April 22, 2024
Liver Fibrosis Treatment

Liver Fibrosis Treatment: Understanding The Conditions And Available Options

Liver fibrosis is a serious medical condition where excess scar tissue called fibrosis builds up in the liver. This scarring can over time develop into a life-threatening cirrhosis. Liver fibrosis is generally treated through addressing the underlying cause and relieving its symptoms. In this article, we will look at the key aspects of liver fibrosis treatment including available medications, lifestyle changes and procedures.

What Causes Liver Fibrosis?

Alcohol Abuse: Long-term excessive use of alcohol puts a lot of stress on the liver which causes it inflammation and damage over time leading to fibrosis.

– Hepatitis: Chronic viral infections like hepatitis B and C cause persistent liver inflammation often developing into significant fibrosis within 10-20 years.

– Nonalcoholic Fatty Liver Disease: Excessive accumulation of fat in liver cells (steatosis) in the absence of heavy drinking can progress into nonalcoholic steatohepatitis (NASH) and advanced fibrosis.

– Iron & Copper Overload: Some genetic conditions lead to iron and copper deposition in liver cells damaging them and instigating fibrosis.

– Autoimmune Diseases: Certain autoimmune diseases like autoimmune hepatitis and primary biliary cholangitis can induce chronic inflammation evolving into fibrosis.

– Medications & Toxins: Some prescription drugs and environmental toxins cause direct damage to liver cells promoting scarring.

Lifestyle & Dietary Changes
Making positive lifestyle modifications at an early stage can help slow or halt the progression of liver fibrosis. These include:

– Alcohol Abstinence: Complete avoidance of alcohol for alcoholic Liver Fibrosis Treatment ┬ápatients or limiting intake to no more than one drink daily for women and two drinks for men.

– Weight Loss: Losing 5-10% of total weight through diet and exercise helps reduce liver fat buildup in case of NASH. Following a Mediterranean diet is beneficial.

– Exercise: Regular moderate physical activity like brisk walking for 30 mins daily strengthens overall health and helps control weight.

– Stress Management: Practicing relaxation techniques relieves stress known to aggravate liver conditions.

– Herbal Supplements: Milk thistle is a widely used herbal extract shown to protect liver cells from injury and enhance healing.

Pharmacological Therapies
Various drugs approved for liver fibrosis treatment work by modulating the fibrotic response and include:

– Anti-Fibrotic Agents: Drugs like Pentoxifylline suppresses hepatic stellate cells responsible for collagen production.

– Anti-Oxidants: S-Adenosylmethionine (SAMe) protects liver cells from oxidative stress; Vitamin E reduces NASH severity.

– Immunomodulators: Corticosteroids and immunomodulators like Mycophenolate mofetil reduce fibro-inflammatory activity in autoimmune liver diseases.

– Antivirals: Treating the causative virus with Direct-Acting Antivirals halts progression from hepatitis B & C induced liver fibrosis.

– Insulin-Sensitizing Agents: Drugs like pioglitazone address insulin resistance in NASH by reducing liver fat and ballooning.

– Angiotensin Receptor Blockers: Medications like losartan aid NASH treatment through anti-fibrotic and anti-inflammatory properties.

Liver Transplant Evaluation
In severe advanced cirrhosis, specialists evaluate eligibility for potentially lifesaving liver transplantation based on:

– Liver Function Status: Degree of portal hypertension, hepatic encephalopathy and liver synthetic ability.

– Cancer Screening: Rule out hepatocellular carcinoma which precludes transplantation.

– Comorbidities: Cardiac, renal or pulmonary reserve to withstand surgery.

– Abstinence: Mandatory 6 month sobriety for alcohol-related cirrhosis patients.

– Support System: Physical and financial support post transplantation.

– Organ Availability: Waiting times are usually 1-3 years depending on region and blood group.

Liver transplantation remains the sole curative option for end-stage decompensated liver disease and selected non-responders to other therapies. Careful postoperative compliance to immuno-suppression maintains graft function.

Surgical Procedures
Certain patients may require the following surgical procedures to treat complications of advanced liver fibrosis:

– Transjugular Intrahepatic Portosystemic Shunt (TIPS): This minimally invasive procedure relieves portal hypertension by bypassing the congested portal vein. It reduces bleeding risk from varices.

– Paraumbilical Vein Ligation: Tying off enlarged superficial veins (caput medusae) resolves troublesome bleeding from bulging portal vein branches below the navel.

– Liver Biopsy: Percutaneous or transjugular biopsy under imaging guidance precisely stages fibrosis providing therapeutic guidance.

– Laparoscopic Banding: Placement of an adjustable silicone band around the esophagus above the stomach reduces variceal bleeding triggered by high portal pressure.

The road to arresting or reversing liver fibrosis is long but achievable when appropriate lifestyle and medical interventions are diligently followed under specialist supervision. Combination therapies yield optimal results by targeting multiple fibrogenic pathways simultaneously. With timely diagnosis and proactive management, significant improvement in quality of life and prognosis can be expected.

*Note:
1. Source: Coherent Market Insights, Public sources, Desk research
2. We have leveraged AI tools to mine information and compile it.