What Is Chronic Liver Disease?

Chronic liver disease is a serious, deadly condition that sickens and kills many people every year. This condition killed 44,358 people in the United States in 2019, according to the Centers for Disease Control and Prevention.

As the name indicates, chronic liver disease is a long-term condition in which the liver doesn’t function as it normally does. Without treatment, this condition becomes progressively worse.

If it progresses to the final stage, chronic liver disease is often known as cirrhosis or cirrhosis of the liver.

What Are the Complications of Cirrhosis?

Serious, ongoing liver disease can cause fibrosis, the destruction of tissue that ends by scarring. This scarred tissue replaces the healthy tissue in the organ. An accumulation of scar tissue in the liver can make it hardened and cause cirrhosis.

Different factors contribute to fibrosis and cirrhosis:

• Alcohol abuse and addiction
• Obesity
• Hepatitis C (a viral liver infection)
• Accumulated fat in the liver
• Viruses
• Autoimmune diseases/inherited diseases
• Effects from drug toxins

Since the liver is a vital organ, cirrhosis can disrupt and endanger bodily functions. The body uses healthy liver tissue to:

• Eliminate wastes (toxins such as poisonous drugs and alcohol, medicines)
• Store sugar that are used to produce energy
• Create bile, a substance that aids in the digestion of fat
• Produce new proteins

When the liver tissue is scarred, it’s unable to do its functions as easily as it normally can (liver disease) or it can’t do these functions at all (liver failure). Tissue scarring disrupts the body and can cause different symptoms.

What Are the Symptoms of Cirrhosis and Other Liver Problems?

A healthy liver’s job is to aid digestion and eliminate wastes. When their livers are unhealthy, people may not be able to process and use food properly. Toxins may accumulate and people might experience different symptoms, including:

• Yellowish discoloration of the eyes and skin (jaundice)
• Bruising, bleeding easily, and enlarged blood vessels (veins that resemble spider webs)
• Itching
• Loss of muscle
• Appetite loss and unwanted weight loss
• Vomiting blood
• Fluid accumulation (ascites and edema)
• Gallstones
• Reduced numbers of white blood cells in the spleen
• Darkening of the urine
• Increased pressure in the vein system leading to the liver (portal hypertension)
• Accumulation of medication in the body, and heightened sensitivity to medication
• Fatigue
• Confusion, problems with memory, sleep, and poor concentration
• Coma in the final stage

Cirrhosis thus creates – as it progresses -symptoms that could range from irritating to life-threatening.

How Is Cirrhosis Diagnosed?

In fact, doctors might discuss their patient’s alcohol use to determine if they could be at risk for cirrhosis. Doctors might also note if their patients are obese or have other factors that could contribute to liver disease.

After discussing their patients’ medical histories and current life circumstances, doctors might conduct physical examinations. If patients’ livers feel hard or if it seems as if they have fluid in their abdomens, they could be exhibiting symptoms of cirrhosis or other conditions.

They might undergo tests that could include:

• An upper endoscopy. In this procedure, a doctor places a thin tube attached to a tiny camera into the patient’s mouth to search for blood in the esophagus and stomach.
• Ultrasounds, magnetic resonance imaging (MRI), computerized tomography (CT) scans, or liver scans. These tests can determine if people have excess fluid, problems with blood flow, or enlarged livers.
• Laparoscopy. To look at the liver directly, doctors might use a laparoscope, a device with a camera that transmits pictures to view on a computer screen.
• Biopsy. Using a needle, a doctor extracts a small amount of liver tissue during a biopsy to determine if a patient has cirrhosis or other conditions.
• Blood tests. By testing the blood, medical professionals can determine if people have cirrhosis or other problems of the liver.

Once doctors determine a person has liver disease, they may perform other tests to determine its severity. They may use a system known as Model for End-Stage Liver Disease (MELD) to assess the likelihood of their patients’ survival. A higher score on this assessment means a patient is more likely to die, a lower score, less likely.

Heavy Alcohol Use and the Stages of Chronic Liver Disease

Liver disease is chronic, which means that doesn’t occur suddenly. It progresses over a period of time and increasingly worsens. Stages of liver disease include:

Inflammation

While their livers might become inflamed or enlarged in the early stages of liver disease, people might not know because they aren’t experiencing any symptoms. If they do discover that they have inflamed livers, they may be able to reverse the damage at this point.

Fibrosis

Without treatment, inflamed livers begin to scar and fibrosis occurs. Scarred liver tissue is unhealthy and can’t perform its normal functions, which can affect the operation of the entire organ. People might still not notice any symptoms, however.

Cirrhosis

If fibrosis continues without any intervention, cirrhosis can occur. In this stage, more of the liver is scarred, which means there’s less healthy tissue to carry out the organ’s ordinary functions. This can cause complications and symptoms for a person with cirrhosis.

End-stage liver disease (ESLD)

As their liver functioning continues to deteriorate, people with cirrhosis might experience end-stage liver disease (ESLD). This condition causes severe complications such as ascites, which is an accumulation of fluid in the abdomen. It can also cause a dangerous condition known as hepatic encephalopathy, where liver damage fails to clear bodily toxins, they accumulate in the bloodstream, and ultimately cause brain damage.

Liver cancer

People can develop liver cancer at any stage of liver disease. People with diseased livers might not develop cancer, but they do have an elevated risk for it. Prolonged heavy alcohol use can contribute to the above conditions and make them worse. Since people might not experience symptoms or complications of liver disease, a patient’s heavy drinking could prompt medical professionals to look for the conditions, diagnose them, and treat them.

How Is Cirrhosis Treated?

Of course, a diagnosis of cirrhosis isn’t necessarily fatal. Quick, decisive action can help stop liver disease from worsening while making the patient’s life more comfortable.

For example, people with cirrhosis should try to create and follow a nutritious diet. Liver disease can cause malnutrition, so eating a balanced, healthful diet can help people restore the nutrients they’ve lost.

Giving up alcohol and recreational drugs is another way to stop the progression of liver disease. People might attend inpatient (residential) addiction treatment centers, participate in outpatient programs, or join sobriety support groups to quit alcohol and drugs, and stay sober.

Medications can help people treat cirrhosis, other liver diseases, and complications from the conditions.

Other treatments address the complications of cirrhosis and liver disease. Doctors might insert shunts to relieve pressure or use bands to stop bleeding if someone has portal hypertension, which is increased pressure in the vein system leading to the liver.

People with hepatic encephalopathy have an excess of bodily toxins, so they might receive enemas, take laxatives, or consume less protein. In more advanced cases, they might undergo hemodialysis to remove poisonous wastes that have accumulated in their blood.

Finally, if these treatments don’t work or stop working, a person’s liver might stop functioning, leading to liver failure. People may be candidates for liver transplants at this point.

Not everyone is a candidate for an organ transplant. People must be healthy enough to withstand the transplant surgery and the period that follows. They must follow their medical teams’ advice before and after surgery to obtain the best results. After surgery, their bodies might still reject their new livers, even if they’ve taken all the necessary precautions.

Such complications, and the fact that there aren’t enough healthy transplant livers for the people who want them, means that liver transplants are relatively rare. They’re an option people can explore only after they’ve exhausted all the other possibilities.

It’s much better to capture liver disease before people get to that point. Better yet is preventing cirrhosis and other stages of liver disease in the first place.