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:
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Treatment for alcohol dependency. People with cirrhosis caused by excessive alcohol use should try to stop drinking. If stopping alcohol use is difficult, your health care provider may recommend a treatment program for alcohol addiction. If you have cirrhosis, it is very important to stop drinking since any amount of alcohol is toxic to the liver.
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Weight loss. People with cirrhosis caused by nonalcoholic fatty liver disease may become healthier if they lose weight and control their blood sugar levels.
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Medicines to control hepatitis. Medicines may limit further damage to liver cells caused by hepatitis B or C through specific treatment of these viruses.
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Medicines to control other causes and symptoms of cirrhosis. Medicines may slow the progression of certain types of liver cirrhosis. For example, for people with primary biliary cholangitis that is diagnosed early, medicine may significantly delay progression to cirrhosis.
Other medicines can relieve certain symptoms, such as itching, fatigue and pain. Nutritional supplements may be prescribed to counter malnutrition associated with cirrhosis. Supplements also can help prevent weak bones, known as osteoporosis.
Treatment for complications of cirrhosis
Your health care provider will work to treat any complications of cirrhosis, including:
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A buildup of fluid in your body. A low-sodium diet and medicine to prevent fluid buildup in the body may help control ascites and swelling. More-severe fluid buildup may require procedures to drain the fluid or surgery to relieve pressure.
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Portal hypertension. Certain blood pressure medicines may control increased pressure in the veins that supply the liver, called portal hypertension, and prevent severe bleeding. Your provider will regularly perform an upper endoscopy to look for enlarged veins in the esophagus or stomach that may bleed. These veins are known as varices.
If you develop varices, you likely will need medicine to lower the risk of bleeding. If you have signs that the varices are bleeding or are likely to bleed, you may need a procedure known as band ligation. Band ligation can stop the bleeding or reduce the risk of further bleeding. In severe cases, you may need a small tube — a transjugular intrahepatic portosystemic shunt — placed in your vein to reduce blood pressure in your liver.
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Infections. You may receive antibiotics or other treatments for infections. Your provider also is likely to recommend vaccinations for influenza, pneumonia and hepatitis.
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Increased liver cancer risk. Your provider will likely recommend regular blood tests and ultrasound exams to look for signs of liver cancer.
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Hepatic encephalopathy. You may be prescribed medicines to help reduce the buildup of toxins in your blood caused by poor liver function.
Liver transplant surgery
In advanced cases of cirrhosis, when the liver stops working properly, a liver transplant may be the only treatment option. A liver transplant is a procedure to replace your liver with a healthy liver from a deceased donor or with part of a liver from a living donor. Cirrhosis is one of the most common reasons for a liver transplant. Candidates for liver transplant have extensive testing to determine whether they are healthy enough to have a good outcome following surgery.
Historically, those with alcoholic cirrhosis have not been liver transplant candidates because of the risk that they will return to harmful drinking after transplant. Recent studies, however, suggest that carefully selected people with severe alcoholic cirrhosis have post-transplant survival rates similar to those of liver transplant recipients with other types of liver disease.
For transplant to be an option if you have alcoholic cirrhosis, you would need to:
- Find a program that works with people who have alcoholic cirrhosis.
- Meet the requirements of the program. These would include lifelong commitment to alcohol abstinence as well as other requirements of the specific transplant center.
Potential future treatments
Scientists are working to expand current treatments for cirrhosis, but success has been limited. Because cirrhosis has a variety of causes and complications, there are many potential avenues of approach. A combination of increased screening, lifestyle changes and new medicines may improve outcomes for people with liver damage, if started early.
Researchers are working on therapies that will specifically target liver cells, helping to slow or even reverse the fibrosis that leads to cirrhosis. However, no targeted therapy is quite ready.