So, Cirrhosis? What is that?

Your mind probably went immediately to the idea of someone who has been imbibing alcoholic beverages for a long time at high volume when you heard the word cirrhosis. Abusing alcohol can cause it but the condition of cirrhosis is not limited to alcohol-related liver disease. Cirrhosis really just means scarring of the liver occurred as a result of a liver disease that clobbered the liver to the point that it couldn’t function. Liver cells were destroyed and scars formed.

The scars are like battlements put up by the liver to protect itself from additional damage. The liver tries to contain the damage with the scars. Unfortunately though, scars can impede the flow of blood in the liver and keep it from doing its work too. Some scarring is called fibrosis but when the scars outnumber the healthy cells, the liver gets hard and lumpy. This latter state gets labeled cirrhosis.

A cirrhotic liver is more susceptible to complications and disease (but it isn’t inevitable). Once cirrhosis occurs, a liver may not be able to repair itself (remember, the healthy liver has some regenerative properties which is why someone can donate a part of a liver and then recover with growth afterward). Some believe cirrhosis is irreversible but more recent research has shown that in some cases, if the damaging disease is halted, the liver can heal and in the early stages reverse the cirrhosis. The tricky thing is that the “point of no return” is not clearly marked. People with cirrhosis who manage their nutrition, their exercise, and their encounters with whatever triggered the damage, can live very long lives.

Remember, Roy’s doctors are treating his condition “as if he has cirrhosis” but he does not conclusively have this condition. It’s likely but not certain.

It doesn’t really matter which disease caused cirrhosis, the condition of cirrhosis shows up in specific symptoms and the extent of the cirrhosis can be difficult to measure. Cirrhosis may manifest vaguely as fatigue, loss of libido, nausea or decreased appetite; in this form, the condition is considered to be “compensated.” Compensated cirrhosis still carries the risk of potentially fatal complications: ascites, encephalopathy, and/or internal bleeding. Once one of these manifests, the patient moves into a “decompensated cirrhosis” category that means the liver can’t repair and a transplant should be considered.

Laboratory results can suggest cirrhosis. According to Dr. Melissa Palmer’s Guide to Hepatitis & Liver Disease, doctors might consider its presence if lab results indicate “a low albumin level, an abnormally low cholesterol level, an elevated or prolonged prothrombin time, a decreased platelet count, and/or an elevated alpha-fetoprotein (AFP) level of 100 ng/ml (nanograms per milliliter).” Imaging may also suggest the condition but only a liver biopsy can show for sure.