Treatment for cirrhosis depends on the underlying cause and whether complications are present. Cirrhosis cannot be cured because scarring cannot be reversed. In the early stages of cirrhosis, the goals of treatment are to slow the formation of scar tissue and prevent complications. As cirrhosis progresses, additional treatments and hospitalization may be necessary to manage complications.
In general, people with cirrhosis should not drink any alcohol or take any illegal substances. Alcohol and illegal substances will cause further liver damage, especially when cirrhosis affects the liver's ability to detoxify chemicals and metabolize drugs.
People with cirrhosis should also be careful about starting new prescription and over-the-counter medications. Cirrhosis decreases the liver's ability to chemically process medications from the blood, which means medications will act longer than normal and accumulate in the body.*
Some causes of cirrhosis can be treated and cured, which can slow or prevent further scarring of the liver. For example, antiviral medications can be prescribed for chronic hepatitis B and C infections. Some inherited liver diseases are also treatable if they are detected early. Liver diseases that result from the blockage or loss of bile ducts may be treated with ursodiol, a nontoxic bile acid that can be taken orally to replace bile acids normally produced by the liver.
Treating cirrhosis often means managing symptoms and complications. For example, a beta-blocker or nitrate may be prescribed to treat portal hypertension and varices. Edema and ascites may be treated with diuretics, and a provider may drain ascitic fluid and prescribe antibiotics to prevent infection. Lactulose, a type of laxative, may be used to help remove toxic byproducts of metabolism through flushing the bowel in order to treat hepatic encephalopathy. Hepatorenal syndrome, or kidney failure due to cirrhosis, may require dialysis treatment, which filters waste and extra fluid from the body. Gallstones and bile duct stones may be removed surgically or endoscopically.
When treatment for complications is ineffective, or when cirrhosis leads to liver failure, a healthcare provider may recommend a liver transplant. During a liver transplantation surgery, the diseased liver is removed and replaced with a healthy liver from a deceased donor or part of a liver from a living donor. Patients who have a liver transplantation surgery must take anti-rejection medications for the rest of their lives.
In addition to treatment of underlying causes and complications of cirrhosis, people with cirrhosis require regular surveillance for the development of liver cancer. Successful treatment of liver cancer depends on early detection, so providers may recommend that people with cirrhosis be screened for tumors or liver cancer every six months. Screening may include imaging tests, such as ultrasound, CT scan, or MRI, and a blood test called alpha-fetoprotein, or AFP.
*People with cirrhosis should also be wary of starting new supplements. Many supplements can be directly toxic to the liver.