Cirrhosis is a progressive liver condition characterized by permanent scarring and damage to liver tissue. The scarred tissues replace healthy ones, impairing normal liver function and obstructing blood flow. As cirrhosis advances, liver failure becomes increasingly likely. According to a 2019 estimate, 1 in 400 American adults had liver cirrhosis. Cirrhosis claims approximately 25,000 lives each year, making it the 11th leading cause of disease-related death in the United States.

Patients with cirrhosis may not show any symptoms (asymptomatic) or may exhibit symptoms (symptomatic) based on whether their cirrhosis is clinically compensated or decompensated.

Common findings in compensated cirrhosis include a mild to moderate increase in liver enzymes and a possible spleen or liver enlargement. Over time, the liver becomes increasingly firm, making it difficult for blood to flow properly in from the portal vein, the liver’s main blood vessel. Due to limited healthy cells, the liver becomes overwhelmed, and symptoms may surface. However, approximately one-third of cirrhosis patients never experience symptoms.

Frequently, initial symptoms and signs of cirrhosis are nonspecific. They may include:

• General fatigue as a result of cytokine release
• Loss of appetite
• Feeling generally unwell
• Weight loss
• Nausea
• Abdominal pain
• Spider angiomas, tiny red blood vessels resembling spiders that can be seen on the skin

As liver function deteriorates, the following symptoms and signs may manifest:

• Enlarged fingertips (clubbing)
• Jaundice, or yellowing of the skin and eyes. This skin discoloration results from the pigment of high bilirubin levels.
• Ascites: Fluid accumulation in the abdomen can make eating and breathing challenging. It can also lead to peritonitis, a severe infection in the area around the liver and intestines.
• Hepatic encephalopathy, a reversible syndrome seen in patients with severe liver dysfunction marked by confusion and various neuropsychiatric abnormalities. This occurs due to poor blood filtering by the liver and the buildup of neurotoxic substances, such as ammonia, in the brain.
• Edema: Swelling can take place in the legs due to fluid accumulation.
• Palmar erythema, or the reddening of the palms
• Increased susceptibility to bruising
• Clay-colored stools: Insufficient absorption of fats and fat-soluble vitamins can lead to stools that are light in color, soft, bulky, oily in appearance, and have a particularly strong, unpleasant odor.
• Reddish purple rash of tiny dots caused by bleeding from the skin’s blood vessels.
• Swollen glands: The salivary glands located in the cheeks become enlarged.
• Muscle atrophy
• Peripheral neuropathy, referring to the malfunction of the peripheral nerves, which are outside the brain and spinal cord.
• Loss of libido
• Itchy skin
• Hair loss

Males may experience erectile dysfunction, testicular atrophy, and breast enlargement since the impaired liver loses its ability to metabolize estrogens (female hormones) as it normally would.

Late-stage symptoms and signs include the following:

• Bleeding varices: Elevated blood pressure pushes blood through delicate, smaller vessels lining the stomach and esophagus, which can burst and bleed. Bleeding can also result in black, tarry stools and blood appearing in vomit.
• Kidney failure
• Multiple organ failure: This results from long-term toxin accumulation within the body due to liver malfunction. Organ failure can eventually lead to death.

Cirrhosis develops due to chronic liver inflammation, which many factors can cause. Among them, hepatitis C virus (HCV), alcoholic liver disease, and nonalcoholic steatohepatitis (NASH) are the leading causes of cirrhosis in developed countries, whereas hepatitis B virus (HBV) and HCV are the predominant causes in developing nations. In some cases, no specific cause can be identified.

Alcoholic Liver Disease

Nearly 50 percent of all cirrhosis-related deaths in the United States result from excessive alcohol consumption. The liver, the largest internal organ, performs crucial functions such as removing toxins from the body, producing bile for digestion, storing sugar for energy, and synthesizing proteins. Although it breaks down alcohol, excessive alcohol consumption can lead to scarring and damage to liver cells.

According to a study involving 13,285 participants with a 12-year follow-up, the risk of developing liver disease was lowest when alcohol intake was one to six beverages per week (with one beverage equaling 12 grams of pure alcohol, a little below the amount found in a 12-ounce beer). However, it sharply increased beyond this level, especially at seven to 13 beverages per week for women and 14 to 27 for men. Also, age didn’t seem to affect risk.

Alcohol-related cirrhosis typically appears after a decade or more of heavy alcohol consumption. Some individuals are more prone to liver damage from alcohol for reasons not fully understood. Heavy drinking poses a higher risk of liver damage in women compared to men, partly due to differences in body size.

Chronic Liver Disease

Chronic liver disease can cause cirrhosis. The following are forms of liver disease or causes of liver disease:

• Nonalcoholic steatohepatitis (NASH): NASH is an advanced stage of nonalcoholic fatty liver disease (NAFLD), now called metabolic-associated steatotic liver disease (MASLD), caused by the accumulation of fat in the liver. If this fat buildup leads to inflammation and damage, it becomes NASH, which can lead to cirrhosis. People with obesity, diabetes, high cholesterol, and/or high blood pressure are at a higher risk for NASH. Many people with NASH are unaware of the condition as they don’t experience symptoms until cirrhosis eventually develops.
• Infection by hepatitis viruses: Hepatitis refers to liver inflammation, and if left untreated, it can lead to liver damage over time, eventually progressing to cirrhosis. Certain types of hepatitis, such as hepatitis B, C, and D, can directly cause cirrhosis. It typically takes 10 to 20 years for viral hepatitis to advance to cirrhosis.

Less Common Causes

The following can also cause liver disease that leads to cirrhosis, though less commonly:

• Toxins and medications: Long-term exposure to toxins, industrial solvents, pollutants, and certain medicines can cause cirrhosis. The liver plays an essential role in processing chemicals and drugs entering the bloodstream, converting them into forms that can be eliminated through bile or urine. However, this process can sometimes generate unstable and highly toxic byproducts that can damage the liver. Drug-induced liver injury is a common occurrence caused by almost all classes of medications, leading to liver disease such as cirrhosis. However, most cases of injury are mild, and cirrhosis can usually be avoided once the drug is discontinued. Medications that can cause cirrhosis include alpha-methyldopa, amiodarone, isoniazid, methotrexate, and troglitazone.
• Autoimmune issues: Autoimmune liver disease occurs when the immune system produces antibodies that mistakenly attack a healthy liver. Examples include autoimmune hepatitis, primary biliary cholangitis, and primary sclerosing cholangitis.
• Genetics: Some rare genetic conditions can also cause cirrhosis. These include hemochromatosis, which involves a buildup of iron in the liver and other body parts, and Wilson’s disease, which involves a buildup of copper.
• Bile duct blockage: Conditions that block the bile ducts, including bile duct cancer or pancreatic cancer, can hinder bile flow in the liver or ducts. Bile aids fat absorption in the intestine and transports toxins and waste into the intestine for excretion in stool. Scar tissue blocking bile flow through bile ducts impairs fat and fat-soluble vitamin absorption, decreasing the elimination of toxins and waste from the body. Biliary atresia, a condition resulting from either absent or damaged bile ducts, is the leading cause of cirrhosis in infants.
• Heart disease: Severe heart disease can also cause liver congestion.
• Budd-Chiari syndrome: Budd-Chiari syndrome is a liver condition caused by blocked hepatic veins that normally drain blood from the liver. It leads to liver congestion and damage to liver cells due to reduced oxygen supply. This damage often results in fibrosis, a precursor to cirrhosis.
• Vitamin A excess: Excessive vitamin A intake can cause liver damage, liver and spleen enlargement, portal hypertension, and cirrhosis. The recommended daily intake for vitamin A is 300 to 700 micrograms for children and 700 to 900 micrograms for adults, typically achievable through a balanced diet.
• Unknown reasons: In around one-third of cases, cirrhosis can occur due to unknown conditions, referred to as “cryptogenic cirrhosis.”

Cirrhosis can be categorized based on its causes:

• Viral cirrhosis is caused by chronic infections with certain viruses, including hepatitis B, C, and D.
• Toxic cirrhosis usually occurs due to long-term exposure to harmful substances such as alcohol, certain drugs, and toxins.
• Autoimmune cirrhosis is commonly caused by autoimmune hepatitis.
• Cholestatic cirrhosis is characterized by impaired bile flow within the liver or bile ducts, resulting in the accumulation of bile and liver damage. Conditions such as primary biliary cholangitis and primary sclerosing cholangitis can lead to cholestatic cirrhosis. Cholangitis is inflammation of the bile duct.
• Vascular cirrhosis is associated with disorders affecting the blood vessels supplying the liver. For instance, it can be caused by Budd-Chiari syndrome.
• Metabolic cirrhosis results from metabolic disorders or genetic conditions that disrupt normal liver function and lead to liver damage. Hemochromatosis, nonalcoholic steatohepatitis (NASH), Wilson’s disease, and alpha-1 antitrypsin deficiency are examples of conditions that can cause metabolic cirrhosis. These disorders often involve abnormal accumulation of substances such as iron, fat, or proteins within the liver, leading to inflammation and scarring.

Cirrhosis can also be categorized as either compensated or decompensated.

In compensated cirrhosis, patients often do not show symptoms because there are still sufficient healthy liver cells to meet the body’s requirements. The condition is typically detected incidentally through lab tests, physical exams, or imaging studies. Approximately 40 percent of cirrhosis patients have compensated cirrhosis and remain symptomless for one to 10 years. In fact, they can remain symptom-free for as long as their cirrhosis remains compensated.

In contrast, patients with decompensated cirrhosis usually experience a range of signs and symptoms due to a combination of liver dysfunction and portal hypertension, or high blood pressure in the portal vein. This high portal vein pressure impairs the normal delivery of blood draining to the liver from the intestines and other abdominal organs.

Cirrhosis develops in four stages of liver disease.

• Initially, fatty liver, a common occurrence in heavy drinkers, occurs as a result of alcohol breakdown but can improve or reverse with reduced alcohol intake.
• In the second stage, alcoholic hepatitis, characterized by liver inflammation, affects about 10 percent to 35 percent of heavy drinkers and can progress to potentially fatal liver failure.
• Liver fibrosis (scar tissue) is the third stage, where the body’s natural way of healing wounds in the liver responds to ongoing liver damage and inflammation. This process leads to the buildup of extra connective tissue. As liver cells are repeatedly injured and repaired, fibrosis gradually replaces healthy liver tissue, making the liver more rigid. This stiffness is a characteristic feature of cirrhosis.
• Cirrhosis, the fourth stage, affects around 10 percent to 20 percent of heavy drinkers annually and represents advanced liver damage.

Cirrhosis patients are at a higher risk of liver cancer, with an annual incidence rate of 2 percent to 3 percent.

The following factors make one more likely to develop cirrhosis:

• Sex: Cirrhosis occurs more frequently in men than in women, and males are twice as likely to die from cirrhosis than females.
• Age: Cirrhosis is more common in individuals over the age of 50.
• Hereditary diseases: These disorders include alpha1-antitrypsin deficiency, glycogen storage diseases, cystic fibrosis, porphyria (which results from heme production abnormalities and impacts vital organs), Wilson’s disease, and hemochromatosis.
• Alcohol abuse
• Metabolic disorders
• Underlying conditions: These may include diabetes, high cholesterol, high triglycerides, sleep apnea, hypothyroidism, and polycystic ovary syndrome.
• Poor diet
• Overweight or obesity: Obesity can lead to NASH, a cause of cirrhosis.

Cirrhosis can be diagnosed through symptoms, medical history, physical exam, and lab tests. Your doctor will ask whether you have a history of medical conditions that can potentially cause cirrhosis. During a physical exam, your doctor will search for signs and symptoms indicating the disease.

Your doctor may offer multiple tests if cirrhosis is suspected after the physical exam, including the following.

Blood Tests

Blood tests are performed to assess liver function. Their results can help your doctor diagnose specific causes of cirrhosis and evaluate the severity of the condition. It is best to have a battery of blood tests, as a single one may show normal results since the liver can continue its essential functions even when its function is reduced by up to 80 percent. These blood tests include:

• Liver function tests, also known as a liver panel, which analyze substances produced by your liver using a blood sample. Cirrhosis may be suspected if your liver tests exhibit increased levels of liver enzymes, such as alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (GGT), and alkaline phosphatase; increased bilirubin levels; and abnormal levels of albumin or immunoglobulins in the blood. These changes are the results of liver inflammation.
• Complete blood count (CBC): A CBC is a routine blood test that evaluates the cellular components of your blood, including red blood cells, white blood cells, and platelets. Platelets are often abnormally low in liver disease. A CBC also assesses parameters such as hemoglobin, which indicates oxygen-carrying capacity. The CBC’s results can indicate infection and anemia, which could be due to internal bleeding.
• Hepatitis virus testing
• Autoimmune liver condition testing: Tests for autoimmune liver conditions include the anti-nuclear antibody (ANA), anti-smooth muscle antibody (SMA), and anti-mitochondrial antibody (AMA) tests.

Persistently abnormal liver function test results are strongly associated with underlying liver disease confirmed by biopsy. Therefore, patients with consistently abnormal liver function tests should undergo further targeted testing to determine the specific liver condition.

Imaging Tests

Imaging tests can reveal the liver’s size, shape, texture, and fat content, and some can also assess liver stiffness. They include:

• Ultrasound
• Magnetic resonance imaging (MRI)
• X-rays: One type of X-ray is computed tomography (CT) scans, which use a blend of X-rays and computer technology to generate detailed images of the liver.
• Transient elastography scan: A transient elastography scan, also known as a Fibroscan, resembles an ultrasound scan and measures liver stiffness.
• Upper endoscopy: An upper endoscopy, also known as EGD, may also be used. It involves inserting a flexible camera through the mouth into the upper digestive tract to examine enlarged blood vessels prone to bleeding due to cirrhosis.
• Other specialized imaging tests: When conventional imaging results are unclear, specialized noninvasive imaging tests such as magnetic resonance elastography, acoustic radiation force impulse imaging, and 2D shear wave elastography are more helpful in identifying early cirrhosis.

Liver Biopsy

While being invasive and prone to sampling error, liver biopsy is considered the gold standard for diagnosing cirrhosis, especially when other test results are inconclusive. It can also help identify the cause of cirrhosis and guide treatment. This procedure involves using a needle to extract tiny liver tissue samples, which a pathologist examines under a microscope. However, liver biopsy referral should be made after thorough noninvasive tests fail to confirm cirrhosis diagnosis, provided the benefits of biopsy outweigh the risks, and it’s believed to positively impact chronic liver disease treatment.

Common complications of cirrhosis include:

• Portal hypertension: This is a serious complication that can lead to various other common complications, including ascites, edema, hepatic encephalopathy, and enlarged esophagus veins (varices) that may catastrophically rupture. Of note, variceal rupture is the most common fatal complication.
• Portopulmonary hypertension: Portal hypertension can lead to portopulmonary hypertension, a condition where high blood pressure affects the arteries in the lungs, causing symptoms such as difficulty breathing, fatigue, and heart failure.
• Infections: Cirrhosis raises the risk of bacterial infections such as peritonitis (most common), urinary tract infections, and pneumonia.
• Liver failure
• Liver cancer: Hepatocellular carcinoma is the most prevalent cancer associated with cirrhosis.
• Bone diseases like osteoporosis
• Gallstones
• Issues with bile ducts
• Malabsorption and malnutrition: Gradually, cirrhosis-induced inadequate absorption of fats and especially fat-soluble vitamins can result in various issues, such as malnutrition and osteoporosis (due to the lack of vitamin D to help with calcium absorption).
• Splenomegaly, or enlarged spleen.
• Bleeding issues: Cirrhosis can lead to bleeding irregularities due to disordered blood clotting caused by various factors. For instance, an enlarged spleen may trap platelets and blood cells, thus reducing the body’s clotting ability, while liver damage reduces the production of clotting proteins. Conversely, some liver issues can lead to excessive blood clotting, particularly in blood vessels near the liver. A person may also bleed or bruise easily due to low platelets and inadequate production of clotting proteins.
• Sensitivity to medications
• Insulin resistance
• Type 2 diabetes: Cirrhosis leads to insulin resistance, prompting the pancreas to produce more insulin to manage glucose levels, thus resulting in the development of Type 2 diabetes.
• Kidney disease or failure: Liver failure can progress to hepatorenal syndrome, where kidney function declines, leading to reduced urine production and toxic substance buildup. This can cause breathing difficulties from excessive fluid retention and may necessitate dialysis due to severe kidney impairment.

While there are no definitive cures for cirrhosis, addressing its underlying causes can prevent or slow liver damage, while managing its complications can prevent worsening and liver failure. In addition, experimental data and clinical studies suggest that liver fibrosis can be reversed, and cirrhosis can also be improved.

The most effective strategy is to stop cirrhosis in its initial stages by addressing its cause. Doctors typically advise diet and lifestyle modifications or prescribe medications for this. Importantly, people with cirrhosis may need to take lower doses of certain medications because the liver may not metabolize them properly, thus leading to potential drug toxicity.

For diet, extra calories and protein may be necessary since damage to the liver can impair its ability to store glycogen, a carbohydrate crucial for short-term energy. This deficiency can result in the body using muscle tissue for energy, leading to muscle wasting and weakness. It’s also beneficial to have several small meals per day. In addition, raw or undercooked shellfish, fish, and meat should be avoided.

To improve cirrhosis symptoms, doctors may suggest the following approaches:

• Reduce fluid buildup: A low-sodium diet or diuretics can help decrease fluid retention.
• Lower bleeding risk: Beta blockers lower blood pressure and decrease the risk of bleeding. Vitamin K and emergent plasma infusions can also be used to treat bleeding. Tablets can also be prescribed to lower high blood pressure in the portal vein.
• Reduce skin itchiness with topical creams.

End-stage liver disease (ESLD) refers to a stage of cirrhosis where signs of decompensation are present, and the cirrhosis cannot be reversed with medical treatment, necessitating consideration of a liver transplant. Successful liver transplantation leads to normal to near-normal liver function and the resolution of cirrhosis and liver failure symptoms. However, doctors typically consider a liver transplant as the last resort after all other treatment options are ruled out and ESLD threatens your life. Before your condition worsens significantly, you may want to discuss with your doctor the possibility of being a suitable candidate for a liver transplant in the future.

Mindset can play a role in liver cirrhosis management in several different ways, including:

• Stress management: A negative mindset can exacerbate stress or anxiety, potentially worsening symptoms and negatively impacting overall well-being. Stress management techniques, psychological support, and maintaining a positive outlook may contribute positively to liver health in individuals with cirrhosis.
• Adherence to treatment plans: Positivity can lead to better adherence to medication and treatment plans, including alcohol abstinence, thus helping with the management of cirrhosis.
• Lifestyle changes: A positive mindset can result in more determination to make lifestyle changes, such as a healthy diet and regular exercise, which also improve the condition.

Other natural approaches may be used to treat cirrhosis in addition to lifestyle changes. However, you should always consult your doctor before adopting any of them.

Herbs and Herbal Medicines

Herbal medicines have a long history of use in treating liver diseases globally, including in China, India, Iran, Japan, Mexico, Sri Lanka, and many other countries. The following are a few evidence-based options:

• Milk thistle (Silybum marianum): Milk thistle, also known as silymarin, has been used as a remedy for liver, kidney, and gallbladder issues for two millennia. Research indicates that compounds in milk thistle may help protect the liver. Among them, a flavonoid called dihydroquercetin can decrease fat accumulation in the liver, especially in individuals who consume alcohol, thus helping prevent fatty liver. Silymarin can protect the liver from toxins. In a pooled analysis of studies involving cirrhosis patients, milk thistle treatment was linked to a notable decrease in liver-related mortality. However, study results have been mixed regarding whether milk thistle improves liver function tests. In addition, individuals allergic to ragweed may also have an allergy to milk thistle.
• Dandelion (Taraxacum officinale): Dandelion roots and leaves have historically been used to treat liver issues. Dandelion extract has antioxidant properties that combat free radicals, thus potentially protecting DNA from damage. Dandelion root is also used in clinical settings to support liver detoxification. One study discovered that rats with carbon tetrachloride-induced chronic cirrhosis had significantly improved serum markers after receiving dandelion leaf water extract, indicating the extract’s ability to restore liver function and protect hepatocytes from damage.
• Licorice (Glycyrrhiza glabra): Both Eastern and Western medicine have historically used licorice root to treat liver disease. One study found that licorice treatment effectively inhibited alcohol-induced liver changes in rats, demonstrating the herb’s potential anti-inflammatory effects and improved antioxidant defense against alcohol-induced liver injury. Stronger Neo-Minophagen C (SNMC) is a preparation comprising 0.2 percent glycyrrhizin, 0.1 percent cysteine, and 2 percent glycine. Glycyrrhizin is the primary active constituent of licorice root. In one Japanese study, SNMC given intravenously improved liver health in patients with chronic hepatitis and decreased the risk of developing liver cirrhosis or liver cancer in long-term users compared to non-users.
• Green tea (Camellia sinensis): One meta-analysis found that green-tea drinkers had a significantly lower risk of liver disease, including hepatocellular carcinoma, liver steatosis, hepatitis, cirrhosis, and chronic liver disease. This protective effect was observed across different races.
• Traditional Chinese medicine: In a study using Taiwanese health data, 1,522 patients with newly diagnosed chronic hepatitis B and liver cirrhosis were studied. Those using traditional Chinese medicine (TCM) had a 56 percent reduced risk of death compared to non-TCM users, and those using TCM for over 180 days had a 67 percent lower risk of death. Further study is needed since proportionately more women used TCM, and this group is known to have less severe disease overall. Baseline severity of disease in both groups was not noted. The meta-analysis found 10 medicinal ingredients and herbal formulae that could reduce future mortality risk.

Supplements

The following supplements have some efficacy in treating cirrhosis:

• Branched-chain amino acids (BCAAs): BCAAS have shown potential in treating hepatic encephalopathy, as research indicates that BCAAs may improve liver function tests and motor ability in people with this condition.
• S-adenosylmethionine (SAMe): SAMe is an antioxidant known for its antidepressant effects and involvement in liver processes. Low SAMe levels in people with liver disease may lead to reduced glutathione levels, impacting toxin removal by the liver. Some research suggests that SAMe supplementation can alleviate liver disease symptoms and normalize bilirubin and liver enzyme levels, but further studies are needed for confirmation.

Mind-Body Practices and Complementary Medicine

The following are mind-body or physical practices and alternative treatments for cirrhosis:

• Yoga and naturopathy: In one study, a 39-year-old man with liver cirrhosis underwent integrated naturopathy and yoga therapies along with Indian Ayurveda and conventional medications for four weeks. The treatment, including hydrotherapy, mud therapy, massage therapy, diet therapy, yoga practices, and meditation, demonstrated significant improvements in various health indicators, including body weight, abdominal girth, blood pressure, breath-holding time, hemoglobin level, liver function test, and renal function test.
• Acupuncture: Acupuncture is commonly used in China to treat liver cirrhosis. A meta-analysis of 15 studies involving 1,066 patients indicated that acupuncture could be considered a complementary therapeutic approach for cirrhosis patients. In addition, one review discovered that acupuncture is effective in treating NAFLD, likely by targeting multiple pathways and signaling pathways. Specifically, acupuncture may reduce inflammation, regulate lipid metabolism, improve insulin resistance, combat oxidative stress, and alleviate endoplasmic reticulum stress.
• Meditation: Patients with cirrhosis often experience impaired health-related quality of life, including sleep and mood dysfunction. A four-week dedicated mindfulness-based stress reduction (MBSR) and supportive group therapy have been shown to significantly improve depression and sleep quality in cirrhotic men, suggesting that mindfulness can be a valuable approach for enhancing patient outcomes.
• Exercise: As per one review of seven studies focusing on training interventions lasting four to 14 weeks with exercise frequencies of three to five days per week, exercise resulted in increased maximal oxygen consumption, improved performance in the six-minute walk test, and a decrease in hepatic venous pressure. One of the seven studies measured hepatic venous pressure and found that it decreased. No adverse effects were reported from the exercise programs.

Ways to prevent cirrhosis or lower its risk include:

• Avoiding smoking
• Avoiding or limiting alcohol consumption: Men should limit their alcohol intake to two drinks or less per day and women one drink or less per day. According to estimates, avoiding alcohol abuse could prevent 75 percent to 80 percent of cirrhosis cases. Consuming even moderate amounts of alcohol can be highly detrimental to the liver once cirrhosis has developed, regardless of the underlying cause of the condition.
• Maintaining a healthy weight: Having a healthy weight by exercising regularly and eating a balanced diet can lower the risk of developing NAFLD.
• Practicing good hygiene can lower the risk of developing infections. Hepatitis B and C can be contracted through unprotected sex or sharing needles for drug injection. High-risk individuals, including police officers and social care workers, can get vaccinated against hepatitis B, but there’s no vaccine for hepatitis C currently available.
• Managing underlying metabolic conditions: These conditions include high blood pressure, diabetes, and high cholesterol.
• Reviewing medications: If you already have liver damage, it could be a good idea to inform your doctor about all the medicines you’re taking, including over-the-counter drugs, such as acetaminophen, herbal products, and dietary supplements, as a damaged liver may have difficulty metabolizing them.
• Treating underlying cirrhosis-associated diseases: To treat chronic hepatitis B and C virus infection, doctors prescribe antiviral medicines that target and attack the viruses. Autoimmune hepatitis is managed with immunosuppressants or corticosteroids. Hemochromatosis is typically treated with phlebotomy (bloodletting) to lower abnormally high iron levels. Wilson’s disease is managed with medications that eliminate excess copper from the body. These include chelating agents, penicillamine, zinc, and trientin.
• Staying up to date with routine monitoring: Regular checking of fluid balance in the body, kidney health, varicose vein formation, and the progression of any liver disease is necessary, especially if you already have liver damage.