Treatment Overview

No treatment will cure cirrhosis or repair scarring in the liver that has already occurred. But treatment can sometimes prevent or delay further liver damage. Treatment involves lifestyle changes, medicines, and regular doctor visits. In some cases, you may need surgery for treatment of complications from cirrhosis.

Lifestyle changes

Your doctor will recommend some lifestyle changes to help prevent further liver damage.

• Stop drinking alcohol. You need to quit completely.
• Talk to your doctor about all of the medicines you take, including nonprescription drugs such as acetaminophen (for example, Tylenol), aspirin, ibuprofen (for example, Advil or Motrin), and naproxen (Aleve). These could increase the risk of liver damage and bleeding.
• Get immunized (if you have not already) against hepatitis A(What is a PDF document?) and hepatitis B(What is a PDF document?), influenza, and pneumococcus(What is a PDF document?).
• Begin following a low-sodium diet if you have fluid buildup (ascites). Reducing your sodium intake can help prevent fluid buildup in your belly and chest. For more information, see Home Treatment.

Treatment for complications of cirrhosis

Cirrhosis can cause other problems (complications) that need treatment with medicines or procedures. Complications include:

• Fluid buildup in the belly (ascites). It can be deadly if it is not controlled. Treatment can include:
  • Following a low-sodium diet.
  • Medicines such as diuretics and antibiotics.
  • Removing fluid with a needle (paracentesis).
  • Transjugular intrahepatic portosystemic shunt (TIPS). This procedure diverts fluid from the belly.
• Bleeding from enlarged veins.Variceal bleeding in the digestive tract can be treated with:
  • Beta-blocker and vasoconstrictor medicines.
  • Shunts to move blood or other fluid away from the belly.
  • Endoscopic variceal banding or sclerotherapy to stop bleeding.
  • Balloon tamponade. A doctor inserts and inflates a balloon in the lower part of the esophagus or upper part of the stomach. This stops bleeding by pressing against the veins.
• Changes in mental function.Encephalopathy may occur when the liver cannot filter poisons from the bloodstream. As these toxins build up in your blood, they can affect your brain function. You may need to:
  • Eat a limited amount of protein. Too much protein can cause toxins to build up.
  • Take lactulose. This medicine helps prevent the buildup of ammonia and other toxins in the large intestine.
  • Avoid sedative medicines, such as sleeping pills, antianxiety medicines, and narcotics. These can make symptoms of encephalopathy worse.

Follow-up visits

It's important to work with your doctor to watch your condition, especially because symptoms may not start until a problem has become severe. In addition to regular checkups and lab tests, you will also need periodic screening for enlarged veins (varices) and liver cancer (hepatocellular carcinoma).

• The American College of Gastroenterology recommends testing for varices with endoscopy for all people who have been diagnosed with cirrhosis. If your initial test does not find any varices, you can be tested again in 2 to 3 years. If you already have large varices, you may need more frequent testing and treatment with beta-blocker medicines to try to prevent future bleeding episodes.¹
• Testing to check for liver cancer usually takes place every 6 months. You will likely have a test for alpha-fetoprotein and a liver ultrasound or a magnetic resonance imaging test (MRI).

Liver transplant

Receiving a liver from an organ donor (liver transplant) is the only treatment that will restore normal liver function and cure portal hypertension. A liver transplant is usually considered only when liver damage is severe and threatening your life.

Before your condition becomes severe, you may want to talk to your doctor about whether you will be a good candidate for a liver transplant if your disease becomes advanced.

Liver transplant surgery is very expensive. You may have to wait a long time for a transplant, because so few organs are available. Even if a transplant occurs, it may not work. With these things in mind, doctors must decide who will benefit most from receiving a liver. Good candidates include those who have not abused alcohol or illegal drugs for the previous 6 months and those who have a good support system of family and friends.

Talk to your doctor about what steps you can take now to improve your overall health so that you can increase your chances of being considered a good candidate.

Palliative care

If your cirrhosis gets worse, you may want to think about palliative care. This is a kind of care for people who have illnesses that do not go away and often get worse over time. Palliative care focuses on improving your quality of life—not just in your body but also in your mind and spirit.

For more information, see the topic Palliative Care.

End-of-life issues

If you have not already made decisions about the issues that may arise at the end of life, consider doing so now. Many people find it helpful and comforting to state their health care choices in writing (with an advance directive such as a living will) while they are still able to make and communicate these decisions. You may 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 Health Care Agent.

A time may come when your goals change from treating or curing an illness to maintaining comfort and dignity. Hospice care health professionals can provide palliative care and comforting surroundings for someone who is preparing to die.

For more information, see the topic Hospice Care.