Written by Pliro
Jul 11, 2019 Last updated: Jul 12, 2019

What and where is the liver? The liver is the great chemical plant of the body in charge of detoxification, digestion, clotting, hormone production, drug metabolism, etc. This organ is located in the upper right-hand portion of the abdominal cavity above the stomach and intestines.

Any disturbance of liver function can have serious consequences over the body. Liver failure is an extreme case in which the organ becomes completely incapable of performing its normal activities, however, this can happen over a long or short period of time. In this article we’ll focus on a chronic (long-term) condition called liver cirrhosis.

Cirrhosis of the liver is a condition which represents the final state of all chronic liver diseases. Its main features are a series of morphological changes in liver tissue and several symptoms like: Jaundice (yellow skin), fatigue, weakness, itching, loss of appetite and bruising. 

In Pakistan, liver cirrhosis kill over 30,000 people each year, according to some of the latest studies (2014). As a result, this condition is in the top 20 of causes of death worldwide because of the associated loss of liver function (liver failure) which leads to an accumulation of toxins and organ damage.  

How do Liver Cirrhosis Develop?

Liver disease is usually linked to inflammation and tissue damage. Over time the disease causes small wounds in the liver, which are quickly repaired, leaving behind a “scar”. After months or even years of this, the scar tissue slowly replaces large portions of the organ in a process called fibrosis. Fibrosis is then one of the main drivers of cirrhosis.

The process of fibrosis creates new fibrillar tissue that will need to be provided with oxygen, this is accomplished by promoting angiogenesis (formation of new blood vessels). The interaction between these 2 processes joined to the presence of a liver disease in the background will promote liver damage and loss of function.

At the final stages, the liver gets smaller, mostly composed of dead, fibrous and inflammatory tissue. An additional problem is the fact that around 80% of all patients with liver cirrhosis will develop hepatocellular carcinoma.

In industrialized countries, the main causes of cirrhosis are: Alcoholism and hepatitis C. Both of these will damage liver tissue over an extended period.

What Can You do About It?

Studies have shown that cirrhosis can be reversed to a certain extent, if: 1) The element promoting tissue damage is eliminated and 2) The formation of scar tissue can be reduced. For advanced cases, where the liver is simply too damaged a liver transplant is recommended.

Patients with less advanced stages of cirrhosis have more alternatives:

  • Stop drinking alcohol: Alcohol cause liver damage when consumed in excess, therefore, any patient will need to quit drinking as the first step in his/her treatment.
  • Losing weight: Fatty liver is a condition that often leads to cirrhosis if left untreated. Weight loss and normal blood glucose levels will help against tissue damage.
  • Medication against infectious agents: Hepatitis B and C are powerful promoters of liver damage, treating these infections is a good way to indirectly treat cirrhosis. Example: Interferon.
  • Other medications: Some drugs have a more direct effect over cirrhosis and its symptoms, like: Anti-fibrotic agents, ursodiol, etc.

Who Should You Visit?

Initially, a general practitioner is often the first doctor you’ll consult, he/she will examine you and order some tests, based on the results patients are referred to the appropriate specialist. Liver diseases of any degree of severity are ultimately diagnosed and treated by a liver specialist called a Hepatologist. Gastroenterologist can also be helpful in this context.