Treatment depends on the cause and stage of the cirrhosis. The aim of treatment is to stop the cirrhosis getting worse, to reverse any damage (if this is possible) and to treat any disabling or
life-threatening complications.
Stopping the progression
Many causes of liver disease can now be treated much more successfully than before to stop or at least slow down any decline in the condition of your liver.
This includes treating infections such as hepatitis B or C with new anti-viral medications and
autoimmune diseases such as autoimmune hepatitis (AIH) with steroid-based drugs. Genetic
haemochromatosis (GH), an inherited liver disease, can be managed successfully with phlebotomy or venesection, a procedure similar to blood donation in which a quantity of blood is
regularly taken from a vein in your arm.
Reversing the problem
Until recently, it was thought that a liver with cirrhosis could not be healed. This is usually the case because most diseases that cause scarring of your liver (fibrosis) are long-term and difficult to ‘cure’.
However, recent research has shown that it may be possible to heal scarring and even cirrhosis
where the liver disease causing this damage is able to be successfully treated.
The treatment of hepatitis B and C, as already mentioned, gives hope for the development of new drugs to combat scarring of the liver. More research, however, needs to be done before any
new treatments become widely available.
Treating and managing the effects of cirrhosis
Another aspect of treatment is to deal with the complications of cirrhosis as early as possible. For this reason your doctor may suggest you have regular tests to identify problems even before you notice any symptoms.
For instance, variceal bleeding may lead to internal bleeding and will require treatment in hospital. If swelling of the abdomen occurs, it may be necessary to take diuretic drugs (water pills) or insert a drain to remove any excess fluid (ascitic drain).
Treatments for encephalopathy include lactulose and other laxatives, or an antibiotic, to help your body remove poisonous substances (toxins). You may also be given other drugs to reduce
blood pressure, to prevent and treat infections and to help support your body’s functions.
Severe complications from portal hypertension, such as uncontrolled bleeding from varices, may mean having a procedure to lower pressure in the portal vein. This is commonly transjugular intrahepatic portosystemic shunts (TIPSS). In this procedure a metal or plastic tube (stent) is passed across your liver to make a shunt, or bypass, to make your blood to travel straight into the hepatic vein which carries the blood from your liver. This is done using a needle guided by a catheter inserted through a tiny puncture in your neck. This is not painful in itself but you will be given a local anaesthetic and usually some sedation.
Some people with cirrhosis develop liver cancer, most commonly hepatocellular carcinoma (HCC). The aim is to detect and treat liver cancer as early as possible.
Liver transplantation
If your liver is very badly damaged, a liver transplant may be needed. This is a procedure where a diseased liver is removed during a lengthy operation and replaced with a healthy donor liver.
A liver transplant is usually only recommended if other treatments are no longer helpful and your life is threatened by end stage liver disease. It is a major operation and you will need to plan it carefully with your medical team, family
and friends.
Liver transplantation is usually very successful although in some cases it is possible for liver diseases to return and affect your new liver.
Discuss any worries you have about your suitability for treatment with your specialist nurse or doctor and those nearest to you.