Can Cirrhosis, a form of Chronic Liver Disease (CLD), Be Reversed?

Liver cirrhosis is a chronic condition in which the liver progressively worsens and gets severe tissue scarring, leading to poor liver function. Fundamentally, the liver filters toxins from the blood, manufactures bile, and conducts other metabolic activities. Over time, due to cirrhosis, it becomes increasingly damaged. The replacement of healthy liver tissue with scar tissue reduces the capability of the organ to function properly, which causes severe health complications.

There are two stages to cirrhosis: compensated and decompensated. In the compensated stage, the liver can still manage to do most of its vital functions even with severe damage. Symptoms are either mild or not significant. Only when cirrhosis passes to the decompensated stage will it have more severe symptoms, such as jaundice, ascites, which is a big fluid collection within the abdomen, variceal bleeding, and hepatic encephalopathy, characterized by mental confusion.

Who is at risk?

Causes of liver cirrhosis include chronic alcohol consumption and viral hepatitises, primarily Hepatitis B and C. Another significant cause is non-alcoholic fatty liver disease (NAFLD), usually in combination with obesity, diabetes, and metabolic syndrome. Other factors involve autoimmune diseases, genetic conditions, and long exposure to toxins and some medications.
Those patients who have a history of heavy alcohol consumption, have been infected with hepatitis viruses, and those with metabolic disorders are at higher risk of developing cirrhosis. Besides, age and gender can play a role in one's susceptibility; the most common is among men and the elderly.

Diagnostic Methods

Diagnostics may range from medical history, liver biopsy, and various tests. Blood tests will show the amount of liver function, plus imaging tests that may involve ultrasounds, CT or MRI scans, will determine the size and shape of the liver, and the degree of scarring in the liver. An analysis of a small tissue specimen for the degree of liver damage, however, will come with a liver biopsy, invasive as it may be. More specialized tests, such as elastography, can be done to measure the stiffness of the liver for signs of fibrosis or cirrhosis. Constant examinations will help determine and monitor the level of cirrhosis in the liver.

Can Cirrhosis Be Reversed?

Whether it can be reversed is usually one of the first questions asked by patients upon an initial diagnosis of cirrhosis. Its reversibility varies, depending on its stage and underlying cause.

Early-stage cirrhosis, specifically in the compensated stage of liver tissue damage, can be corrected by lifestyle modifications and treatment of the cause. For instance, cirrhosis as a result of alcohol can be stopped from progressing and inflicting more damage, and some of its effects can even be reversed by stopping the intake of alcohol by the patient. Similarly, the control of viral hepatitis through the use of antiretroviral drugs may decrease the extent of inflammation of the liver and halt scarring.

However, advanced cirrhosis—especially decompensated cirrhosis—is usually irreversible. The liver becomes far too scarred, and although treatment can ease symptoms and halt progression, some damage can never be reversed. Liver transplant is the only permanent solution for this. Liver transplant price in India is also reasonable compared to many other countries.

Options for Treatment

A complete reversal of the tissue scarring is very difficult. A number of treatments rather aim to diminish the advancement of the disease and its symptoms. Cirrhosis of the liver is a fatal, progressive disease that needs identification at an early stage and proper management to slow its progression and manage complications. In many cases, cirrhosis can be stopped and partially reversed, particularly when the condition is in its earlier phases. In contrast, late phases of cirrhosis remain mostly irreversible. Lifestyle changes, medications, and liver transplantation are the main forms of treatment.

• Alterations in Lifestyle - Patients with alcoholic cirrhosis need to stop drinking alcohol. An appropriate diet, reduction in weight if overweight, and an adequate exercise routine are many times sufficient in patients with non-alcoholic fatty liver disease.
• Medications - Antiviral medications for hepatitis B or C lower the virus count with reduced inflammation of the liver. Besides, drugs to treat symptoms such as ascites, hepatic encephalopathy, and variceal bleeding are also essential in the management of liver cirrhosis at its advanced stage.
• Liver Transplant - In end-stage liver disease patients, mostly only a liver transplant can save them. Usually, a successful transplant can reestablish a quality life, with regular liver function. However, the availability of appropriate donors and immunosuppressive medications that need to be continued for life, presents huge problems. Liver transplant cost in India would be around 20 to 35 lakhs INR but the same treatment will cost more in Western countries. India provides the best quality treatment at affordable prices.