The way cirrhosis is treated depends on the underlying cause. Cirrhosis can't be cured, but treatment aims to manage the symptoms and any complications, as well as stopping the condition from getting worse.
It's usually not possible to reverse any liver damage that's already occurred.
Stopping cirrhosis getting worse
Ways to stop the cirrhosis from getting worse include:
- taking medication to treat an underlying disease that has caused liver damage. For example, if you have viral hepatitis you may be prescribed interferon. If you have autoimmune hepatitis you may be given steroid-based medication, such as prednisolone or an immunosuppressant such as azathioprine.
- making lifestyle changes – you may be advised to cut down on your alcohol intake or to lose weight if you're overweight or obese. Read more about living with cirrhosis.
Easing symptoms
A number of treatments can ease the symptoms of cirrhosis. They include:
- a low-sodium (salt) diet or water tablets to reduce the amount of fluid in your body
- tablets to reduce high blood pressure in your portal vein (the main vein from the liver) and prevent or treat any infection
- creams to reduce itching
Managing end-stage complications
With advanced cirrhosis, it's only possible to treat the end-stage complications. It's not possible to treat jaundice (yellowing of the skin and the whites of the eyes) because it's simply a sign that your liver isn't working properly.
Swollen varices
If you vomit blood or pass blood in your faeces, you probably have swollen veins in your oesophagus (food pipe). These are known as oesophageal varices. You'll need urgent medical attention, which means seeing your GP or going to the accident and emergency (A&E) department of your nearest hospital immediately.
Certain procedures can help stop the bleeding and reduce the risk of it happening again. Any of the techniques described below may be used to correct the cause of your bleeding.
- Banding – an endoscopy is carried out (a thin, flexible tube is passed down your throat; it has a light and a camera on the end) and a small band is placed around the base of the varices to help control the bleeding.
- Injection sclerotherapy – following an endoscopy, a substance will be injected into the varices to make the blood clot and scar tissue to form, which helps to stop the bleeding.
- A Sengstaken tube with a balloon on the end – this is another option if bleeding can't be stopped using an endoscopy. The tube is passed down your throat into your stomach and the balloon is inflated, putting pressure on the varices and stopping the bleeding. You'll be heavily sedated during the procedure.
- A transjugular intrahepatic portosystemic stent shunt (TIPSS) – this procedure may be used if bleeding can't be controlled using the above methods. A metal tube called a stent is passed across your liver to join two large veins (the portal vein and hepatic vein). This creates a new route for your blood to flow through, therefore relieving the pressure that causes the varices.
Fluid in the abdomen and legs
Ascites (a build-up of fluid around your stomach area) and peripheral oedema (fluid around your legs and ankles) are common complications of advanced cirrhosis. They'll need to be addressed as soon as possible.
You may have 20 to 30 litres of free water in your stomach area (abdomen), which can make it difficult for you to eat and breathe properly. The fluid may also become infected. The main treatments are restricting sodium (salt) in your diet and taking diuretic tablets, such as spironolactone or furosemide.
In severe cases of ascites, tubes may be used to drain the fluid from your abdomen. This will usually be repeated every few weeks. TIPSS can also be used to treat ascites (see above).
Encephalopathy
People with cirrhosis can sometimes develop problems with their brain function (encephalopathy). This occurs because the liver isn't clearing toxins properly.
The brain’s functioning ability can be impaired, causing confusion and drowsiness and, at a later stage, a coma. Treatment may include taking antibiotics and clearing out the bowel with laxatives or enemas.
Bleeding
Cirrhosis can affect the liver's ability to make the blood clot (thicken), leaving you at risk of severe bleeding if you cut yourself. Vitamin K and plasma can be given in medical emergencies to treat episodes of bleeding. You'll need to apply pressure to any cuts that bleed.
Liver transplant
Your liver may stop functioning if it's severely damaged by scarring. In this situation, a liver transplant is the only option. This is a major procedure that involves removing your diseased liver and replacing it with a healthy donor liver. However, there are more people waiting for a transplant than there are donors.
