The first step in treating cirrhosis is avoiding whatever the insult is to the liver, says Lindenmeyer. “If autoimmune hepatitis is the root cause of the liver damage, the treatment would be treating the hepatitis. For alcohol-related liver disease, the treatment would begin with avoiding alcohol. Metabolic risk factors, such as being overweight or having diabetes, would be addressed to treat MASLD. For hemochromatosis, the treatment would be decreasing the systemic level of iron overload,” she says.
Regardless of the primary cause of a patient’s cirrhosis, any behaviors or conditions that might further damage the liver should be avoided. For example, those with hepatitis-related cirrhosis should also avoid alcohol.
The overall goal of the therapy is to stop the progression of the disease and prevent liver failure, says Lindenmeyer.
Medication Options
For example, lactulose may be prescribed for hepatic encephalopathy, or confusion that results from toxic substances entering the brain. Lactulose is a laxative that can help decrease the absorption of substances that can be harmful to the brain.
Diuretics, or water pills, may be prescribed to reduce ascites, or the accumulation of fluid in the abdomen.
Antibiotics may be prescribed to prevent or treat infections. Rifaximin (Xifaxan) is an antibiotic that can help treat hepatic encephalopathy. Rifaximin is commonly prescribed with lactulose and is used when lactulose is inadequate to treat symptoms of encephalopathy or after a hospitalization related to encephalopathy.
Certain types of blood pressure medications (beta-blockers) can lower pressure in the portal vein, which brings blood to the liver. Lowering pressure in the portal vein can, in turn, decrease the risk of internal bleeding.
Liver Transplantation
When medication can no longer control the complications of cirrhosis, a liver transplantation is often the only remaining option for treatment.
Complementary Therapies
There are a number of supplements on the market that claim to “cleanse” or “support” liver health. Most of these supplements have no scientific evidence to back these claims, and some have been shown to contain harmful ingredients. Those products that have been studied in clinical trials generally haven’t shown efficacy in those trials.
Since some herbal remedies and other alternative or complementary therapies can be toxic to the liver, tell your doctor about any products you’re taking or are interested in taking. In addition, cleanses or detox regimens are not recommended.
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