Treatment

The treatment for cirrhosis depends on what has caused it. Cirrhosis cannot usually be cured, but there are ways to manage the symptoms and any complications, and stop the condition getting worse.

Lifestyle changes

If you have cirrhosis, there are several lifestyle changes you can make to reduce your chances of further problems and complications. These include:

• avoid alcohol 
• quit smoking
• lose weight if you're overweight or obese
• do regular exercise to reduce muscle loss
• practise good hygiene to reduce your chance of getting infections
• speak to a GP about vaccinations you may need, such as the annual flu vaccine or travel vaccines
• speak to a GP or pharmacist if you're taking over-the-counter or prescription medicines, because cirrhosis can affect the way some medicines work

Dietary changes

Malnutrition is common in people with cirrhosis, so it's important you eat a healthy, balanced diet to help you get all the nutrients you need.

Cutting down on salt can help reduce the chance of swelling in your legs, feet and tummy caused by a build-up of fluid.

The damage to your liver can mean it's unable to store glycogen, which is a type of fuel the body needs for energy.

When this happens, your muscle tissue is used for energy between meals, which leads to muscle loss and weakness. This means you may need extra calories and protein in your diet.

Eating healthy snacks between meals, or having 3 or 4 small meals each day, rather than 1 or 2 large meals, may help.

Medicine

The medicine you need will depend on what caused the damage to your liver. For example, if cirrhosis is from long-term viral hepatitis, you may be prescribed antiviral medicine.

You may be offered medicines to ease the symptoms of cirrhosis, such as:

• diuretics, which are used in combination with a low-salt diet to reduce the amount of fluid in your body, which helps with swelling (oedema)
• medicine to help with high blood pressure in the main vein that takes blood to the liver (portal hypertension)
• prescription creams to ease skin itching

Managing complications

If cirrhosis progresses and your liver is no longer able to function (decompensated cirrhosis), you may get complications that need treatment.

Swollen or bleeding veins

When cirrhosis has progressed, it can cause the veins in your food pipe (oesophagus) or stomach to become swollen. These are called oesophageal varices and gastric varices.

An endoscopy may be used to diagnose oesophageal and gastric varices.

You may be given a type of medicine called a beta blocker, such as propranolol, to reduce the chance of the varices bleeding, or to help control bleeding.

If you vomit blood, or have blood in your poo, it may be because the varices are bleeding (a variceal haemorrhage). You will need urgent treatment. Go to your nearest A&E department immediately.

There are several treatments used to prevent or stop the bleeding, such as medicines and fitting a band around the veins (endoscopic variceal band ligation).

Find out more about the treatments for oesophageal and gastric varices from The British Liver Trust.

Fluid in the tummy and legs

A build-up of fluid in your tummy area (ascites) or legs and ankles (peripheral oedema) is a common complication when cirrhosis progresses.

The main treatments are cutting out salt from your diet and taking a type of medicine called a diuretic, such as spironolactone or furosemide.

If the fluid in your tummy becomes infected, you may need antibiotics. In severe cases, you may need to have the fluid drained from your tummy area with a tube.

Encephalopathy

Cirrhosis can sometimes cause problems with your brain function (encephalopathy).

Symptoms include confusion, feeling sleepy, and problems concentrating. This happens because the liver is no longer able to clear toxins properly.

The main treatment for encephalopathy is lactulose syrup. This acts as a laxative and helps clear toxins from your body. You may also need to take an antibiotic called rifaximin, to prevent infection.

Bleeding

Cirrhosis can affect your liver's ability to make your blood clot, which means there's a chance of severe bleeding if you cut yourself or have an operation or dental work.

You may be given medicines, or a blood product called plasma, to prevent or treat bleeding.

Talk to your doctor about your condition and the risk of bleeding before having an operation, including any dental work.

Liver transplant

If cirrhosis progresses and your liver is severely damaged, a liver transplant may be the only treatment option.

This is a major operation that involves removing your diseased liver and replacing it with a healthy liver from a donor.

You will probably have to wait a long time for a suitable donor liver to become available.

You will not be able to have a liver transplant if cirrhosis was caused by alcohol-related liver disease and you continue to drink alcohol.

Find out more about a liver transplant from the British Liver Trust.

Diabetes

Diabetes may get worse if you have type 2 diabetes and develop cirrhosis.

This is because cirrhosis can increase your resistance to insulin, a hormone produced by the body to control blood sugar levels.

Managing cirrhosis and diabetes can be very challenging. You will need careful monitoring and may need to take several different medicines.

Liver cancer

Having cirrhosis increases the chance of liver cancer, most commonly a type called hepatocellular carcinoma (HCC).

Many symptoms of liver cancer are the same as symptoms of cirrhosis, so regular checks for liver cancer are important.

You should have an ultrasound scan, and may also have blood tests, every 6 months to check for HCC.

Read more about liver cancer.