Curable or not?

[MoodySunflower]

I was diagnosed with alcoholic hepatitis and end-stage liver disease/cirrhosis last year. I had jaundice and recurrent ascites, and my last paracentesis was in December. (The fluid has stayed off.) I had doctors in the US tell me that I have a shortened life expectancy, cannot live alone, etc. I have been on an extended visit to Canada (going back to the US this week) and today a Canadian doctor told me that cirrhosis is curable. I didn’t think it was. Is it? I’m more confused than ever because American docs think my condition is very serious and the people up here seem to have a cavalier attitude about it. Any thoughts?

[AyrshireK]

Cirrhosis is not generally considered curable though some damage can be reversed. The British Liver Trust page on cirrhosis states:-

"Reversing the problem

Until recently, it was thought that a liver with cirrhosis could not be healed. This is usually the case because most diseases that cause scarring of your liver (fibrosis) are long-term and difficult to ‘cure’.However, recent research has shown that it may be possible to heal scarring and even cirrhosis where the liver disease causing this damage is able to be successfully treated."

If you are able to remain abstinent and look after your liver going forward then you stand a chance of reversing the current level of illness - ascites and jaundice would be considered symptoms of decompensated cirrhosis which can revert to compensated if you look after your liver.

To help make sense of cirrhosis, it's many stages and facets have a read at the BLT page on cirrhosis, there are also helpful pages on diet and other issues that might help you look after your liver going forward.

britishlivertrust.org.uk/li...

All the best,

Katie

[Hidden]

Curable is not the word. The word is regression. Basically as it was explained to me is this: Cirrhosis was mostly considered unable to regress. But since we now are seeing treatments and cures for things like hepatitis C we can monitor these regressions in ways we simply could not before as the aeitologies were mostly untreatable. I asked when told this about why alcohol was not documented for its regression. The answer was that most people who are diagnosed with alcoholic liver cirrhosis either return to drinking at some point in their lives and/or they dont keep up with medical follow ups which makes documenting these cases scarce in comparison. If you research cases of cirhosis regression in alcoholic patients you will find that to be quite true. However since we now can see just how possible regression is in other aeitologies there is strong suggestion to the fact that alcoholic cirrhosis can do the same. However this could take YEARS to see.

The regression will very likely never find a person back to a normal liver architecture but we can most likely hope to see a breakdown in the extra cellular matrix and a regression in the bridging septa. However keep in mind that cirrhosis develops a bit differently in different aeitologies. So the regression would then likely occur differently as well and most importantly to remember is that even if the liver can regress to a precirrhotic state, the increased risk of hepatocellular carcinoma that came along with cirrhosis DOES NOT regress with it.

PS I am Canadian.

-Phoenix

[Hidden]

Hi MoodySunflower,

We have no experience with alcoholic hepatitis, so can't comment on that.

We live in the US and my husband's liver doctor told him at one of his liver follow up appointments that his life expectancy was pretty much the same as any one else's. He was in liver & kidney failure in Nov 2015, quit drinking while in the hospital and has not started again. The follow ups are primarily to catch live cancer in its early stages.

I know he was checked for the various hepatitis' and took the Hep B vaccines.

Perhaps you need different doctors when you return to the US.

Best wishes,

Mary

[Garyvh]

Are you sure the Canadian Dr wasn't actually referring to the alcoholic hepatitis being curable (which it is), and not the cirrhosis?

Gary

[MoodySunflower in reply to Garyvh]

Both of the Canadian doctors I saw were referring to cirrhosis. I’m Canadian but have lived in the States for 20+ years.