Cirrhosis explained

Written by: Dr Deepak Joshi
Published: | Updated: 07/05/2019
Edited by: Top Doctors®

Cirrhosis is the result of long-term damage to the liver. Normal liver tissue is replaced by scar tissue, a process which is known as fibrosis. The liver regenerates and forms nodules. Severe fibrosis is known as cirrhosis.

What are the symptoms of cirrhosis?

In the early stages of cirrhosis, there are no symptoms or they are non-specific. They can include tiredness, loss of appetite, nausea and weight loss. In the advanced stages, people can develop itching, yellowing of the eyes (jaundice), swelling of the ankles, dark urine, pale stools, bruising and swelling of the abdomen (ascites).


What causes cirrhosis and who is most at risk?

The commonest causes of cirrhosis are excessive alcohol use, chronic viral infections such as hepatitis B or hepatitis C, and fatty liver disease. Rarer causes include conditions where the person’s own immune system attacks the liver or the bile ducts (autoimmune conditions). Men and women are equally affected and cirrhosis can occur at any age.


How is cirrhosis treated?

If an underlying cause can be found then we can treat potentially treat that. For example, if the cause of cirrhosis is hepatitis C then there are excellent, well tolerated treatments which are likely to result in a cure. If you develop fluid in the abdomen or around the ankle then we can use water tablets (diuretics).


Have there been any recent developments in the treatment of cirrhosis?

There are new treatments becoming available for certain liver diseases. They include new anti-viral agents for hepatitis C and hepatitis B and for certain autoimmune conditions. Liver transplantation is also an option with excellent outcomes.

By Dr Deepak Joshi
Hepatology (liver specialist)

Dr Deepak Joshi is a leading consultant hepatologist practising at private clinics in London. Dr Joshi specialises in liver disease, liver transplant, pancreatic diseases, bile duct diseases, and cirrhosis amongst others. At present, Dr Joshi is practising at the Guthrie Clinic, a part of King's College Hospital, the Institute of Liver Studies, and the London Liver Centre.

After qualifying in medicine from King's College in 2001, he went on to train in hepatology at the Institute of Liver Studies for five years, where he carried out a PhD researching into predictors of fibrosis in patients following a liver transplant. He further honed his skills in adult and paediatric endoscopy and ERCP whilst training at the reputable University College London Hospitals.

An active researcher in the hepatology field, he has published extensively in peer-reviewed papers, contributed to book chapters, and co-authored "Hepatology at a Glance". His main clinical interests include biliary disease, as well as treatment and management of all kinds of conditions to do with the liver or pancreas.

Dr Joshi educates future hepatologists as a clinical lecturer at King's College London outside of his practising and research hours. In addition, he sits on the expert panel of the PSC Support, a leading charity for primary sclerosing cholangitis. Additionally, he is a Liver Committee member for the British Society of Gastroenterology, which he has been a participant of since 2016.

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