Liver cirrhosis is a late-stage scarring (fibrosis) of the liver caused by various forms of liver diseases and conditions, such as hepatitis and chronic alcoholism. Each time your liver is injured — whether by disease, excessive alcohol consumption, or another cause — it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function. Advanced cirrhosis is life-threatening.

The liver is a vital organ located in the upper right quadrant of your abdomen, beneath your diaphragm. It performs hundreds of essential functions, including:

Filtering toxins from your blood

Producing bile, which helps digest fats

Storing glucose for energy

Producing proteins that help with blood clotting

When cirrhosis occurs, the scar tissue replaces healthy liver tissue, impairing these crucial functions.

In the early stages, liver cirrhosis often has no signs or symptoms.

As the disease progresses, symptoms may become more apparent and include:

Fatigue and Weakness: Feeling unusually tired and lacking energy.

Nausea and Loss of Appetite: Leading to unintentional weight loss.

Jaundice: Yellowing of the skin and eyes, caused by a buildup of bilirubin.

Edema: Swelling in the legs, ankles, and feet due to fluid retention.

Ascites: Fluid accumulation in the abdomen, causing swelling and discomfort.

Easy Bruising and Bleeding: Due to decreased production of clotting factors.

Itchy Skin: Caused by bile products depositing in the skin.

Dark Urine: Due to increased bilirubin.

Spider Angiomas: Small, spider-like blood vessels that appear on the skin, particularly on the chest and face.

Enlarged Spleen: Due to portal hypertension.

Confusion and Memory Problems (Hepatic Encephalopathy): Caused by toxins building up in the brain.

Loss of Libido: Decreased sex drive.

A wide range of diseases and conditions can damage the liver and lead to cirrhosis.

The most common causes include:

Chronic Alcohol Abuse: Excessive and prolonged alcohol consumption is a leading cause worldwide.

Chronic Viral Hepatitis: Hepatitis B and Hepatitis C are major contributors to cirrhosis.

Non-alcoholic Fatty Liver Disease (NAFLD) and Non-alcoholic Steatohepatitis (NASH): These conditions are increasingly common, especially in individuals with obesity, diabetes, and high cholesterol.

Autoimmune Hepatitis: A condition where the body's immune system attacks liver cells.

Bile Duct Diseases: Such as primary biliary cholangitis (PBC) and primary sclerosing cholangitis (PSC), which cause inflammation and scarring of the bile ducts.

Genetic Diseases: Including hemochromatosis (iron overload) and Wilson's disease (copper overload).

Certain Medications: Prolonged use of some drugs can cause liver damage.

Cystic Fibrosis: A genetic disorder that can affect the liver.

Alpha-1 Antitrypsin Deficiency: A genetic condition that can lead to lung and liver disease.

Diagnosing liver cirrhosis often involves a combination of medical history, physical examination, and various tests:

Physical Examination: Your doctor will look for signs such as jaundice, fluid retention, and an enlarged liver or spleen.

Blood Tests:

Liver Function Tests (LFTs): To check levels of liver enzymes, bilirubin, and albumin, which indicate liver damage and function.

Blood Clotting Tests: Such as prothrombin time (PT) and international normalized ratio (INR), to assess the liver's ability to produce clotting factors.

Tests for Hepatitis Viruses: To identify the presence of Hepatitis B or C.

Tests for Autoimmune Markers: If autoimmune hepatitis is suspected.

Tests for Genetic Conditions: If genetic causes are suspected (e.g., iron or copper levels).

Imaging Tests:

Ultrasound: Often the first imaging test, can show liver size, texture, and fluid in the abdomen.

CT Scan (Computed Tomography): Provides more detailed images of the liver and surrounding organs.

MRI (Magnetic Resonance Imaging): Can detect liver scarring and other abnormalities.

Elastography (e.g., FibroScan): A specialized ultrasound or MRI that measures liver stiffness, indicating the degree of scarring.

Liver Biopsy:

In some cases, a small sample of liver tissue is removed and examined under a microscope. This is considered the most definitive way to diagnose cirrhosis and determine its cause and severity.

Treatment for liver cirrhosis focuses on slowing the progression of the disease, managing symptoms, and preventing or treating complications.

While the damage caused by cirrhosis is generally irreversible, early intervention can significantly improve outcomes.

1. Treating the Underlying Cause:

Alcohol Cessation: For alcohol-related cirrhosis, stopping alcohol consumption is crucial.

Antiviral Medications: For chronic Hepatitis B or C, antiviral drugs can suppress the virus and prevent further liver damage.

Weight Loss and Lifestyle Changes: For NAFLD/NASH, managing weight, diabetes, and cholesterol is essential.

Medications for Autoimmune Hepatitis: Immunosuppressants are used to control the immune response.

Chelation Therapy: For genetic conditions like hemochromatosis (iron removal) or Wilson's disease (copper removal).

2. Managing Symptoms and Complications:

Diuretics: To reduce fluid retention (edema and ascites).

Low-Sodium Diet: To help manage fluid retention.

Lactulose and Rifaximin: To treat hepatic encephalopathy by reducing toxin buildup in the brain.

Beta-blockers and Band Ligation: To prevent bleeding from esophageal varices (enlarged veins in the esophagus).

Antibiotics: To treat infections, especially spontaneous bacterial peritonitis (SBP).

Nutritional Support: To address malnutrition and provide adequate nutrients.

Itch Relief Medications: For pruritus (itchy skin).

Stem Cell Therapy: A Promising Emerging Treatment

Stem Cell Therapy, particularly using Mesenchymal Stem Cells (MSCs) like Human Umbilical Cord Mesenchymal Stem Cells (hUC-MSCs), shows significant promise.

Concord Stem Cell Limited, as the only DGDA approved stem cell manufacturer and provider lab in Bangladesh with cGMP facility, is at the forefront of this research and application.

The potential benefits of stem cell therapy for liver cirrhosis include:

Anti-inflammatory Effects: MSCs can reduce the chronic inflammation that drives liver scarring.

Immunomodulation: They can modulate the immune system, preventing further immune-mediated damage.

Anti-fibrotic Effects: MSCs may help to inhibit the progression of scar tissue formation and even promote the breakdown of existing scar tissue.

Regenerative Potential: While not fully regenerating a cirrhotic liver, MSCs may contribute to the repair of damaged liver cells and improve liver function by releasing growth factors and other beneficial molecules.

Paracrine Effects: MSCs release various bioactive molecules that can stimulate resident liver cells to regenerate and function better.

It's important to note that while stem cell therapy holds great promise; Patients considering this option should consult with our specialist to understand the potential benefits.