Cirrhosis is most often caused by alcohol

Cirrhosis is a serious liver condition in which the liver is scarred as healthy tissue is replaced by connective tissue. Finns have one of the highest mortality rates in Europe from cirrhosis and other liver diseases. The main cause of cirrhosis is the high-risk use of alcohol.

What leads to cirrhosis?

Cirrhosis means the hardening of the liver. The liver is scarred as healthy tissue is replaced by connective tissue.

The most common cause of cirrhosis is heavy and constant alcohol consumption. Viral infections (such as hepatitis C) and fatty liver disease (caused by abdominal obesity) can also lead to cirrhosis.

Heavy and constant alcohol consumption also causes fatty liver disease. When alcohol is burned in the liver, it alters the liver’s metabolism. This has various effects, such as disturbing the utilisation of nutrients. When fatty acids from food cannot be burned, fat begins to accumulate in the liver. Once the alcohol has been removed from the body, the fat that has formed in the liver disappears. However, if you continually consume large quantities of alcohol, the accumulated fat will never be removed and this will result in fatty liver disease. If left untreated, fatty liver disease may lead to hepatitis, and prolonged hepatitis can lead to cirrhosis.

Men have a clearly increased risk of cirrhosis when they consume 4–5 restaurant servings of alcohol per day. For women, a lower quantity is already dangerous.

Symptoms of cirrhosis

In its early stages, cirrhosis does not really cause any symptoms. The symptoms may also be extremely vague, such as fatigue, mild fever, loss of appetite, nausea, or pressure in the upper stomach. You can suffer from early-stage and moderate cirrhosis for a long time before it is detected. Liver function blood tests may not necessarily show any changes either. The most reliable way to detect cirrhosis is to examine a liver tissue sample.

Advanced, late-stage cirrhosis is associated with many troublesome symptoms, the majority of which stem from the still-functioning liver tissue being unable to perform the liver’s function in the body. Typical symptoms include jaundice and itching. Jaundice occurs when the liver is unable to remove bilirubin from the blood. (Bilirubin is produced during the breakdown of red blood cells.) Other metabolic products, which a healthy liver would handle normally, will also accumulate in the blood. This causes fatigue and eventually impaired consciousness. A cirrhotic liver is also unable to produce enough proteins and coagulants, which leads to swelling and bleeding.

In late-stage cirrhosis, fluid accumulates in the abdominal cavity. This fluid seeps into the abdominal cavity as pressure in the portal vein, which connects the abdominal organs to the liver, increases. Increased blood pressure also causes varicose veins, which can burst and cause life-threatening bleeding.

Advanced cirrhosis leads to metabolic disorders that are severe enough to have an effect on brain function. They may impair consciousness or lead to a hepatic coma. A hepatic coma is a life-threatening condition.

Both the symptoms of cirrhosis and the problems it causes often progress in the same way regardless of the underlying cause of the condition.

Alcohol-induced cirrhosis is also the most common cause of liver cancer.

Treating cirrhosis

Cirrhosis cannot be cured. Liver tissue that has become connective tissue cannot be restored with medication or other treatments. The goal of cirrhosis treatment is, therefore, to prevent any further progression of the disease. The most important measure is to stop drinking alcohol. Cirrhosis is often associated with malnutrition, which is treated through diet therapy.

The symptoms of cirrhosis can also be treated. For example, fluid accumulation in the abdominal cavity can be reduced with diuretics.

For severe cases of cirrhosis, the only treatment is a liver transplant. If cirrhosis has been caused by alcohol, a transplant will only be considered when the patient’s alcoholism is under treatment and the patient has demonstrated that they can refrain from consuming alcohol.

How do you prevent cirrhosis?

The best way of preventing cirrhosis is to drink alcohol in moderation. Read more about the risk limits for alcohol consumption.

A healthy lifestyle and avoiding abdominal obesity (and thereby fatty liver disease) also reduce the risk of developing cirrhosis.

Duodecim Terveyskirjasto
Kidney and Liver Assosiation

Article picture: 123RF