Can cirrhosis of the liver be cured?

introduction

Cirrhosis of the liver is an irreversible change in liver tissue caused by chronic liver diseases such as inflammation, fat and iron deposits or alcohol damage. Chronic diseases of the liver can in principle lead to reversible damage to the liver cells. Fatty liver is also one of the structural changes in the liver tissue, which, however, can be reduced and cured if the triggering causes, for example alcohol abuse, are eliminated.

In the further course, however, the liver can be converted into connective tissue and thereby irreversibly damaged, which is referred to as liver cirrhosis. This can be accompanied by numerous accompanying symptoms and secondary diseases, which can be observed over the course of the disease using clinical symptoms and laboratory values. The sequelae of liver cirrhosis can nowadays be controlled symptomatically, so that in the early stages there is no significant limitation of the prognosis. Drug-based causal treatments are still not available for advanced liver impairment.

Can cirrhosis of the liver be cured?

In principle, a cirrhotic change in the liver structure is irreversible and therefore incurable. Nevertheless, the causal and symptomatic treatment of liver cirrhosis must be considered differently depending on the individual stage and the accompanying circumstances.

Cirrhosis of the liver is often based on a chronic liver disease that drives the connective tissue remodeling of the liver cells. Before the development of liver cirrhosis, the tissue often changes in the form of liver swelling, fatty liver or chronic inflammation. Here, too, damage to the liver tissue occurs, but it can be cured with the treatment of the underlying disease. Treatment may include abstinence from alcohol or consistent treatment of liver inflammation. Especially in the early stages of liver cirrhosis, the functions of the damaged parts of the liver can be sufficiently compensated for by the remaining liver tissue. Only when a large part of the organ is irreversibly damaged do noticeable symptoms, changes in blood values ​​and secondary diseases in other organs occur.

If the cause is treated at an early stage, the cirrhotic remodeling of the liver can be slowed down or even stopped so that those affected can live largely symptom-free. A causal therapy with a regression of the cirrhotic tissue into healthy liver cells is not possible. In the late stages of liver cirrhosis, the only treatment option for healing is liver transplantation. However, this depends on various factors such as a sufficient physical condition, abstinence from alcohol, age and place on a transplant list.

Find out all about the topic here: Therapy of cirrhosis of the liver.

The prognosis of the early stage

Liver cirrhosis is a chronic, progressive disease that can take various forms. Only when a large part of the liver is diseased and the healthy parts of the liver tissue can no longer compensate for the functional failure do the first symptoms and signs of liver cirrhosis appear. Depending on the severity of the disease, the clinical picture and the prognosis of liver cirrhosis vary enormously.

In order to be able to assess the damage and consequences for the body, various criteria and values ​​are determined and assessed, the presence of which indicates the impairment of certain liver functions. For this purpose, the bilirubin and albumin levels are first determined in the blood. The status of the coagulation system can also be checked with a blood test based on the so-called "Quick value". Then the typical complications of liver cirrhosis such as ascites, the so-called "ascites" and hepatic encephalopathy, a functional disorder of the brain, are clinically checked. Using these 5 criteria, a point value can be determined which divides the disease into one of 3 stages based on the Child-Pugh classification.

In the early stages, almost all liver functions are still preserved, so that there are no deviations from the values ​​determined. Cirrhosis of the liver is therefore present, but can be completely compensated for by the rest of the liver. Adequate treatment of the underlying disease can prevent the cirrhosis from progressing so that the disease remains in its current stage. The prognosis for survival in this so-called “Child A” stage is almost unrestricted.

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The prognosis of the middle stage

The middle stage of liver cirrhosis is also called "Stage Child B". On the basis of the 5 criteria mentioned, a higher number of points is obtained at this stage, so that individual liver functions are already restricted in clotting, detoxification or the production of important hormones and messenger substances.

At this stage it is already a life-threatening clinical picture, as so-called "decompensation" with sudden severe functional restrictions and secondary diseases due to liver insufficiency can occur at any time. The subsequent symptoms must be treated symptomatically and medically examined in good time so that there are no severe, sudden bleeding, neurological restrictions or other dangerous complications.

The possibilities of causal therapy are limited at this stage. Treating the root cause can slow the progression of liver cirrhosis, but the life-threatening form of the disease remains.Overall, a 1-year survival rate of 85% can be assumed in the middle stage of liver cirrhosis.

Read more about the topic here: Symptoms of cirrhosis of the liver.

The prognosis of the late stage

The late stage of liver cirrhosis, also known as the end stage, is associated with numerous secondary symptoms and complications. Both the production of vital proteins such as albumin and the elimination of bilirubin or other toxic metabolic processes are already considerably restricted. The congestion of blood in the liver (portal hypertension) leads to changes in other organs with sometimes considerable complications. As a result, the blood vessels can form bypass circuits which, in combination with severely reduced blood clotting, can lead to severe bleeding.
The blood count is also significantly changed by organic changes in the spleen, so that infections can occur more favorably. The treatment of cirrhosis of the liver in the late stage has to be done in an intensive care unit because the numerous complications of the disease can lead to new problems.

Symptomatic therapy is in the foreground in the end stage of liver cirrhosis; liver transplantation remains the only causal therapy option. However, transplantation can only be considered under certain conditions and strict criteria. Using the Child-Pugh classification, in addition to the staging, an exact personal risk of the occurrence of further complications and death can be calculated. Overall, around 35% of those affected survive within a year in stage Child C, so there is a rather low life expectancy with liver cirrhosis at this stage.

Find out more about the topic here: The liver transplant.