Cirrhosis: It's not just caused by alcohol

June 22, 2021

Providence Seniors Health Team

Key takeaways:

Learn what cirrhosis of the liver is and what causes it.
As the liver ages, it may change over time and not process medicines as efficiently.
Healthy eating, exercise and limiting alcohol can help prevent cirrhosis.

[5 MIN READ]

The wedge-shaped liver is the largest organ in the body and performs many complex functions. Think of it almost as a chemical factory. It produces chemical substances in the body that cause blood to clot during bleeding and regulates the levels of chemicals in the body.

But it helps the body in many other ways, too. Including:

Fighting infections
Cleaning the blood
Making protein
Helping to digest food
Storing energy

However, if scar tissue forms on the liver, it can keep it from performing those vital functions. One of the causes of scar tissue on the liver is cirrhosis.

Recently, we addressed fatty liver disease as part of our new liver health series. Now we’re taking a deep dive into cirrhosis of the liver. These FAQ will help you explore what it is and how your habits, including nutrition and weight management can help make a difference.

What is cirrhosis and what causes it?

When something such as a virus like hepatitis B or a buildup in the liver (fatty liver disease) attacks the liver and damages it, liver cells die. Then the liver forms scar tissue, which is called fibrosis. The scarring happens little by little over the years. Once the whole liver is scarred, it hardens and shrinks. This is called cirrhosis.

Any illness or injury that affects the liver over a long time may lead to fibrosis and, finally, cirrhosis. There are several causes of cirrhosis, including:

Viruses like hepatitis B or hepatitis C (one of the most common causes)
Heavy drinking (another common cause in the U.S.)
Fatty liver disease
Genes for certain conditions that cause liver disease
Bile in the liver
Certain prescription and over-the-counter medicines
Poisons in the environment
Autoimmune hepatitis, which is when a person’s own immune system attacks the liver

How does aging affect the liver?

As your liver ages there may be changes in the way it looks and functions. The color of the liver may be light brown and begin to become a darker brown. The liver’s blood flow and size may decrease. Even then your liver tests will usually show normal results.

Another thing that happens to your liver as it ages: it can’t process medicines like it used to. The amount of time it takes to become active in your body and the side effects change as you get older.

Along those same lines, the liver can’t handle stress as well as it did when it was younger. So, in some cases older people’s livers can’t handle the toxic substances in certain drugs that younger people can. Also, damaged cells in older people’s livers repair more slowly.

Unfortunately, nothing will make cirrhosis go away. But treating the causes can keep it from getting worse.

How is cirrhosis diagnosed and treated?

If you’re showing certain symptoms, your doctor may decide to test your liver function. Those symptoms include:

Jaundice, which is a condition that makes your eyes and skin turn yellow
Light-colored stool
Dark-colored urine
Diarrhea
Nausea and throwing up
Stomach pain
Fatigue

You may also be at higher risk for cirrhosis if you:

Have a condition that makes it hard to control how much you drink
Have a family history of liver disease
Take medicines that may cause liver damage
Think you’ve been exposed to a hepatitis virus at some time in your life

How is liver function tested?

Tests for liver function are usually in the form of blood tests. The tests are also called liver panel, liver function panel and liver profile hepatic function panel. They measure the proteins, enzymes and other substances your liver makes:

Protein – the total amount in the blood
Albumin – a protein that's made in the liver
Different enzymes made by the liver – including ALP (alkaline phosphatase), ALT (alanine transaminase), AST (aspartate aminotransferase) and gamma-glutamyl transpeptidase (GGT)
Bilirubin – this waste product is made by the liver
Prothrombin time (PT) – a protein involved in blood clotting
Lactate dehydrogenase (LD) – an enzyme found in most of the body's cells after cells have been damaged by injury or disease

If the level of any of these substances is outside the normal range, it can indicate liver disease. In addition to diagnosing liver disease, these tests are used to monitor the liver to see how well treatment is working, check how badly a liver has been damaged and check any side effects of medicines you’re taking.

Other tests on your liver may include a physical exam, imaging tests such as CT scan and an ultrasound of your abdomen, and a biopsy of your liver tissue.

If you are showing symptoms or if you are concerned about your risk of developing cirrhosis, your doctor can recommend testing to determine your care plan.

Are there treatments for cirrhosis of the liver?

While doctors don’t have specific treatments that can cure cirrhosis, they can treat many of the diseases that cause cirrhosis. If you already have cirrhosis, treating the underlying causes of the condition may keep the cirrhosis from getting worse. That can help prevent liver failure.

Treating the underlying causes of cirrhosis may even slowly improve some your liver scarring.

Prevention is the best way to fight cirrhosis

In many ways, healthy aging — and a healthy liver — start with prevention. Try these tips to help your liver age well along with you.

Stay at a healthy diet and weight. The two go together. Eating right helps keep blood sugar under control and lower blood pressure. Eat a diet that’s low in fat and includes enough protein; cut down on sodium; avoid canned or prepared foods; don’t eat raw or undercooked shellfish; keep high calorie-meals, refined carbs such as white bread, and sugars to a minimum. As for maintaining a healthy weight, it’s all about making lifestyle changes. Follow your healthy eating plan, exercise and be less sedentary.
Be smart about drinking alcohol. Alcoholic beverages destroy liver cells and scar your liver. Ask your doctor how much alcohol is right for you.
Avoid toxins. As best you can, avoid toxins that can damage liver cells. Avoid direct contact from cleaning products, insecticides, additives and chemicals. Also, don’t smoke — it adds major toxins in your body.

Other do’s and don’ts to help prevent injury and disease that can lead to cirrhosis:

Don’t share personal hygiene items. This includes razors and toothbrushes.
Do practice safe sex. Not having protection and having multiple partners raises your risk of having hepatitis B and hepatitis C.
Do wash your hands. Clean up with soap and warm water right after using the bathroom, before making or eating a meal or when you’ve changed a diaper.
Do be careful about taking your medicines. Avoid making these medicine mistakes: taking too much medicine or mixing it with alcohol. Let your doctor know about any over-the-counter medicines, supplements, and natural or herbal remedies that you use.
Do get your shots for hepatitis. You can get your hepatitis A and B shots (but none for hepatitis C at this time).

You and your doctor will work together to decide what’s causing your cirrhosis and the appropriate treatment plan to address your unique situation. You’ll also discuss problems you may be having because of the condition and see about having them treated right away.

Avoiding the causes of cirrhosis of the liver is the best way to treat them. Share your tips and motivations with us @providence. #Aging #Health

Find a doctor

Having a healthy lifestyle is one of the most important things you can do to reduce your risk for cirrhosis of the liver. Maintaining a good relationship with your doctor is also critical as you team up to keep your liver well. Your doctor can help you manage risk factors and look out for concerning signs and symptoms that you may overlook.

If you want to learn more about lowering your cirrhosis risk, talk with your doctor. You can find a Providence doctor using our provider directory or search for one in your area.