centered image

centered image

Cirrhosis: The Hepatitis C Complication You Should Know About

Discussion in 'Gastroenterology' started by D. Sayed Morsy, Aug 31, 2020.

  1. D. Sayed Morsy

    D. Sayed Morsy Bronze Member

    Joined:
    Aug 11, 2020
    Messages:
    503
    Likes Received:
    1
    Trophy Points:
    945
    Gender:
    Male
    Practicing medicine in:
    Egypt

    Here’s how to spot the signs of liver scarring, and what you can do to manage it.

    [​IMG]

    Cirrhosis can be a common liver complication among people with hepatitis C.

    Chronic hepatitis C, a liver infection caused by the hepatitis C virus, is a curable disease. But if it isn’t treated with medication, it can cause long-term health problems such as cirrhosis, or scarring of the liver.

    “Hepatitis C causes inflammation of the liver,” says Marie Laryea, MDCM, an associate professor of gastroenterology and hepatology in the department of medicine at the University of Rochester Medical Center in New York. “If chronic, the liver lays down scar tissue, which eventually leads to cirrhosis. Many people associate [this condition] with alcohol, but many things can cause cirrhosis, hep C being one of them.”

    According to the Centers for Disease Control and Prevention, 10 to 20 percent of people who have hepatitis C will develop cirrhosis over the next 20 to 30 years. Those who have both hep C and cirrhosis are also more likely to develop liver failure or liver cancer.

    Still, there are ways to treat both hepatitis C and cirrhosis as well as keep your liver healthy. Here’s what you need to know.

    The signs and symptoms of cirrhosis don’t appear for years.

    Cirrhosis is known as a “silent disease.” That’s partly because the liver is particularly efficient at its job: “You likely won’t have symptoms until cirrhosis is pretty well established, which means your liver is below 25 percent function,” says Dr. Laryea. Plus, the early symptoms that do appear, including fatigue or a poor appetite, are too subtle and nonspecific to be immediately connected to liver disease.

    The signs and symptoms of advanced cirrhosis include jaundice (a yellow tint in the whites of the eyes and skin), bruising and bleeding easily, swelling in the lower legs, ankles, or feet, a bloated belly, itchy skin, and dark urine, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). “Patients may also experience hepatic encephalopathy, which is basically a change in the way the brain works that’s related to the liver,” says Laryea. “It’s a slowing of mental facilities akin to a sleeping pill effect.”

    Everyone with hepatitis C should be screened for cirrhosis.

    Just because you aren’t experiencing symptoms of cirrhosis doesn’t mean you don’t have the disease. “Looking at you from the outside may not tell us what’s going on in the inside,” says Laryea. Tests may include blood work to assess liver enzyme levels; imaging tests such as an MRI, ultrasound, or CT scan; or a liver biopsy to analyze the level of liver scarring or confirm cirrhosis if an imaging test is inconclusive, says the NIDDK.

    “When we find someone has [the] hepatitis C infection, our goal is to cure them,” says Nancy Reau, MD, a professor of transplant hepatology and gastroenterology at Rush University Medical Center in Chicago. If your follow-up screening has ruled out cirrhosis, your future outlook is positive. “After you’re cured [of hep C] and healthy, the risk of other liver complications is almost zero,” she says. You won’t need continued monitoring.

    If you are diagnosed with cirrhosis, you’ll likely need a liver ultrasound twice a year, along with blood work to monitor the disease, says Laryea. Treating the hep C virus also allows your liver function to stabilize and even improve somewhat, adds Dr. Reau. “Even with cirrhosis, the risk of bad complications improves monumentally once you cure hepatitis C,” she says.

    Your doctors will target the underlying cause of cirrhosis.

    Unfortunately, there is no treatment that will reverse cirrhosis. “There is some evidence that after treating hep C, some of the scar tissue may improve, but the global thinking is that for most patients, this is a permanent condition,” says Laryea.

    Rather, doctors will treat the cause of cirrhosis, which should prevent the disease from getting worse. Over time, some scarring can get better, says the NIDDK. Beyond that, doctors will treat the complications of cirrhosis with certain medications; i.e., those that reduce fluid buildup or improve brain function.

    A liver transplant treats liver failure, not cirrhosis, says Laryea. “There are lots of people who have cirrhosis who do not need a liver transplant, because their liver is still working well,” she says. But when the disease is advanced and liver function dips below 25 percent, they may be a candidate for a transplant.


    You can minimize the damage from cirrhosis by adopting healthy lifestyle habits.

    If you’ve been diagnosed with hepatitis C, your first priority is to get treated for the virus. Beyond that, there are several habits that can help shore up your liver health. One of the biggest: Stop smoking. “We know specifically with hep C that smoking seems to accelerate scar tissue in the liver,” says Laryea, “but after hep C is cured, we don’t know the role cigarette smoking plays [in any future damage].”

    You also need to clean up your lifestyle habits that may accelerate liver damage. “It’s best to be proactive about your health and do a lot of maintenance,” says Laryea. This may mean cutting alcohol out of your diet, according to the Mayo Clinic. Sustaining healthy cholesterol and blood sugar levels through diet, exercise, and weight management is also key. “Metabolic syndrome — high blood pressure, blood sugar, and cholesterol and triglycerides, and excess belly fat — puts you at risk for fatty liver disease, which is very similar to alcoholic liver disease,” she says. Your goal is to not have these extra stresses on your liver at this time.

    Laryea also tells people to reduce their intake of refined sugars, eat a Mediterranean-style diet (whole grains, olive oil, fruits and vegetables, legumes, and some lean meats and dairy) and find time for daily moderate exercise — walking counts. You’ll also want to avoid alcohol. Remember: “What’s good for the whole body is also good for your liver,” says Reau.

    Source
     

    Add Reply

Share This Page

<