Diagnosis & Treatment

Diagnosis & Treatment

Diagnosis

People with early-stage cirrhosis of the liver usually don’t have symptoms. Often, cirrhosis is first detected through a routine blood test or checkup. Your doctor may order one or more laboratory tests that may suggest a problem with your liver, such as cirrhosis.

Laboratory tests, your blood is checked for:

• Liver function
  excess bilirubin, which is a product of red blood cells breaking down, as well as for certain enzymes that may indicate liver damage.
• Kidney function
  creatinine as kidney function may decline in later stages of cirrhosis (decompensated cirrhosis).
• Tests for hepatitis B and C
  the hepatitis viruses.
• Clotting
  your international normalized ratio (INR) is checked for your blood’s ability to clot.

Your doctor may order imaging and other tests to further diagnose cirrhosis:

• Magnetic resonance elastography or transient elastography
  These noninvasive imaging tests detect hardening or stiffening of the liver and may eliminate the need for a liver biopsy.
• Other imaging tests
  MRI, CT and ultrasound create images of the liver.
• Biopsy
  A tissue sample (biopsy) is not necessarily needed to diagnose cirrhosis. However, your doctor may use it to identify the severity, extent and cause of liver damage.

If you have cirrhosis, your doctor is likely to recommend regular diagnostic tests to monitor for signs of disease progression or complications, especially esophageal varices and liver cancer.

Treatment

Treatment for cirrhosis depends on the cause and extent of your liver damage. The goals of treatment are to slow the progression of scar tissue in the liver and to prevent or treat symptoms and complications of cirrhosis. You may need to be hospitalized if you have severe liver damage.

Treatment for the underlying cause of cirrhosis

In early cirrhosis, it may be possible to minimize damage to the liver by treating the underlying cause. The options include:

• Treatment for alcohol dependency
  People with cirrhosis caused by alcohol abuse should stop drinking. If you have cirrhosis, it is essential to stop drinking since any amount of alcohol is toxic to the liver. If stopping alcohol use is difficult, your doctor may recommend a treatment program for alcohol addiction.
• Weight loss
  People with cirrhosis caused by nonalcoholic fatty liver disease may become healthier if they lose weight and control their blood sugar levels. It is important to maintain adequate protein intake while attempting weight loss in the setting of cirrhosis.
• Medications to control –
  • hepatitis
    Medications may limit further damage to liver cells caused by hepatitis B or C through specific treatment of these viruses.
  • other causes and symptoms of cirrhosis
    Medications may slow the progression of certain types of liver cirrhosis. For example, for people with primary biliary cirrhosis (now known as primary biliary cholangitis) that is diagnosed early, medication may significantly delay progression to cirrhosis.

Other medications can relieve certain symptoms, such as itching, fatigue and pain. Nutritional supplements may be prescribed to counter malnutrition associated with cirrhosis and to prevent weak bones (osteoporosis).