Frequently asked questions about Liver Cirrhosis

The definitive reference test to diagnose liver cirrhosis is a liver biopsy. However, there are other tests that, looked at in combination, can diagnose liver cirrhosis; e.g., laboratory tests, ultrasound and transient hepatic elastography. 

No, liver cirrhosis is not cancer. Cirrhosis is the presence of fibrous tissue or scars on the liver that alters its normal structure and function. However, liver cirrhosis has been associated with an increased risk of developing a particular type of liver cancer, hepatocellular carcinoma; so special monitoring must be done in people who have liver cirrhosis. 

Yes. Liver cirrhosis is caused by any prolonged damage to liver cells over time. Any disease that causes chronic inflammation of the liver can end up causing cirrhosis. Alcohol consumption is one of the main causes of cirrhosis, but not the only one. Viral hepatitis, non-alcoholic fatty liver disease and autoimmune diseases can also cause cirrhosis. What is more, the last two have increased in recent years. 

Alcohol consumption is not recommended in patients with chronic liver disease; especially if this has already reached the cirrhosis phase. Patients with liver cirrhosis of whatever cause have a higher risk of complications if they drink alcohol. Alcohol is also a factor in promoting progression of the disease. 

Removing or controlling cirrhosis triggers (such as alcohol use, metabolic or autoimmune factors or viral hepatitis) can stop progression of liver disease and lead to a regression of the changes caused up to that point. However, cirrhosis occurs after a long period of continuous damage to liver cells, which makes it very difficult for these lesions to be completely reversed. Therefore, in most cases, once established, the disease is not reversible. 

In general, a varied, balanced diet is recommended. In advanced stages, when the disease is decompensated, it may be necessary to follow a low-salt diet, but this will always be supervised by the medical team. 

There is currently no evidence that any dietary supplement or parapharmacy product has a beneficial effect on the liver. It should be taken into account that some parapharmacy or herbal products may have a potential toxic effect on the liver. For all this, the use of these types of products is generally discouraged.

Patients with liver cirrhosis should be monitored by specialist doctors, ideally hepatologists, or specialists in internal medicine or gastroenterologists. In general, patients with liver cirrhosis should be seen every 6 months to monitor and screen for complications. For those in the decompensated phase, these checks can be carried out at shorter time intervals. However, if patients with liver cirrhosis have rapid swelling of the belly or legs, black stools, fever or are disorientated, they should go quickly to their referral hospital. 

The use of non-steroidal anti-inflammatory drugs (NSAIDs) is not recommended in all patients with liver cirrhosis, as it can cause a deterioration in renal function and the appearance of complications such as ascites. For the same reason, the use of metamizole (Nolotil) is discouraged. For the symptomatic treatment of pain, patients with cirrhosis should take paracetamol in moderate doses of no more than 2-3 grams per day. 

A liver transplant is the only curative treatment for cirrhosis and is appropriate in only some cases. Eliminating or reducing the triggering factor of the disease is essential to control and prevent progression of the disease. Other drugs, such as statins or albumin, are being evaluated as possible new treatments for patients with cirrhosis.