Explanation required please!! - British Liver Trust

British Liver Trust

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Explanation required please!!

Deb3822 profile image

Hi all,

Sooo, I was under the impression that liver cirrhosis was irreversible. I've just returned from my liver specialists, who performed a fibroscan, and informed me that my liver has regenerated itself and I'm out of the danger zone. My reading was 10.4.

Can someone please explain to me how this is possible??

26 Replies

Looking back at your old posts you've had this cirrhosis/not cirrhosis thing going on for 5 years or more. As your initial issue was I understand alcohol related and you have been sober since then it is possible for the liver to repair to a degree. Your care over the years hasn't been great, hope you get better care from now on. Continue looking after yourself.

Katie

Deb3822 profile image
Deb3822 in reply to AyrshireK

What do you mean by my care over the yrs?? I've not touched a drop of alcohol since my diagnosis.

AyrshireK profile image
AyrshireK in reply to Deb3822

I mean when you have a diagnosis of cirrhosis (which you seemed to have from years ago) there is a minimum standard of health care you should have i.e. minimum - 6 monthly scans and 6 monthly bloods etc. but in previous posts of yours you've said you've gone years without follow up, mixed messages from various doctors & your details becoming 'lost'. Hence what I mean about the standard of care you've received.

Katie

Deb3822 profile image
Deb3822 in reply to AyrshireK

I got lost in the system and then I was found lol. I have been having 2 scans a yr and regular bloods taken. In that time my consultant has told me she is not convinced I have cirrhosis. This was after a biopsy. I then recieved a later from her stating I was at the cirrotic stage. Today she told me my scan had come back fine and then performed a fibroscan on me and said it was great news, it was 10.4 and I was out of the "danger zones of liver cancer and transplant".

I'm really not sure how scar tissue is able to disappear. I have always considered cirrhotic scar tissue is unrepairable, While the liver may still be able to get most of it's functionality back,

Scar tissue will always remain, that is until stem cell liver treatments are available.

Even the Mayo Clinic says Cirrhosis can be reversed. Rarely, but it's not impossible. I trust them.

mayoclinic.org/diseases-con....

A lot of people had Cirrhosis due to Hepatitis C and then a cure was found. Many of these patients (or I guess now they would be former patients) have significantly reduced liver disease are now and are free or close to it. Maybe I'm a dummy, but to me, cirrhosis is cirrhosis and if can be reversed in Viral Hepatitis, why not in other kinds if you stop whatever is causing the damage (like alcohol, bad diet, etc). I mean, I don't think there is a special kind of "Only Hepatitis C Cirrhosis" as far as I know.

Recent studies have confirmed that if you have fibrosis - or even cirrhosis - and are treated and cured of hep C, the development of fibrosis will stop, and fibrosis will reverse in the majority of patients. Liver damage reversal is possible even when cirrhosis has developed. A recent review of multiple studies found that 53 percent of patients who were cured of hep C had regression of cirrhosis.

healthcentral.com/article/c...

Professors and Doctors speak out - Very Long And Complicated Article, but just reading the abstract and conclusion gives you the picture - quote -

"In the past, liver cirrhosis was considered an irreversible phenomenon. However, many experimental data have provided evidence of the reversibility of liver fibrosis. Moreover, multiple clinical studies have also shown regression of fibrosis and reversal of cirrhosis on repeated biopsy samples."

ncbi.nlm.nih.gov/pmc/articl...

Deb3822 profile image
Deb3822 in reply to kensimmons

Thank you so much for this reply xx

HepC cirrhosis does actually seem to regress better than many kinds of cirrhosis, and alcoholic liver disease generally does not reverse as readily. From the second paper you cited

"Clinical evidence for regression of fibrosis in alcoholic liver disease is limited. Results from randomized controlled trials (RCTs) assessing the effects of pharmacological agents on alcoholic fibrosis and cirrhosis have been disappointing."

One thing to keep in mind is when in disease progression the cirrhosis is caught is critical for stabilizing cirrhosis or even reversal. For alcoholics, disease is often caught when symptoms show up, i.e. when portal hypertension is pretty advanced. That seems to be past the point of no return according to the articles you cite, though by no means do all early cases of cirrhosis reverse whem the cause of disease is something else.

Alcohol also causes all sorts of issues that contribute to continued inflammation and therefore continued scarring even after alcohol is stopped. Look up liver-gut axis and alcoholic liver disease if curious. Similar issue with NASH/metabolic disease.

From the articles I recall, cirrhosis from HCV/B, AIH, and hemochromatosis tended to regress more readily than cirrhosis from ALD or NASH.

My understanding is that the reason isn't that it's a different type of cirrhosis, it's just easier to eliminate what is causing the damage in things like Hep C and AIH. Sometimes you just need to take some pills. Alcohol and NAFLD have the same type of cirrhosis as other people with cirrhosis do, it's just tough for some people to stop drinking, smoking, eating badly etc.

I remember reading an article where one hep doc with many decades under his belt said that in his experience alcoholic disease patients did one of two things, kept drinking or stopped. Those who kept drinking almost always ended up needing a transplant very soon but those that stopped the harm immediately lived on and could live a normal life. As this doctor said in the interview " many times, it's all up to the patient". It's a shame I didn't save the article and I can't find it again, don't recall where I saw it. Oh well.

This is a different article, but it also made me optimistic when I saw it a while back.

The doctor interviewed says most people with cirrhosis can be treated without a transplant and for most cirrhosis is NOT a death sentence.

sandiegouniontribune.com/ne...

Again, I am not a doctor, so people shouldn't listen to me about anything, I am just passing on what I have read.

A lot depends on when the cirrhosis is caught. Many problem drinkers with early cirrhosis never find out because of no symptoms, and keep drinking until serious symptoms pop up. It can be years from early cirrhosis to advanced cirrhosis. Serious symptoms also means portal hypertension, and the start of many more complications and no chance of regression. Also, bad gut-liver interactions. Lots of interesting articles on this issue.

Also, causes of cirrhosis do show up differently. Check out micronodules, macronodules, and the patterns of fibrosis by etiology. Advanced cirrhosis leads to the same complications regardless of cause, but the disease does develop differently (and at different speeds) depending on cause.

Your actually wrong. Scar tissue can repair in some cases.. Look up scar wars on YouTube. The liver has its own mechanisms to degrade scars. Hence why my reading went from 12.7 to 3.6 kpa in 2 years. My uncle was same 25 years back. Until it gets into a decompensated state it can fully repair. This was confirmed recently with my liver nurse..

Str8jacket profile image
Str8jacket in reply to CHRISR999

Fibroscan measures liver stiffness, which is an approximation for scarring but can also result from inflammation. Curious, were you diagnosed with cirrhosis, or was it hepatitis?

Deb3822 profile image
Deb3822 in reply to Str8jacket

I was diagnosed with liver cirrohis, I had fluid removed and told that if I continued drinking, I would only have 2-5yrs to live. I stopped drinking immediately, I never thought I drank that much anyway.

I was diagnosed with cirrhosis 25 years ago. I cut down alcohol by half.Stopped totally 2 years ago and no sign of cirrhosis.

Deb3822 profile image
Deb3822 in reply to Palpman

It's crazy isn't it!!

deanw41 profile image
deanw41 in reply to Palpman

Wow!!! I guess it’s be kind to yourself,enjoy life and anything else is a Brusie Bonus!!!

Well that’s brilliant new!! My consultant did say,they DONT say it not reversible anymore. Everyone is so different,who knows!! Yayy to you!!!

Deb3822 profile image
Deb3822 in reply to deanw41

Thank you xx

Great news! Keep up the good work! I know there are medications these days that regenerate cells and help the liver. They are based on healthy stuff you get from food but perhaps the right diet and just staying away from alcohol allows the liver to slowly regenerate tissue that had been scarred. Whatever the reason, it sounds like good news. Now the person who was diagnosed with cirrhosis 25 years ago and cut drinking in half then and only fully quit 2 years ago (23 years after diagnosis), that is awfully hard to believe but good for you on the result. Obviously not a recommended course of action for anyone else though.

I was told my liver had regenerated itself in parts but still had areas showing as cirrhosis which would always be there. My problems caused by sudden onset budd Chiari though and damage occurred over a period of weeks and resolved by TIPS in similar timescale

It used to be thought that cirrhosis was irreversible and progressive but over the last couple of decades it's been found that cirrhosis can reverse if discovered relatively early and the cause of hepatitis(inflammation) removed. Once established though it's considered progressive.

So well done! Stopping drinking paid off. Stay healthy.

Worrysome1 profile image
Worrysome1 in reply to MisterX

Can it not be managed though?

MisterX profile image
MisterX in reply to Worrysome1

Yes of course - as long as the source of inflammation is dealt with and other interventions are made to prevent further stress on the organ and allow it to perform to the best of its ability - but it does require a level of discipline, vigilance and supervision nevertheless.

Doctors used to believe, universally, that cirrhosis, once established, was irreversible.

That view has now begun to change. Starting in the 1980's, studies were done on people who had been treated for Hep C hepatitis, whose cirrhosis had been confirmed by diagnosis, but who, after treatment, had returned to stable, normal liver tests numbers (ALT, AST, bilirubin, etc. These patients were then subjected to a second biopsy. The doctors discovered that a percentage of these patients had seen their cirrhosis regressed to an earlier stage of fibrosis or to a completely normal liver structure.

After this study, other studies were undertaken with liver disease patients from other etiologies (autoimmune, Hep B, alcohol-related and fatty liver). These studies also found that cirrhosis could be regressed to an early stage or even F0.

Scientists and doctors, who keep abreast of the studies, now see fibrosis and cirrhosis as "dynamic" rather than "static" [rocesses. That means that the if there is less collagen deposited than is taken away by processes that degrade the fibrosis matrix, then your liver will begin to see the fibrosis/cirrhosis "dissolve".

I believe that one reason that doctors, even those who are aware of the studies, do not discuss reversal possibility with patients is that very few patients are willing to change the bad habits that caused certain types of liver disease (not autoimmune or possibly NASH), in the first place.

In any event, cirrhosis is now seen as potentially reversible. Regression/ reversal is now a medical fact established by "before" and "after" biopsies. Does it happen in every case? No. But it can and does happen. I believe the best aproach is simply to carry on living in a healthy way, if you have been diagnosed with cirrhosis. Congratulations on your wonderful news.

Hi,just wondering what was your original fibro scan,interested because mine was high last Oct,but at that time I was recovering from some colon infections ,and wasn't that aware because I smoke had a probable impact of the test,but feeling OK after couple if years off booze,look after your self.

Deb3822 profile image
Deb3822 in reply to Charloy

I can't tell you sorry, I really don't know. I do know that my consultant was really pleased and happy for me.

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