Cirrhosis - Diagnosis

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Recognizing Signs of Dangerous Complications

Patients with cirrhosis are susceptible to infections and bleeding, both of which can be life threatening. Contact your doctor’s office or go to the emergency room if you experience any of the following symptoms:

• Fever (temperature greater than 101 °F)
• Confusion that is new or suddenly becomes worse
• Vomiting more than once a day
• Rectal bleeding, vomiting blood or blood in the urine
• Diarrhea
• Abdominal or chest pain
• Shortness of breath
• Abdominal swelling or ascites that is new or suddenly becomes worse
• Jaundice (yellowing skin or eyes) that is new or suddenly becomes worse

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Treatment of Underlying Conditions

Treatment for cirrhosis depends on the cause of cirrhosis.

Chronic Hepatitis. Many types of antiviral drugs are used to treat chronic hepatitis B, including pegylated interferon, nucleoside analogs, and nucleotide analogs. Patients with chronic hepatitis C are treated with combination therapy with pegylated interferon and ribavarin. [For more information, see In-Depth Report #59: Hepatitis.]

Autoimmune Hepatitis. Autoimmune hepatitis is treated with the corticosteroid prednisone and also sometimes immunosuppressants, such as azathioprine (Imuran).

Bile Duct Disorders. Ursodeoxycholic acid (Actigall), also known as ursodiol or UDCA, is used for treating primary biliary cirrhosis but does not slow the progression. Itching is usually controlled with cholesterol drugs such as cholestyramine (Questran) and colestipol (Colestid). Antibiotics for infections in the bile ducts and drugs that quiet the immune system (prednisone, azathioprine, cyclosporine, methotrexate) may also be used. Several surgical procedures may also be tried to open up the bile ducts.

Nonalcoholic Fatty Liver Disease (NAFLD) and Nonalcoholic Steatohepatitis (NASH). Weight reduction through diet and exercise, and diabetes and cholesterol management are the primary approaches to treating these diseases. Investigators are also studying whether various drugs used to treat type 2 diabetes may help treat NAFLD and NASH.

Hemochromatosis. Hemachromatosis is treated with phlebotomy, a procedure that involves removing about a pint of blood once or twice a week until iron levels are normal.

Review Date: 11/04/2010
Reviewed By: Harvey Simon, MD, Editor-in-Chief, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org).