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Liver cirrhosis is a chronic liver disease characterised by the scarring of liver tissue, leading to impaired liver function.
This condition is often a result of long-term damage and inflammation in the liver caused by various factors such as chronic alcohol abuse, viral infections (hepatitis B and C), fatty liver disease, autoimmune conditions, or certain genetic disorders.
The symptoms of liver cirrhosis can vary depending on the stage of the disease.
In more severe cases, symptoms can include vomiting blood, tea-coloured urine, itchy skin, swelling in the legs, personality changes, memory loss, and difficulty concentrating. If you experience any of these symptoms, it is important to seek medical attention immediately.
Liver cirrhosis, a condition marked by irreversible liver scarring, comes from various causes:
Drinking excessive amounts of alcohol over many years can lead to cirrhosis.
Long-term infection with hepatitis B or C viruses can cause cirrhosis.
A severe form of NAFLD, called non-alcoholic steatohepatitis (NASH), can cause cirrhosis due to excess fat buildup in the liver.
Problems affecting the bile ducts, such as primary biliary cholangitis, can cause cirrhosis.
Certain inherited conditions and long-term use of certain medications can cause cirrhosis.
The diagnosis of cirrhosis involves a combination of medical history, physical examination, and various tests.
Doctors may ask about symptoms, alcohol use, prescription and over-the-counter medications, herbal supplements, family history of liver conditions, and any recent changes in weight or appetite.
Doctors may look for jaundice (yellowish tint to the whites of the eyes and skin), rashes, swelling in the legs, tremors, an enlarged liver, and other signs of liver damage.
Liver tests can show if liver enzyme levels are higher or lower than normal, indicating liver damage. Complete blood count (CBC) can show signs of infection and anaemia caused by internal bleeding. Tests for viral infections like hepatitis B or C, and autoimmune liver conditions may also be conducted.
Ultrasound, CT, MRI, or transient elastography scans can provide liver images to assess its size, shape, and abnormalities. These tests can also help detect scarring (fibrosis) or other signs of cirrhosis.
It may be performed to remove a sample of liver cells for examination under a microscope. This can help confirm the diagnosis and assess the severity of cirrhosis.
If cirrhosis is suspected, seeing a doctor for proper diagnosis and evaluation is essential. Early detection and appropriate treatment can help slow the progression of the disease and manage symptoms effectively.
Consult our dual fellowship-trained surgeon for a personalised treatment plan today.
Surgical treatments for liver cirrhosis provide different procedures to handle complications and treat the root causes of the disease.
Liver resection is considered in the presence of a liver tumour in the setting of liver cirrhosis.
In advanced cases of cirrhosis where the liver stops functioning properly, a liver transplant may be the only treatment option. A liver transplant involves replacing the diseased liver with a healthy liver from a deceased donor or with part of a liver. Liver transplants are typically considered for patients with small tumours or resectable cancers.
This procedure involves creating a shunt to redirect blood flow in cases of portal hypertension to reduce pressure in the veins supplying the liver.
For varices (swollen blood vessels), doctors can tie a special rubber band around them to stop bleeding.
Non-surgical treatments for liver cirrhosis focus on managing symptoms and preventing complications.
Eating, diet, and nutrition are important in managing liver cirrhosis. The following are some key points to consider.
People with cirrhosis may need more calories and protein to meet their body’s energy demands, as their liver can no longer store glycogen effectively. Foods rich in protein include beans, pulses, nuts, eggs, dairy products, fish, lean cuts of meat, and poultry.
Cirrhosis patients can benefit from eating smaller, more frequent meals throughout the day, known as “grazing”. This helps prevent the body from breaking down muscle protein for energy.
Avoid foods and drinks that are difficult for the liver to process, such as those high in unhealthy fats, alcohol, raw or undercooked meat, eggs, seafood, and high sodium foods. Additionally, people with cirrhosis are to avoid sugary drinks, especially those containing fructose.
In cases of ascites (abnormal fluid buildup in the abdomen), reducing salt intake can help reduce fluid retention. This can be achieved by avoiding adding salt to food and using it sparingly in cooking, as three-quarters of the salt.
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Dr Thng Yongxian is a dual fellowship-trained Hepatopancreatobiliary & General Surgeon who has performed over 6000 surgical procedures.
He pursued his subspecialty training in Hepatopancreatobiliary surgery first in the Department of Hepatopancreatobiliary Surgery, Singapore General Hospital. Following this, he completed a clinical fellowship in Minimally Invasive Hepatopancreatobiliary Surgery at Seoul National University Hospital in Bundang, South Korea.
Dr Thng set up and pioneered the Minimally invasive surgery program for his hospital in complex liver and pancreas cases. His surgeries were featured on live national television. His surgical videos have also been presented at international surgical conferences. He also pioneered the use of capsule colonoscopy for colorectal screening.
Dr Thng has served on various committees at hospital, cluster and ministry level. Dr Thng served as a member of the Ministry of Health (MOH) Laparoscopic cholecystectomy Clinician workgroup for value-driven care (VDC).
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820 Thomson Road, #06-05 ,Singapore 574623
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3 Mount Elizabeth, #08-06, Singapore 228510
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38 Irrawaddy Road, #08-43, Singapore 329563
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319 Joo Chiat Place, #05-01, Singapore 427989
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6 Napier Road, #05-10, Singapore 258499
Monday-Friday: 9.00am-5.00pm
(Lunch: 1.00-2.00pm)
Saturday: 9.00am-1.00pm
Sunday & PH: Closed
820 Thomson Road, #06-05 ,Singapore 574623
Monday-Friday: 9.00am-5.00pm
(Lunch: 1.00-2.00pm)
Saturday: 9.00am-1.00pm
Sunday & PH: Closed
A balanced diet is essential for people with cirrhosis. Avoiding salty foods and limiting salt intake can help reduce the risk of fluid retention. Ensuring adequate protein intake from lean sources such as beans or lentils is also important. Salt restriction is recommended to less than two grams of total daily intake.
Vaccinations are crucial for patients with cirrhosis to prevent complications from certain infections. Recommended vaccinations include hepatitis A and B, pneumococcal (pneumonia) vaccine, and annual flu shots.
Liver cirrhosis is not a form of cancer. Cirrhosis is a condition characterised by severe scarring of the liver, which is a result of long-term liver damage from various causes like alcohol abuse, viral infections, or obesity.
In some cases, damage to the liver can be slowed, but complete reversal is generally not possible. Abstaining from alcohol, losing weight for fatty liver disease, and treating underlying causes like hepatitis C can help improve liver function.
It promotes conditions like NAFLD, insulin resistance, hepatic inflammation, fibrosis, metabolic liver disease, and sarcopenic obesity. Managing obesity through weight loss interventions and lifestyle changes is crucial in preventing the progression of cirrhosis in at-risk people.
Cirrhosis makes it more difficult for your liver to process medicines. For this reason, seek a qualified hepatologist before taking any medicines, including non-prescription ones. Don’t take aspirin and ibuprofen (Advil, Motrin IB, others). If you have liver damage, a hepatologist may recommend that you not take acetaminophen (Tylenol) or take it in low doses for pain relief.