Cirrhosis

Home Treatment

Cirrhosis is a potentially life-threatening condition that occurs when inflammation and scarring damage the liver. The following lifestyle changes may reduce symptoms caused by complications of the disease and may slow the development of new liver damage.

Giving up alcohol

In Canada and the United States, drinking excessive amounts of alcohol is the most common cause of cirrhosis. If you are diagnosed with cirrhosis, it is extremely important that you stop drinking alcohol completely, even if alcohol was not the cause of your cirrhosis. If you do not stop, liver damage may quickly become worse. For information about how to quit drinking if you need help, see the topic Alcohol Abuse and Dependence.

Changing your diet

Changes in your diet may be necessary, such as restricting the amount of salt or protein you consume.

If your body is retaining fluid, the most important dietary change you need to make is to reduce your sodium intake by reducing the amount of salt in your diet. People with liver damage tend to retain sodium. This can contribute to fluid buildup in your abdomen (ascites), the most common complication of cirrhosis. For more information, see:

Cutting back on sodium.

If you are at risk for altered mental function (encephalopathy) because of advanced liver disease, your doctor may want you to temporarily limit the amount of protein you eat. You will still need protein in your diet to be well nourished, but you may need to get most of your protein from vegetable—rather than animal—sources and to avoid eating large amounts of protein at one time.

Avoiding harmful medications

Some medicines should be used carefully or avoided by people who have cirrhosis. For example, acetaminophen (such as Tylenol) can accelerate liver damage if you have cirrhosis but you are still drinking alcohol. Non-steroidal anti-inflammatory drugs (such as ibuprofen and ASA) increase the risk of variceal bleeding if you have enlarged veins (varices) in the digestive tract. Talk to your doctor or pharmacist about what medicines are safe for you.

Certain prescription medications used to treat other conditions may be harmful if you have cirrhosis. Make sure your doctor knows all the medications you are taking.

Improving your general health

Taking other steps to improve your overall health may help you cope with the symptoms of cirrhosis.

• Stop smoking. Quitting tobacco use will improve your overall health, which may help make you a better candidate for a liver transplant if you need one.
• Your doctor may encourage you to take a multivitamin. Do not take one containing extra iron unless your doctor tells you to, and do not take iron supplements.
• Brush and floss your teeth daily to avoid dental problems that could lead to infection (abscess). Be gentle when you floss to avoid making your gums bleed.
• Make sure you have been vaccinated against:
  • Influenza (flu). Get a flu shot every year. People with cirrhosis are at increased risk for serious complications from the flu.
  • Hepatitis A and hepatitis B.
  • Pneumococcus, which can cause pneumonia or abdominal infection (peritonitis). Ask your health professional how often you should be revaccinated.

Using complementary and alternative medicine wisely

In general, you should avoid most herbal and other supplements, which may make liver disease worse. Kava is particularly bad for people with liver problems.

Limited research has shown that the herbal supplement milk thistle may help protect the liver, but other research has not shown a benefit.⁶ Milk thistle will not reverse existing liver damage, and it will not cure infection with the hepatitis B or C virus. Talk to your doctor about whether you should try milk thistle (or any other alternative treatment).

Making decisions about end stages of life

Cirrhosis can be a progressive, fatal condition. You may want to consider discussing health care and other legal issues that may arise near the end of life.

Many people find it helpful and comforting to state their health care choices in writing (with an advance directive or living will) while they are still able to make and communicate these decisions. Some people want every possible medical treatment to sustain life, while others prefer measures to maintain their comfort without prolonging life. It may be helpful to think about what kind of medical treatment you want. Also think about who you would choose as your health care agent to make and carry out decisions about your care if you were unable to speak for yourself.

For more information, see the topics:

• Writing an Advance Directive.
• Choosing a Substitute Decision-Maker.

A time may come when your goals change from treating or curing an illness to maintaining comfort and dignity. Your primary health professional will be able to address questions or concerns about maintaining comfort when cure is no longer an option. Hospice palliative care health professionals can provide palliative care and comforting surroundings for someone who is preparing to die.

For more information, see the topic Hospice Palliative Care.

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Author:	Douglas Dana Shannon Erstad, MBA/MPH	Last Updated: May 30, 2006
Medical Review:	Adam Husney, MD - Family Medicine Kathleen Romito, MD - Family Medicine Steven L. Flamm, MD - Gastroenterology Jerome B. Simon, MD, FRCPC, FACP - Gastroenterology
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