Cirrhosis can be caused by a number of conditions,
including long-standing inflammation, poisons, infections, and heart disease, as well as chronic alcoholism and chronic hepatitis, the most common causes. For 30-50 percent of cirrhosis cases, however, no cause can be found.
- Chronic alcoholism: Alcohol can poison all living cells, causing liver cells to become inflamed and die.
- The death of liver cells leads your body to form scar tissue around veins of your liver. Healing liver cells form nodules, which also press on the liver veins.
- This scarring process occurs in 10-20 percent of alcoholics and is the most common form of cirrhosis in the United States.
- The severity of the process depends on how much you drink and how long you have been abusing alcohol. The amount of alcohol needed to injure the liver varies widely from individual to individual.
- Some families are more susceptible to cirrhosis than others.
- Hepatitis: Hepatitis means inflammation of the liver from any cause, but it usually refers to a viral infection of the liver.
- Over many years the inflammation damages liver cells and leads to scarring.
- Hepatitis B,hepatitis C, and hepatitis D all can cause cirrhosis.
- Worldwide, hepatitis B is the most common cause of cirrhosis, but in the United States hepatitis C is a more common cause.
- Biliary cirrhosis: Bile is a substance produced by the liver to help the body digest fats.
- Bile is carried from the liver to the gallbladder and eventually into the intestines by small tubes called bile ducts.
- If these ducts become blocked, the bile backs up and can damage the liver. The liver becomes inflamed, starting the long process of cell damage that leads to cirrhosis.
- In adults, gallstones are a common cause of bile duct blockage. Surgery to remove the gallbladder also blocks the bile ducts.
- Children may be born with a condition that blocks the bile ducts called biliary atresia.
- This disease usually affects women aged 35-60 years.
- Autoimmune cirrhosis: The body's immune system defends against "invaders" such as bacteria, viruses, or allergens.
- Autoimmune diseases occur when the immune system instead begins to fight healthy body tissues and organs.
- In autoimmune hepatitis, the body's immune system attacks the liver, causing cell damage that leads to cirrhosis.
- Nonalcoholic fatty liver:This is a condition in which fat builds up in the liver, eventually causing scar tissue to form.
- Inherited diseases: A variety of genetic diseases can damage the liver.
- Drugs, toxins, and infections: Various substances and germs can cause damage to the liver.
- Certain medications (for example, acetaminophen [Tylenol]), poisons, and environmental toxins can lead to cirrhosis.
- Reactions to certain drugs can damage the liver. This is rare.
- Long-term infections with various bacteria or parasites can damage the liver and cause cirrhosis.
- Cardiac cirrhosis: Your heart is a pump that pushes blood throughout your body. When your heart doesn't pump well, blood "backs up" into the liver.
- This congestion causes damage to your liver.
- It may become swollen and painful. Later it becomes hard and less painful.
- The cause of the heart failure may be a heart valve problem, smoking, or infection of the heart muscle or the sac around the heart.
Scott H Plantz, MD, FAAEM
Francisco Talavera, PharmD, PhD
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