Diagnosing cirrhosis involves a comprehensive approach that combines clinical evaluation, laboratory tests, and imaging studies to assess liver damage and function. Here’s how medical professionals typically diagnose cirrhosis:

1. Patient History: The diagnostic process starts with a detailed review of the patient’s medical history. This includes inquiries about symptoms such as fatigue, jaundice, and abdominal pain, as well as risk factors like excessive alcohol consumption, viral hepatitis, or a history of liver disease. Understanding the patient’s lifestyle, medication use, and any family history of liver disorders also provides valuable context.

2. Physical Examination:During the physical exam, the healthcare provider looks for signs indicative of cirrhosis. This includes assessing jaundice (yellowing of the skin and eyes), abdominal tenderness, and the presence of ascites (fluid buildup in the abdomen). They may also check for signs of liver enlargement or reduced liver size and observe for symptoms like spider angiomas (small, spider-like blood vessels on the skin) and edema (swelling in the legs and ankles).

3. Blood Tests: Several blood tests are essential in diagnosing cirrhosis and evaluating liver function:

• Liver Function Tests (LFTs): These tests measure levels of liver enzymes (e.g., ALT, AST), bilirubin, and other substances to assess the extent of liver damage and inflammation.
  
• Complete Blood Count (CBC): This test helps evaluate overall health and detect anaemia, which can be associated with liver disease. Coagulation Profile: This includes tests like prothrombin time (PT) to assess the liver’s ability to produce clotting factors.

4. Imaging Studies: Imaging techniques provide visual insights into liver structure and damage. A liver ultrasound is often the first imaging test used to detect changes in liver size, texture, and the presence of fluid or tumours. It’s non-invasive and helps assess the liver’s general condition. For more detailed imaging, CT scans or MRI may be used to evaluate the liver’s structure, detect complications like liver cancer, and assess blood flow in the liver.

5. Liver Biopsy: A liver biopsy involves obtaining a small sample of liver tissue, usually with a needle, to examine under a microscope. This test provides a definitive diagnosis by revealing the degree of liver fibrosis or cirrhosis. It helps in staging the disease and guiding treatment decisions.

6. FibroScan: A specialised ultrasound technique that measures liver stiffness, correlating with the level of fibrosis or cirrhosis. It’s a non-invasive alternative to biopsy, providing quick and reliable results.

7. Additional Evaluations: In some cases, additional tests may be performed to identify the underlying cause of cirrhosis, such as viral hepatitis panels or autoimmune markers. These tests help tailor the treatment approach to the specific cause of liver damage.

Accurate diagnosis of cirrhosis is critical for effective management and treatment. Early detection allows for interventions that can slow disease progression, manage complications, and improve overall quality of life.

Treating cirrhosis involves a multifaceted approach focused on managing symptoms, addressing the underlying causes, and preventing complications. Here’s an overview of how medical professionals typically manage cirrhosis:

1. Medications: The treatment plan often includes medications tailored to the underlying cause of cirrhosis. For instance, antiviral drugs are used for viral hepatitis (e.g., Hepatitis B or C) to reduce liver inflammation and prevent further damage. In cases of autoimmune hepatitis, corticosteroids or other immunosuppressants are prescribed to reduce liver inflammation. Diuretics may be used to manage fluid buildup in the abdomen (ascites) and reduce swelling in the legs.

2. Lifestyle and Dietary Adjustments: Managing cirrhosis also involves lifestyle changes, such as abstaining from alcohol to prevent further liver damage. Dietary modifications are important, including a low-sodium diet to manage ascites and a balanced diet to support overall liver health. Regular monitoring and adjustments are made to ensure the patient’s nutritional needs are met while minimising strain on the liver.

3.Managing Complications: Complications of cirrhosis, such as portal hypertension (increased blood pressure in the liver’s blood vessels), can lead to variceal bleeding or ascites. Treatment may involve procedures like endoscopic variceal ligation to prevent bleeding or paracentesis to remove excess fluid from the abdomen.

4.Liver Transplant: In cases of advanced cirrhosis where the liver is severely damaged and other treatments are no longer effective, a liver transplant may be considered. This procedure involves replacing the diseased liver with a healthy donor liver. The decision for a transplant is based on several factors, including the extent of liver damage, the presence of complications, and the overall health of the patient. A thorough evaluation is conducted to determine if the patient is a suitable candidate for transplantation.

5.Complex Liver Surgeries: In some situations, particularly when cirrhosis is associated with liver cancer or severe structural abnormalities, complex liver surgeries may be required. These surgeries can include partial liver resections, where a portion of the liver is removed, or other specialised procedures to address specific complications. These surgeries are generally performed by hepatobiliary surgeons with expertise in managing liver diseases and surgical interventions.

Overall, the treatment of cirrhosis aims to manage the disease, alleviate symptoms, and improve the patient’s quality of life. For severe cases, interventions like liver transplantation or complex surgeries may be necessary to restore liver function and address life-threatening complications.