DIAGNOSIS: Though cirrhosis is a histological diagnosis, a combination of clinical, laboratory abd imaging features can help to confirm a diagnosis of cirrhosis.
- Liver function test – which evaluates normal functioning of liver. It includes the enzymes/proteins it synthesizes like alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and albumin; the bilirubin-(direct and indirect) which it excretes and the coagulation factors it produces indicated by coagulation studies like prothrombin time.
- Complete Blood Count (CBC)- measures the levels of red blood cells, white blood cells, and platelets
- Serologic testing for specific liver disease: Hepatitis A, B and C markers, serum iron studies (for hemochromatosis), serum ceruloplasmin (for Wilson disease), antibodies (for autoimmune hepatitis)
- Kidney function tests: Urea and creatinine, electrolytes.
- Tumor markers
- Fibroscan-detects hardening or stiffening of the liver.
- Abdominal Ultrasonography
- MRI scan
- CT Scan
Liver biopsy-gold standard.
Treatment for cirrhosis depends on the cause and extent of liver damage. The goals of treatment are to slow the progression of cirrhosis and to prevent or treat symptoms and complications.
- To stop alcohol consumption
- Antiviral medications
- Dietary changes
- Steroids for autoimmune cause
- Toxins and harmful drugs must be avoided.
- Excess fluid removal from the body with medicines (diuretics and albumin infusions) and/or drainage procedures.
- Medicines like beta blockers to reduce blood pressure in portal veins
- Esophageal variceal banding/glue injection for bleeding varices
- A small tube — a transjugular intrahepatic portosystemic shunt — placed in the vein to reduce blood pressure in liver.
- Antibiotics to treat infections
- Periodic follow up to look for progression of cirrhosis and development of complications.
A liver transplant is a procedure to replace patient’s liver with a healthy liver from a deceased donor or with part of a liver from a living donor.