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Treatments and drugs
By Mayo Clinic staffTreatment for cirrhosis depends on the cause and extent of your liver damage. The goals of treatment are to slow the progression of scar tissue in the liver and to prevent or treat symptoms and complications of cirrhosis. Hospitalization may be necessary for severe liver damage.
Treatment for the underlying cause of cirrhosis
In early cirrhosis, it may be possible to minimize damage to the liver by treating the underlying cause. The options include:
- Treatment for alcohol dependency. People with cirrhosis caused by alcohol abuse need to stop drinking. If stopping alcohol use is difficult, your doctor may recommend a treatment program for alcohol addiction.
- Weight loss. People with cirrhosis caused by nonalcoholic fatty liver disease need to lose weight and control their blood sugar levels.
- Medications to control hepatitis. Medications may control damage to liver cells caused by hepatitis B or C.
- Medications to control other causes and symptoms of cirrhosis. Medications may slow the progression of certain types of liver cirrhosis. For example, people with primary biliary cirrhosis that is diagnosed and treated early may never experience symptoms.
Other medications can relieve symptoms such as itching, fatigue and pain. Nutritional supplements may be prescribed to counter malnutrition associated with cirrhosis and to prevent osteoporosis (weak bones).
Treatment for complications of cirrhosis
Your doctor will work to treat any complications of cirrhosis, including:
- Excess fluid in your body. Edema or ascites may be managed with a low-sodium diet and medication to prevent fluid buildup in the body. More severe fluid buildup may require procedures to drain the fluid or surgery to relieve pressure.
- Increased blood pressure. Blood pressure medications may control portal hypertension and prevent severe bleeding. If you develop varices, you may need a procedure (band ligation) to stop the bleeding and medication to help prevent future bleeding. In severe cases, a small tube (stent) may be placed in your veins to reduce blood pressure in your liver.
- Infections. You may receive antibiotics or other treatments for infections. Your doctor also is likely to recommend vaccinations for influenza, pneumonia and hepatitis.
- Increased liver cancer risk. Your doctor will likely recommend periodic blood tests and ultrasound exams to look for signs of liver cancer.
- Hepatic encephalopathy. Medications can be prescribed to help reduce the buildup of toxins in your blood due to poor liver function.
Liver transplant surgery
In advanced cases of cirrhosis, when the liver ceases to function, a liver transplant may be the only treatment option. A liver transplant is a procedure to replace your liver with a healthy liver from a deceased donor or with part of a liver from a living donor. Cirrhosis is the most common reason for a liver transplant.
Extensive testing is needed before a liver transplant to ensure that a candidate is in good enough health to have the transplant operation. Additionally, transplant centers typically require some period of abstinence from alcohol, often at least six months, before transplantation for people with alcohol-related liver disease.
- Sanchez W, et al. Liver cirrhosis. The American College of Gastroenterology. http://patients.gi.org/topics/liver-cirrhosis/. Accessed Dec. 3, 2012.
- 2. Ferri FF. Ferri's Clinical Advisor 2013:5 Books in 1. Philadelphia, Pa.: Mosby Elsevier; 2012. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-0-323-08373-7..00002-9&isbn=978-0-323-08373-7&about=true&uniqId=343863096-23.Accessed Nov. 27, 2012.
- Cirrhosis. National Institute of Diabetes and Digestive and Kidney Diseases. http://digestive.niddk.3.gov/ddiseases/pubs/cirrhosis/index.htm. Accessed Nov. 27, 2012.
- Feldman M, et al. Sleisenger & Fordtran's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/about.do?eid=4-u1.0-B978-1-4160-6189-2..X0001-7--TOP&isbn=978-1-4160-6189-2&about=true&uniqId=229935664-2192. Accessed Dec. 3, 2012.
- AskMayoExpert. What are the clinical manifestations of primary biliary cirrhosis (PBC)? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Starr PS, et al. Cirrhosis: Diagnosis, management and prevention. American Family Physician. 2011;84:1353.
- AskMayoExpert. What are the complications and comorbid conditions associated with primary biliary cirrhosis (PBC)? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Jafri SM, et al. Care of the cirrhotic patient. Infectious Disease Clinics of North America. 2012;26:979.
- AskMayoExpert. When should patients with cirrhosis be screened for esophageal varices? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2010.
- AskMayoExpert. What is the standard follow-up for patients receiving therapy for primary biliary cirrhosis (PBC)? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- AskMayoExpert. What is the initial therapy recommended for patients with nonalcoholic fatty liver disease? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- AskMayoExpert. Will asymptomatic patients who receive a diagnosis of primary biliary cirrhosis (PBC) have symptoms at a later time? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- AskMayoExpert. What is the expected prognosis of primary biliary cirrhosis (PBC) following treatment? Rochester, Minn.: Mayo Foundation for Medical Education and Research; 2012.
- Your liver. Your life. American Liver Foundation. http://www.yourliver.org/Liver-Wellness-Presentation.pdf. Accessed Dec. 3, 2012.
- Liver transplant. National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/livertransplant. Accessed Dec. 28, 2012.
- Verma S et al. Complementary and alternative medicine in hepatology: review of the evidence of efficacy. Clinical Gastroenterology and Hepatology. 2007; 5: 408.
- Rakel D. Integrative Medicine. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.mdconsult.com/das/book/body/208746819-2/0/1494/0.html. Accessed Jan. 3, 2013.
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