Cirrhosis: Symptoms, Risks, and When to Seek Further Care

Q: Cirrhosis: Symptoms, Risks, and When to Seek Further Care

Dr. <br>Yang Guojun responds： The Chinese have a deep affection for the liver, referring to cherished things as "heart and liver treasures." When extremely sad, they say "the liver and intestines are severed," and when fearful, they describe it as "the liver and gallbladder are s

Cirrhosis

Hello Dr.
Yang,
I have a relative who is currently seventy years old.
Recently, they have been experiencing abdominal swelling and sought medical attention.
The doctor informed them that it is liver cirrhosis and prescribed some diuretics.
The doctor casually mentioned that there are no dietary restrictions and no other precautions to take.
I would like to ask if this is a precursor to liver cancer, or should we seek a thorough examination at a major hospital to determine if it is indeed liver cancer? If we go to a major hospital, should we start by making an appointment with the internal medicine department? Thank you for your response.

Fei'er, 20~29 year old female. Ask Date: 2000/09/27

Dr. Yang Guojun reply Internal Medicine

Dr.
Yang Guojun responds: The Chinese have a deep affection for the liver, referring to cherished things as "heart and liver treasures." When extremely sad, they say "the liver and intestines are severed," and when fearful, they describe it as "the liver and gallbladder are split." Liver diseases seem to be particularly intertwined with the Chinese population, with hepatitis and liver cancer being prevalent, often referred to as national diseases.
In Taiwan, liver cancer ranks first among malignant cancers in men, resulting in approximately 5,000 deaths annually from liver cancer and another 5,000 from liver diseases, highlighting the severe threat liver cancer poses to public health.

High-risk groups for liver cancer include: 1.
Carriers of hepatitis B virus; 2.
Family history of liver cancer (direct relatives with over a 10-fold increase in risk); 3.
Patients with liver cirrhosis.
It is essential for these individuals to regularly consult a hepatobiliary specialist every six months for follow-up ultrasounds, alpha-fetoprotein (AFP) levels, and liver enzyme tests (GOT and GPT).
Appointments can be made at our Internal Medicine Clinic 5 for blood tests and ultrasound scans, available on Monday, Tuesday, Thursday, and Friday mornings.
For inquiries, please call 261920, extension 2162.
(Diuretics are used to manage ascites but do not cure liver cirrhosis.)

Reply Date: 2000/09/27

More Info

Cirrhosis is a chronic liver disease characterized by the replacement of healthy liver tissue with scar tissue, which can lead to a decline in liver function. It is essential to understand that cirrhosis itself is not a disease but rather a condition that results from various underlying liver diseases, such as hepatitis, alcohol abuse, or fatty liver disease. The symptoms of cirrhosis can vary widely and may include fatigue, weakness, jaundice (yellowing of the skin and eyes), swelling in the abdomen (ascites), and easy bruising or bleeding.

In your case, the presence of abdominal swelling (ascites) is a common symptom of cirrhosis. The diuretics prescribed by your doctor are typically used to help reduce fluid retention associated with this condition. However, the management of cirrhosis often requires a comprehensive approach, including lifestyle changes, monitoring for complications, and addressing the underlying cause of liver damage.

Regarding your concern about whether cirrhosis could be a precursor to liver cancer, it is important to note that individuals with cirrhosis are at an increased risk of developing hepatocellular carcinoma (HCC), which is the most common type of liver cancer. The risk factors for developing liver cancer include the severity of the cirrhosis, the underlying cause of liver disease, and the presence of other risk factors such as chronic hepatitis B or C infection.

If your relative has been diagnosed with cirrhosis, it is advisable to seek further evaluation, especially if there are any concerning symptoms or changes in health status. A referral to a larger medical center or a specialist in hepatology (liver diseases) may be warranted. At a larger hospital, the process typically begins with an appointment in the internal medicine or gastroenterology department, where a thorough assessment can be conducted. This may include imaging studies such as an ultrasound, CT scan, or MRI, as well as blood tests to evaluate liver function and screen for cancer markers.

In addition to seeking further medical evaluation, it is crucial to monitor for any new or worsening symptoms, such as significant weight loss, changes in appetite, or new abdominal pain. These could indicate complications of cirrhosis or the development of liver cancer.
Lifestyle modifications are also essential in managing cirrhosis. This includes avoiding alcohol, maintaining a healthy diet, and managing any underlying conditions such as diabetes or high blood pressure. Regular follow-up appointments with a healthcare provider are necessary to monitor liver function and assess for any potential complications.

In summary, while cirrhosis can increase the risk of liver cancer, it is not a definitive diagnosis of cancer. A thorough evaluation by a specialist is recommended to determine the extent of liver damage and to rule out any malignancy. Early detection and intervention can significantly improve outcomes for individuals with liver disease.

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