Cirrhosis, a chronic liver disease, occurs when the liver cells become damaged leading to the buildup of scar tissue. Viral hepatitis and excessive alcohol consumption commonly lead to cirrhosis. Cirrhosis develops slowly over time, often only causing symptoms once complications develop. Because cirrhosis remains the third most common cause of death in the United States, according to the Merck Manual, it is important to diagnose and begin treatment early. Cirrhosis cannot be cured, therefore treatment focuses on treating the underlying cause and the complications as they arise to help slow down the progression of the disease.
Interferon Alpha
Although all strains of hepatitis, including A, B and C, can cause cirrhosis, hepatitis C often leads to a chronic infection and about 20 percent of patients will develop cirrhosis, as reported by the National Digestive Diseases Information Clearinghouse. Doctors prescribe interferon alpha as the standard treatment for chronic hepatitis. Interferon alpha is a protein made to respond to the hepatitis virus to attack and kill the viral particles. By destroying the virus causing the damage to the liver, the progression of cirrhosis slows.
Diuretics
All of the blood leaving the stomach and intestines flows through the liver. The liver then breaks down nutrients, filters waste products and regulates chemicals. As scar tissue builds up, the blood cannot flow freely through the liver. This causes the blood pressure in the portal vein to increase resulting in a condition known as portal hypertension.
The backup of blood causes fluid to build up in the abdomen---known as ascites---and the arms and legs---known as edema. Diuretics, also commonly called water pills, induce the kidneys to filter more salts and water from the blood, therefore reducing the amount of fluid in the body.
Beta Blockers
The high blood pressure in the portal vein causes the blood to try to find another route. As blood enters the smaller blood vessels surrounding the liver, the added volume and pressure can damage these vessels causing them to enlarge, known as varices. Varices in the stomach or esophagus can burst, resulting in internal bleeding.
A class of medications known as beta blockers, such as propanolol, blocks the effects of adrenaline. This slows the nerve signals to the heart helping the heart to beat slower. It also helps blood vessels to dilate reducing blood pressure.
Lactulose
The liver filters waste products, such as ammonia and bilirubin, out of the blood. Cirrhosis inhibits this process allowing toxins to buildup in the blood. Toxins entering the brain can interfere with normal brain functions resulting in confusion, changes in mood and personality, impaired judgement and sluggishness. If left untreated this condition, known as hepatic encephalopathy, can lead to coma and death. A drug known as lactulose, a synthetic sugar, absorbs the toxins such as ammonia from the blood to prevent these symptoms.
