In the case of liver fibrosis, healthy liver tissue is broken down due to previous illnesses and is replaced by collagenous connective tissue. This scarring often forms a transitional stage to cirrhosis of the liver.

What is liver fibrosis?

Fibrosis is the medical term for an increase in connective tissue within an organ. In the case of liver fibrosis, functional liver tissue is replaced by collagenous connective tissue (scar tissue). This is usually a non-reversible process, so that the liver tissue can no longer recover from the fibrosis. If there is severe liver fibrosis, it is also called liver cirrhosis. See AbbreviationFinder for abbreviations related to Liver Fibrosis.

Causes

Liver fibrosis is not an independent disease. Instead, it is a symptom that is caused by various previous illnesses. One of the most common causes of liver fibrosis is excessive alcohol consumption. Alcohol is broken down in the body in the liver.

However, the constant burden of alcohol on this important organ can result in fatty liver. While the fatty liver is sometimes still reversible in an early stage, fibroblasts are increasingly formed in the later stages. This refers to cells that produce connective tissue.

They are ultimately responsible for the development of liver fibrosis. The liver tissue can then no longer regenerate. But not only alcohol is responsible for the development of fatty liver and liver fibrosis, but also the excessive use of drugs such as steroid hormones.

Other possible reasons are adiposity (obesity) and diabetes (diabetes mellitus). Viral hepatitis is also one of the most common causes of liver fibrosis. It is mostly caused by the hepatitis B and hepatitis C viruses.

The viruses cause inflammation of the liver tissue, which has a harmful effect on the healthy tissue. If the liver inflammation lasts longer than six months, doctors speak of chronic hepatitis. In the course of this, the healthy liver cells are displaced by the fibroblasts. The formation of connective tissue eventually leads to liver fibrosis.

If the fibrosis continues for years, there is a risk of liver cirrhosis. Other possible causes of liver fibrosis include chronic congestive hepatitis, often caused by right heart failure, prolonged liver toxicity, alpha-1 antitrypsin deficiency, and chronic cholestasis.

Symptoms, Ailments & Signs

Typical symptoms hardly appear in liver fibrosis. It is not uncommon for her to have no symptoms at all.
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Typical symptoms hardly appear in liver fibrosis. It is not uncommon for her to have no symptoms at all. It is a disease stage that is not yet too pronounced. Symptoms that provide evidence of liver disease are often only detectable in the case of cirrhosis of the liver.

In some cases, liver fibrosis has atypical symptoms such as loss of appetite, weight loss, exhaustion, blood clotting disorders and frequent bleeding gums. Some patients also have an intolerance to alcohol. However, these signs do not automatically mean that you have liver problems, because they can also indicate other diseases.

More definite symptoms of liver disease only become apparent in the advanced stage. This includes above all jaundice (icterus), in which the skin and eyes of the patient turn yellowish. Some patients also suffer from itching all over the body.

Diagnosis & course of disease

For the diagnosis of liver fibrosis, the doctor can fall back on several examination options. Sonography (ultrasound examination) is a tried and tested procedure. With this method, the structural increase in the liver can be detected, but this often happens too late, because the patient usually only decides to seek medical treatment when symptoms occur.

An analysis of the blood is also one of the examination methods. Collagen IV and elevated liver enzymes indicate liver fibrosis. However, an investigation only makes sense at an advanced stage. A puncture, during which the doctor removes liver tissue, provides certainty when making the diagnosis.

This is then examined under a microscope. Depending on how far the liver fibrosis has progressed, medicine divides it into different degrees of severity from F0 to F4. In stage F0 there is still no increase in the connective tissue fibers, while in stage F1 it is a matter of low-grade fibrosis. F2 and F3 are classified as moderate and severe fibrosis, respectively.

F4 is advanced liver fibrosis or liver cirrhosis. The course of liver fibrosis depends on the underlying disease that caused it. In the case of hepatitis, the fibrosis often turns into cirrhosis of the liver. Normally, liver fibrosis cannot regress, so that a promising treatment should already start with fatty liver.

Complications

The symptoms and complications of liver fibrosis usually depend heavily on the stage of the disease. If left untreated, however, in the worst case it can also lead to the death of the person concerned, so that liver fibrosis must be examined and treated by a doctor in any case. Patients often suffer from weight loss and also from loss of appetite.

Bleeding gums and coagulation disorders can also occur. Those affected also do not tolerate alcohol and suffer from jaundice as the liver fibrosis progresses. Itching can also spread all over the body, leading to very unpleasant feelings and a severe reduction in the quality of life. However, the further course of the disease depends heavily on the cause of the liver disease, so that a general prediction is usually not possible.

In most cases, treatment can take place with the help of medication and usually depends on the symptoms. There are no particular complications. In severe cases, those affected also need a liver transplant. Liver fibrosis may also reduce the life expectancy of those affected.

When should you go to the doctor?

If signs of liver disease appear, a doctor must be consulted. Symptoms such as loss of appetite, exhaustion, blood clotting disorders or jaundice indicate fibrosis, which must be examined and, if necessary, treated medically. If this happens early, further complications or late effects can be avoided. At the latest when external changes or cardiovascular problems occur, a doctor’s visit is indicated. People who regularly consume alcohol or take medication should see a doctor as soon as possible if they experience the symptoms mentioned. People with obesity, diabetes or a viral disease must also have unusual signs of illness checked out immediately, as there is an increased risk of developing liver fibrosis.

The family doctor can make an initial suspected diagnosis and refer the patient to a specialist in liver disease. Further treatment usually takes place in the hospital. A liver transplant requires a longer hospital stay. If the state of health deteriorates massively during the treatment, the best thing to do is to inform the emergency services. A specialist center for liver diseases can provide further information on liver fibrosis and support those affected with therapy.

Treatment & Therapy

The focus of therapy for liver fibrosis is the treatment of the underlying disease. Fibrosis can often be stopped by treating hepatitis. Sometimes there is even a regression.

However, it is important to start treatment at an early stage of the disease, as this increases the chances of success. So far, there is no way to stop the progression of liver fibrosis with medication. However, promising experimental therapeutic approaches are now available.

If the patient suffers from advanced fibrosis, treatment is limited to relieving the symptoms. This includes a change in diet, sufficient exercise and the surgical relocation of the bile ducts. Liver transplantation can also be useful in some patients.

Outlook & Forecast

The course of liver fibrosis depends on various factors. These include the progression of the disease, the constitution of the patient and the type of therapy. The prognosis is worse if other diseases are present. If the cause of liver fibrosis cannot be determined, no targeted treatment is possible. Symptomatic therapy is not very promising for liver fibrosis, since the symptoms are usually only clearly felt in the final stages of the disease. The prognosis depends on the causative disease.

Chronic hepatitis can cause liver cirrhosis in the long term. If chronic obstructive cholestasis is the cause, the disease can come to a standstill. Full recovery is possible through papillotomy. The F-score also has an influence on the prognosis. The extent of the disease is divided into five stages, with F0 describing the beginning and F4 a very advanced liver fibrosis. The higher the score, the more negative the prognosis. The doctor can provide a more accurate prognosis. The doctor in charge will take an anamnesis and consider the course of the disease to date. He can also use statistics to support the forecast.

Prevention

The causes of liver fibrosis are different and not every trigger can be prevented. However, some forms of fibrosis can be counteracted by moderate consumption of alcohol and medication and by reducing excess weight.

Aftercare

In the case of liver fibrosis, the aftercare measures are usually severely limited, so that the person affected should primarily consult a doctor. It is a serious disease, so early diagnosis should definitely take place. This is the only way to prevent the symptoms from getting worse.

If liver fibrosis is not treated properly or treated too late, it can even lead to the death of the affected person in the worst case. Most people affected by this disease are dependent on taking various medications. It is always important to ensure that the dosage is correct and that it is taken regularly. If anything is unclear or if you have any questions, you should first consult a doctor.

However, if the medication does not work or does not lead to the desired success, a liver transplant is usually necessary. This cannot always take place and is not always successful either, so that the life expectancy of those affected falls significantly due to liver fibrosis. After a surgical procedure, however, the person concerned should definitely rest and protect his body. Physical exertion or stressful activities should be avoided.

You can do that yourself

If liver fibrosis has been diagnosed, the trigger must be determined and treated in a targeted manner. The complaints are usually based on excessive alcohol consumption, which must be stopped accordingly or at least greatly reduced. If an unhealthy diet is the cause, the diet must be changed.

A healthy lifestyle is generally advisable, because exercise and a balanced diet strengthen the liver and prevent liver fibrosis from progressing. People suffering from obesity should reduce their body weight.

If serious diseases of the heart or bile are the cause, medical treatment is required. In consultation with the doctor, specific measures can then be taken to alleviate the symptoms. In general, medicinal preparations supported by natural painkillers and sedatives help. Naturopathy offers, among other things, arnica, chamomile and feverfew. These remedies help with tension headaches and pain in the liver area. The homeopathic preparations Belladonna and Aconitum are recommended. Ointments and creams made from natural substances such as lemon balm or eucalyptus help against itching.

Parallel to this symptomatic treatment, the underlying disease must be treated medically in order to avoid the development of cirrhosis of the liver.