What is Cirrhosis?

Cirrhosis is a condition where the liver becomes heavily scarred (or fibrotic); this can occur as a result of alcohol, viral hepatitis, fatty liver disease, or any other type of chronic liver disease.

• Cirrhosis can sometimes be diagnosed by imaging tests (such as a CT scan, ultrasound, or MRI) based on a “nodular” or shrunken appearance to the liver. Additionally, a fibroscan may provide valuable information about liver disease stage and if cirrhosis is present. If there is fluid in the abdomen (ascites), or an enlarged spleen, these can also be clues to the presence of cirrhosis. Additionally, cirrhosis can also be diagnosed by liver biopsy, although this is often not necessary.
• Cirrhosis may not be reversible, but the progression of liver scarring may be slowed or halted with appropriate treatment.
• Many patients with cirrhosis have no associated symptoms. This is why cirrhosis is often diagnosed when the late-stage complications of advanced liver disease develop. Fatigue is common with cirrhosis. When patients begin to develop advanced cirrhosis, they may have evidence of muscle loss, jaundice, edema, or fluid build-up in the abdomen called ascites.
• Other complications include portal hypertension, esophageal varices, and hepatic encephalopathy.
• Upper endoscopies may be prescribed for screening purposes. The exact frequency will be determined by the gastroenterologist performing endoscopies.

Frequently Asked Questions about Life with Cirrhosis

Medicine

What medications can I take for mild-moderate pain?

• Tylenol can be taken for moderate pain as long as it does not exceed 2 grams per day. This is the equivalent of 6 regular strength (325mg) tablets, or 4 extra-strength (500mg) tablets.
• Non-steroidal anti-inflammatory drugs (NSAIDs) should be avoided in patients with cirrhosis as they may increase the risk of bleeding, kidney injury, etc. These include ibuprofen, naproxen, diclofenac, etodolac, indomethacin, ketorolac, Aleve, Advil, Motrin, Naprosyn, Toradol, and Voltaren.

Food and Diet

What kind of healthy liver diet should I be on?

• In general, patients need to be on a healthy, low-salt, high-protein diet.
• Protein consumption should not be avoided in cirrhotic patients, and excellent sources of protein include vegetable sources (legumes and other beans), lean white meats (chicken, fish), dairy, and nuts. Try to consume at least 80-100 grams of protein daily.
• Meals should be eaten in smaller quantity spread throughout the day.
• Patients with muscle loss should consume a nutritional supplement before sleep, such as a can of Ensure or Boost.
• Alcohol is strictly forbidden.
• We also advise against raw shellfish (i.e. oysters) because there is an increased risk of fatal food poisoning from Vibrio vulnificans.

Liver Cancer Surveillance

How do I get checked for liver cancer?

• The most common form of liver cancer in patients with cirrhosis is hepatocellular carcinoma (HCC). This cancer can sometimes be diagnosed in patients without cirrhosis but is most common in patients with cirrhosis and chronic liver disease. Your risk of developing HCC increases the longer you have cirrhosis. Survellance for HCC involves a blood test called an alpha-fetoprotein (AFP), as well as some form of liver imaging (ultrasound, CT or MRI). Surveillance can be done every 6-12 months at minimum. If a lesion is seen, this may prompt additional testing such as detailed imaging, or a biopsy in some cases.

Surgery Complications

Are there any special considerations when undergoing unrelated surgeries?

• Patients with cirrhosis have a higher risk of surgical complications and mortality due to their liver disease. Your individual surgical risk depends on the type of surgery being performed, and how advanced your liver disease is. Any upcoming surgery should be discussed with your surgeon and hepatology team first.

Diagnose and Treat Cirrhosis with Arizona Liver Health

Call Arizona Liver Health at 480-470-4000 to set up an appointment with one of our experienced providers who can help diagnose your liver condition and put you on a path toward improved outcomes.