis since every person is unique, with unique overall health issues and specific liver health issues.

If your cirrhosis is advanced, liver transplant may be an option. Your doctor will discuss if this is an option for you.

A: Cirrhosis itself is not an inherited (passed from parent to child) disease. However, some of the diseases that can cause liver damage that lead to cirrhosis are inherited diseases.

A: Parasites and viruses can infect the liver, causing inflammation, progressive fibrosis and scarring leading to cirrhosis. The viruses that cause liver damage can be spread through blood or body fluids, contaminated food or water, or close contact with a person who is infected. The most common types of liver infection are hepatitis viruses, including hepatitis A, B and C.

A: Excessive alcohol leads to excessive fatty acid synthesis in the liver, leading to accumulation of excessive fat in liver. Alcohol also leads to oxidative damage in the liver, causing inflammation and cell death.

Risk of liver cirrhosis increases proportionally with daily alcohol consumption. Binge drinking is particularly harmful as the body is not accustomed to breaking down such large amounts of alcohol at one go.

A: Drug-induced liver injury (DILI) can occur with prescription medication, herbal supplements and traditional medications. These agents can cause liver disease in several ways:

• Drugs that cause dose-dependent toxicity can cause liver disease in most people if enough of the drug is taken. One example of dose-dependent toxicity is acetaminophen (paracetamol) overdose.

• Drugs that cause idiosyncratic toxicity cause disease in only those few patients who have inherited specific genes. These are usually quite rare.

A: Fatty liver disease can cause liver inflammation, also known as non-alcoholic steatohepatitis (NASH) and progressive fibrosis, which in turns leads to cirrhosis. Fatty liver disease is commonly associated with obesity and diabetes and is one of the most common causes of liver cirrhosis around the world.

A: While there is no cure for cirrhosis, removing or controlling the underlying cause can slow the progression of the disease.

There is insufficient medical evidence that alternative medicines are effective in treating liver diseases. Some alternative medications may also harm the liver.

Lifestyle measures and healthy tips to protect your liver:

• Don't drink alcohol. Drinking alcohol may cause further liver damage.
• Eat a low-sodium diet. Excess salt can cause your body to retain fluids, worsening swelling in your abdomen and legs.
• Eat a healthy diet. People with cirrhosis can experience malnutrition. Eat a healthy plant-based diet and choose lean protein. Avoid raw seafood.
• Avoid infections. Cirrhosis makes it more difficult for you to fight off infections. Get vaccinated for hepatitis A and B, influenza, and pneumonia.
• Take over-the-counter medications with care. Cirrhosis makes it more difficult for your liver to process drugs, so ask your doctor before taking any medications.

A: Patients with advanced liver cirrhosis can develop engorged blood vessels in the oesophagus and stomach. These blood vessels are called varices. Bleeding from varices or variceal haemorrhage is a medical emergency and is potentially life threatening. Emergency endoscopy is usually required once the patient is stabilised.