Liver Cirrhosis

How Is Liver Cirrhosis Diagnosed?

Diagnosing liver cirrhosis involves a combination of medical history, physical examination, laboratory tests, and imaging studies, and sometimes a liver biopsy. Since symptoms often develop only in later stages, cirrhosis is sometimes detected during investigations for other medical conditions. Early diagnosis is important to slow progression and prevent complications.

Medical History & Physical Examination

Diagnosis begins with a thorough review of the patient's medical history, including risk factors such as hepatitis, alcohol use, or metabolic disorders. A physical examination may reveal signs like jaundice, abdominal swelling, or skin changes.

Laboratory Tests

Blood tests help assess liver function and identify possible causes of cirrhosis. Common tests include:

Liver enzymes (ALT, AST, alkaline phosphatase, GGT)
Bilirubin
Albumin and total protein
Blood clotting (INR)
Kidney function (creatinine, urea)
Complete blood count
Screening for hepatitis B and C

These tests help determine the extent of liver damage and guide further management.

Imaging Studies

Imaging studies are used to detect changes in the liver and identify complications related to cirrhosis. Common imaging methods include:

Ultrasound: Detects liver size, texture, and the presence of nodules or tumours.
Elastography fibroscan: Measures liver stiffness to assess the degree of fibrosis.
CT scan and MRI: Provide detailed images to evaluate the liver and surrounding structures, and help in detecting liver cancer or advanced disease

Liver Biopsy

A liver biopsy involves taking a small sample of liver tissue for examination under a microscope. This procedure helps confirm the diagnosis of cirrhosis and may identify the cause. Liver biopsy is usually considered when other tests are inconclusive or when more information about the severity of liver damage is needed. There are risks such as bleeding or infection, so it is only performed when necessary.

Monitoring for Complications

After diagnosis, regular monitoring is important to detect complications early. This may include:

Blood tests to check liver function and screen for liver cancer
Imaging studies to monitor for tumours or changes in the liver
Endoscopy to check for enlarged veins (varices) in the oesophagus or stomach

Ongoing monitoring helps manage complications and improve quality of life.

Treatment Options for Liver Cirrhosis

The treatment of liver cirrhosis focuses on slowing disease progression, managing symptoms, and preventing complications. The choice of treatment depends on the underlying cause, the severity of liver damage, and the presence of complications.

Treating the Underlying Cause

Stopping alcohol consumption is essential, especially for alcohol-related cirrhosis.
Antiviral medications for hepatitis B or C.
Weight loss and control of blood sugar, blood pressure and cholesterol are important for metabolic-related liver disease.
Specific treatments may be required for autoimmune or genetic causes.

Managing Symptoms and Complications

Diuretics and a low-sodium diet help control fluid buildup (ascites, oedema).
Beta-blockers or endoscopic procedures may be used for enlarged veins (varices).
Antibiotics are given for infections.
Medications such as lactulose may be used for confusion caused by liver disease (hepatic encephalopathy).
Nutritional support and vitamin supplements may be recommended.

Lifestyle Modifications

Complete avoidance of alcohol.
Following a low-sodium diet.
Eating a balanced diet with adequate protein, unless otherwise advised.
Avoid medications that can worsen liver function, such as certain painkillers.

Advanced Procedures: TIPS (Transjugular Intrahepatic Portosystemic Shunt

In cases where these complications cannot be controlled with medication or endoscopic procedures, advanced treatments such as a Transjugular Intrahepatic Portosystemic Shunt (TIPS) may be considered. TIPS is a minimally invasive procedure performed by interventional radiologists to reduce high pressure in the portal vein caused by cirrhosis

Advanced Treatments: Liver Transplant

A liver transplant may be considered for patients with advanced cirrhosis or liver failure. This involves replacing the diseased liver with a healthy donor liver. Suitability for transplant depends on several medical factors and a thorough evaluation process.

Ongoing Monitoring and Follow-Up

Regular follow-up is important to monitor liver function, screen for liver cancer, and adjust treatment as needed. Ongoing care helps manage complications and improve quality of life.

Preparing for Your Liver Cirrhosis Appointment

If you suspect you may have liver cirrhosis or are at risk, it’s important to consult a healthcare professional. You may be referred to a hepatologist or gastroenterologist for specialised care based on your symptoms and medical history.

How to Prepare for Your Appointment

To make the most of your consultation at SJMC, consider the following steps:

List Your Symptoms: Write down all symptoms you’re experiencing, even if they seem unrelated to your liver. Note when each symptom began and any changes over time.
Bring a Medication List: Prepare a complete list of all medications, vitamins, supplements, and herbal remedies you are taking, including dosages.
Gather Medical Information: Bring key medical information, such as records of previous tests, diagnoses, and a summary of your medical history. Include any family history of liver disease.
Prepare Questions: Create a list of questions to ask your healthcare professional, such as:
- What tests will I need?
- What is the likely cause of my liver condition?
- What are my treatment options?
- What lifestyle changes should I make?
Bring a Companion: A friend or family member can help you remember important details from the discussion.
Being well-prepared ensures that you can actively participate in decisions about your care at SJMC.

What to Expect from Your Doctor

During your visit, your doctor will ask important questions to help diagnose your condition and recommend the best course of action. Expect questions such as:

When did your symptoms first appear?
Are your symptoms constant, or do they come and go?
Have you noticed anything that makes your symptoms better or worse?
Do you have a history of hepatitis, alcohol use, or other liver conditions?
Are you experiencing fatigue, jaundice, swelling, or changes in appetite?

These details help the doctor understand your condition better and tailor a personalised treatment plan to meet your needs.

Advanced Liver Cirrhosis Care at SJMC

At Subang Jaya Medical Centre (SJMC), we provide comprehensive diagnostic and treatment options for liver cirrhosis. Our multidisciplinary team, including hepatologists, gastroenterologists, interventional radiologists, and dietitians that works together to deliver personalised care for every patient.

We use advanced tests like liver scans and elastography to check your liver’s condition. For serious cases, we provide treatments such as endoscopic procedures, radiology treatments, and help with liver transplant assessment. Our goal is to support you with the latest medical care and a plan that fits your needs.

FAQs About Liver Cirrhosis Diagnosis and Treatment

Liver function tests are typically repeated every few months or as advised by the healthcare provider to monitor disease progression and treatment response.

Cirrhosis can sometimes be detected during routine blood tests or imaging done for other reasons, especially if liver function is abnormal.

Endoscopy is used to check for enlarged veins (varices) in the oesophagus or stomach, which are common complications of cirrhosis.

Cirrhosis is potentially reversible if the underlying causes can be treated.

Hospitalisation is needed for severe complications such as bleeding, infection, confusion (encephalopathy), or kidney problems.

Referral for liver transplantation assessment is considered when a patient’s liver function declines despite optimal medical therapy, or when complications such as recurrent ascites, hepatic encephalopathy, or liver cancer develop. Providers use scoring systems like MELD (Model for End-Stage Liver Disease) to help determine timing and urgency for referral.

The choice of imaging test depends on the patient’s symptoms, medical history, and the information needed. Ultrasound is often the initial test due to its accessibility and safety. If more detailed images are required, or if liver cancer is suspected, a CT scan or MRI may be recommended. Elastography may be used to specifically measure liver stiffness and assess the extent of fibrosis.

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