How do you live with liver cirrhosis without transplantation?

many people believe that the main cause of a liver disease known as cirrhosis is alcohol abuse.

However, Dr. Catherine Frenette, medical director of liver transplantation at Scripps Clinics in San Diego, said while over-consumption of alcohol may be the most publicized cause, it’s hardly the most common.

Rather, she said, that distinction goes to hepatitis C, a virus that causes inflammation of the liver that’s spread when blood from an infected person enters the body of someone who’s not infected – often by sharing IV drug needles. And, prior to 1992 when blood supply screening began in the U.S., hepatitis C was often spread through blood transfusions and organ transplants.

The sobering news is that just 50 percent of those with hepatitis C have been diagnosed and symptoms of cirrhosis can take decades to makes itself known – and that typically happens when the disease has advanced.

The good news, however, is that the disease if often treatable without a liver transplant, Frenette said.

“Most people with cirrhosis don’t need a transplant,” she said. “And cirrhosis is not a death sentence.”

The liver maintains the body’s glucose level, helps in food digestion and removes toxins from the body, so proper liver function is important to overall health.

In addition to alcoholism and hepatitis C, Sharma said, other causes include obesity, hepatitis B, toxins and medications, metabolic diseases, autoimmune diseases with some causes being idiopathic, or still unknown.

When it comes to treating cirrhosis, Frenette said, health care providers must treat the underlying cause of the disease. Therefore, in many patients, treating cirrhosis means treating hepatitis C, eliminating consumption of alcohol, treating obesity, preventing hepatitis B, removing exposure to toxins or treating metabolic or autoimmune diseases.

“Medications and surgery are helpful in improving liver blood flow,” Sharma said. “Stopping the damage may allow the liver to repair, regenerate and heal.”

However, because it’s a “forgiving organ” Frenette said, the liver can withstand a lot of damage before symptoms of cirrhosis begin to appear. She said its function could be at 30 percent before symptoms begin to show.

Sharma said symptoms start with decreased appetite, weight loss, nose bleeds/bruising and weakness and progress to mental confusion, abdominal swelling and jaundice - and cirrhosis, which can ultimately lead to death. Cirrhosis is thought to be the seventh leading cause of death in the U.S., and it’s more common in men than in women, with an approximate ratio of 2-to-1. Today, a liver transplant is the only available treatment for end-stage liver disease. While a transplant rids the body of cirrhosis and comes with an 85 percent survival rate after five years, the demand for livers is higher than the supply of available organs.

Sharma said about 17,000 people are awaiting liver transplants, compared to 6,000 liver transplants done annually in the U.S. As a result, Frenette said, 20 to 30 percent of those waiting for a liver transplant die while being on the wait list.