Liver Failure due to Cirrhosis: Understanding Causes, Signs, and More
Understanding Decompensated Cirrhosis: Causes, Symptoms, and Treatment
Decompensated cirrhosis is a serious stage of liver disease that occurs when the liver can no longer function properly due to long-term damage. This condition can lead to end-stage liver failure if left untreated.
Common Causes of Decompensated Cirrhosis
The most common causes of decompensated cirrhosis are chronic liver diseases that damage the liver over time. These include:
- Chronic viral hepatitis (hepatitis B and C infections), which cause persistent liver inflammation leading to fibrosis and cirrhosis.
- Alcohol-related liver disease, caused by excessive alcohol consumption.
- Non-alcoholic fatty liver disease (NAFLD), often linked to obesity, type 2 diabetes, and metabolic syndrome.
- Autoimmune liver diseases, where the immune system attacks liver tissue, leading to inflammation and scarring.
- Inherited disorders such as Wilson disease, hemochromatosis, and alpha-1 antitrypsin deficiency, which cause accumulation of toxic substances in the liver.
- Cholestatic diseases like primary biliary cholangitis and primary sclerosing cholangitis that block bile flow and cause liver damage.
- Less commonly, long-term use of certain medications may lead to cirrhosis.
Recognising Decompensated Cirrhosis
As cirrhosis progresses to its decompensated stage, symptoms such as ascites (abdominal bloating or swelling), jaundice (yellowing of the skin and eyes), hepatic encephalopathy (changes in mental function), portal hypertension (high blood pressure in the liver), edema (swelling in the legs and ankles), and internal bleeding may arise.
Treatment and Management
If you have a formal diagnosis of decompensated cirrhosis or suspect you may have the condition, it is crucial to have regular contact with a healthcare professional. Healthcare professionals may use the Model for End Stage Liver Disease (MELD) score to predict the 90-day survival rate for people living with advanced cirrhosis.
Treatment for decompensated cirrhosis focuses on managing complications and preventing further damage. This may include medications, transjugular intrahepatic portosystemic shunt (TIPS) insertion, endoscopic band ligation (EBL), lifestyle changes, dietary modifications, and in severe cases, liver transplantation.
A 2021 study aimed to develop a decompensated cirrhosis discharge bundle (DCDB) to improve care for those living with the condition. The DCDB includes treatments to manage complications and improve a person's quality of life.
It is important for a person living with decompensated cirrhosis to receive prompt treatment due to the high risk of mortality. If you notice new or worsening symptoms such as vomiting blood, passing black, tarry stools, shortness of breath, fever, changes in mental function, abdominal bloating or pain, it is advisable to seek help from a healthcare professional immediately.
