Definition: what is cirrhosis? The liver is a vital organ and one with the most volume in the human body. Located to the right side of the abdomen between the diaphragm and stomach, the liver has multiple functions: it filters toxins and stores and converts the nutrients absorbed by the intestines. It also makes the proteins that contribute to blood clotting, produces bile which allows fats to be absorbed and also helps to regulate the glucose levels of some hormones. Cirrhosis is a liver disease, which involves a progressive replacement of healthy liver tissue by nodules and fibrous tissue, which progressively alters the function of the liver. It is a serious and irreversible disease which can remain stable or develop further. Causes: how cirrhosis occurs Cirrhosis most commonly stems from chronic liver damage. In 75 to 90% of cases, it is caused by alcohol abuse. To some extent, it can also be caused by a viral infection, most commonly hepatitis B (5% of cases) or hepatitis C (15 to 25% of cases). Symptoms: what does cirrhosis cause? Cirrhosis is a silent disease that occurs only after 80% of the liver cells are affected. It is only at that moment that symptoms start to appear. These include: - increased fatigue, accompanied by a loss of appetite and weight loss (first signs) - nausea and diarrhoea - increased volume of the abdomen (build-up of liquid in the stomach) - jaundice - gastrointestinal haemorrhage due to portal hypertension (medical emergency). It results in vomiting blood or very dark stool. These general symptoms often lead patients to consult doctors and have a check-up. In case cirrhosis is suspected, the doctor will try to palpate the liver, the spleen and will look for the presence of redness in the palms of the hands or the skin. To confirm the diagnosis, a liver biopsy must be carried out so as to visualise the characteristic fibrotic damage. A blood test will evaluate the functioning of the liver and an ultrasound will help to clarify the appearance of the organ. These tests will also provide insights into the cause of the disease. Treatment: how to treat cirrhosis? Cirrhosis is an irreversible disease. There is no efficient treatment to cure it, other than a liver transplant. The patient can however limit the aggravating factors by treating the cause of the disease. Whilst cirrhosis is considered alcoholic, weaning is inevitable. In case of cirrhosis associated with a metabolic syndrome, such as diabetes, the patient must lose weight, control their diabetes and lower lipid levels in the blood. Ultimately, when it is caused by viral hepatitis, antiviral treatments must be administered. To a lesser degree, the patient with cirrhosis has to modify their lifestyle; firstly, by stopping their alcohol consumption. Because it aggravates the disease, tobacco consumption must also be stopped. Some medications and drugs can have a toxic effect on the liver and should also be avoided, so you should talk to your doctor about them. Complications of cirrhosis Without proper care or a lifestyle change, cirrhosis leads to stage called decompensation, where the organ is no longer capable to carry out its functions. This leads to complications such as icterus (the skin and the whites of the eyes become yellow), encephalopathy or varicose veins appearing around the oesophagus. Cirrhosis can also cause an increase in bacterial infections such as liver cancer. When cirrhosis has progressed to the point of endangering life, the only foreseeable option is a hepatic or liver transplant. Nevertheless, the operation does have risks, requires a compatible donor and waiting times can be long.