Treatment for Cirrhosis

In this section:

• How do doctors treat cirrhosis?
• How do doctors treat the causes of cirrhosis?
• How do doctors treat the complications of cirrhosis?
• What can I do to help keep my cirrhosis from getting worse?
• When do doctors consider a liver transplant for cirrhosis?

How do doctors treat cirrhosis?

Doctors do not have specific treatments that can cure cirrhosis. However, they can treat many of the diseases that cause cirrhosis. Some of the diseases that cause cirrhosis can be cured. Treating the underlying causes of cirrhosis may keep your cirrhosis from getting worse and help prevent liver failure. Successful treatment may slowly improve some of your liver scarring.

How do doctors treat the causes of cirrhosis?

Doctors most often treat the causes of cirrhosis with medicines. Your doctor will recommend that you stop activities such as drinking alcohol and taking certain medicines that may have caused cirrhosis or may make cirrhosis worse.

Alcoholic liver disease

If you have alcoholic liver disease, your doctor will recommend that you completely stop drinking alcohol. He or she may refer you for alcohol treatment.

Nonalcoholic fatty liver disease

If you have nonalcoholic fatty liver disease, your doctor may recommend losing weight. Weight loss through healthy eating and regular physical activity can reduce fat in the liver, inflammation, and scarring.

Chronic hepatitis C

If you have chronic hepatitis C, your doctor may prescribe one or more medicines that have been approved to treat hepatitis C since 2013. Studies have shown that these medicines can cure chronic hepatitis C in 80 to 95 percent of people with this disease.⁵

Chronic hepatitis B

For chronic hepatitis B, your doctor may prescribe antiviral medicines that slow or stop the virus from further damaging your liver.

Autoimmune hepatitis

Doctors treat autoimmune hepatitis with medicines that suppress, or decrease the activity of, your immune system.

Diseases that damage, destroy, or block bile ducts

Doctors usually treat diseases that damage, destroy, or block bile ducts with medicines such as ursodiol (Actigall, Urso). Doctors may use surgical procedures to open bile ducts that are narrowed or blocked. Diseases that damage, destroy, or block bile ducts include primary biliary cholangitis and primary sclerosing cholangitis.

Inherited liver diseases

Treatment of inherited liver diseases depends on the disease. Treatment most often focuses on managing symptoms and complications.

Long-term use of certain medicines

The only specific treatment for most cases of cirrhosis caused by certain medicines is to stop taking the medicine that caused the problem. Talk with your doctor before you stop taking any medicines.

How do doctors treat the complications of cirrhosis?

Treatments for the complications of cirrhosis include the following.

Portal hypertension

Doctors treat portal hypertension with medicines to lower high blood pressure in the portal vein. Treatments for the complications of portal hypertension include

• Enlarged veins in your esophagus or stomach, called varices. Your doctor may prescribe medicines to lower the pressure in the veins of your esophagus or stomach. This lowers the chance that the veins become enlarged and burst, causing internal bleeding. If you vomit blood or have black or bloody stools go to a hospital right away. Doctors may perform procedures during upper GI endoscopy or use surgical procedures to stop the internal bleeding.
• Swelling in your legs, ankles, or feet, called edema. Your doctor may prescribe medicines that remove fluid from your body. Your doctor will recommend limiting the amount of salt in your diet.
• Buildup of fluid in your abdomen, called ascites. Your doctor may prescribe medicines that remove fluid from your body. Your doctor will recommend limiting the amount of salt in your diet. If you have large amounts of fluid in your abdomen, your doctor may use a needle or tube to drain the fluid. He or she will check the fluid for signs of infection. Your doctor may prescribe medicines to treat infection or prevent infection.
• Confusion, difficulties thinking, memory loss, personality changes, or sleep disorders, called hepatic encephalopathy. Your doctor may prescribe medicines that help lower the levels of toxins in your brain and improve brain function.

Infections

If you have a bacterial infection, your doctor will prescribe an antibiotic.

Liver cancer

Your doctor may treat liver cancer with the medical procedures that remove or destroy cancer cells, such as surgery, radiation therapy, and chemotherapy. Doctors also treat liver cancer with a liver transplant.

Liver failure

Liver failure, also called end-stage liver disease, happens when the liver stops working. The only treatment for liver failure is a liver transplant.

Other Complications

Your doctor may treat other complications through changes in medicines, diet, or physical activity. Your doctor may also recommend surgery.

What can I do to help keep my cirrhosis from getting worse?

To help keep your cirrhosis from getting worse, you can do the following

• Do not drink alcohol or use illegal drugs.
• Talk with your doctor before taking
  • prescription medicines
  • prescription and over-the-counter sleep aids
  • over-the-counter medicines, including nonsteroidal anti-inflammatory drugs (NSAIDS) and acetaminophen
  • dietary supplements, including herbal supplements.
• Take your medicines as directed.
• Get a vaccine for hepatitis A, hepatitis B, flu, pneumonia caused by certain bacteria, and shingles.
• Get a screening blood test for hepatitis C.
• Eat a healthy, well-balanced diet.
• Avoid raw or undercooked shellfish, fish, and meat.
• Try to keep a healthy body weight.

Talk with your doctor about your risk for getting liver cancer and how often you should be checked.

When do doctors consider a liver transplant for cirrhosis?

Your doctor will consider a liver transplant when cirrhosis leads to liver failure. Doctors consider liver transplants only after they have ruled out all other treatment options. Talk with your doctor about whether a liver transplant is right for you.

References