American Medical Association Family Medical Guide - American Medical Association [520]
See your doctor if you have any symptoms of cirrhosis, especially if you consume an excessive amount of alcohol or if you have chronic hepatitis (see page 788).
Diagnosis
A doctor can often diagnose cirrhosis from the symptoms, a health history, and a physical examination. He or she will press on your abdomen to feel your liver and, if it feels harder or larger than normal, the doctor will order blood tests to see if you have liver damage. The doctor may also want to examine your liver on an image such as a CT scan (see page 112), an ultrasound (see page 111), or a radioisotope scan (which highlights the liver using a harmless radioactive substance). In some cases, a doctor will want to look at the liver directly using laparoscopy, in which a viewing tube (laparoscope) is inserted through a small incision in the abdomen to transmit pictures to a computer screen. To confirm a diagnosis of cirrhosis, a liver biopsy may be done. During a liver biopsy, a doctor inserts a needle through the abdomen into the liver to remove a small sample of tissue to examine for signs of scarring or disease.
Treatment
The treatment of cirrhosis depends on the underlying cause. For example, if it is caused by alcohol dependence, your doctor will ask you to avoid drinking alcohol. Abstaining from alcohol can help prevent cirrhosis from getting worse and should enable you to lead a relatively active life. If the cirrhosis arose from hepatitis (see page 786), your doctor will prescribe medications such as interferon to treat a hepatitis infection or corticosteroids to suppress the abnormal immune response in autoimmune hepatitis.
If you have nausea, your doctor can prescribe medication to relieve it. He or she will recommend that you eat frequent small meals or snacks during the day rather than three large meals. Don’t take any over-the-counter medications, including vitamin supplements and herbal remedies, without talking to your doctor, because your liver cannot filter substances normally.
Any complications of cirrhosis will also be treated. For example, if you have fluid buildup, your doctor will recommend a low-sodium diet and diuretics (drugs that remove fluid from the body). He or she may recommend removing fluid from your abdomen through a needle in a procedure called paracentesis (see page 759). For portal hypertension, your doctor may prescribe a blood pressure medication such as a beta blocker. A low-protein diet can help decrease the buildup of toxins in the blood and brain that can occur when the liver is not filtering normally. If complications cannot be controlled, or if the liver is so damaged that it stops functioning, a liver transplant (see previous page) can be lifesaving.
Tumors of the Liver
Liver tumors can be benign (noncancerous) or malignant (cancerous). Benign tumors in the liver are extremely rare; if they are detected, they can usually be removed safely and completely.
Two types of cancerous tumors develop in the liver—those that have spread there from another part of the body (metastases) and those that originate in the liver (primary cancers). About one third of all cancers in the body eventually spread to the liver. Once a cancer has spread to the liver, the outlook is poor. Cancers that originate in the liver are rare. These tumors often result from infection with the hepatitis B or C virus or from cirrhosis (see page 790).
Liver cancer is twice as common in men as in women and usually is diagnosed after age 60. People who have a family history of this cancer are at increased risk.
Symptoms
If a person has liver cancer that has spread from elsewhere in the body, he or she may first experience symptoms from the primary cancer, most frequently the breast (see page 857), lung (see page 646), or gastrointestinal tract (see page 775). As liver cancer develops, it causes loss of