Sometimes what everyone knows is just wrong. Can cirrhosis improve? Care to join me for a walk down cirrhosis lane?
First what is cirrhosis? In simple terms, it is the formation of scars everywhere in the liver which causes it to fail.
OK, what then are scars? We all know them, we can see scars on our body where we have been wounded.
When liver cells are injured the same process occurs as when you cut yourself. Scar forming processes move in and try to repair the wound. This happens at the cell level so scar tissue forms everywhere within the liver and when it gets bad enough to disrupt the normal function of the liver we call it cirrhosis. That leads to ESLD, end stage liver disease, and death.
So what is a scar really? In the liver, inflammation is a typical culprit. Something, lets say too much fat or alcohol for example, damage liver cells and some of them die. That degeneration of cells causes clotting processes to start and platelets and the other wound healing chemicals move into the area. This process is crucial to your health but it is a balancing act. If the debris removal systems are able to clear out the dead cells all is well and that brief episode of cell death and inflammation is gone and all is well. Liver cells die by the millions every day and this is the normal process.
When you do something that overwhelms the repair systems the wound processes keep going and form strings of fibrous tissue which are the first step in forming the scars you are familiar with. When you think about whether scarring in the liver can be moderated the thing you need to understand is that the formation of the fibrosis is a multi step process. There are several steps that happen as a scar is built. The initial long molecules that become scars are manipulated in several steps and it gets harder to remove them as each one happens. In the final step 3 in the picture above the long fibers are wound into a tough helix, like a rope, and a mass of those helical fibers is what you think of as a scar.
When we talk about reducing the scar tissue through diet we are mostly affecting the earlier steps in the formation of the scar. Once the mature helical form is constructed it is very difficult to reverse so when people say that cirrhosis is irreversible they are really speaking about those tissues. If you can break the cycle of inflammation your liver does have tools for resolving early stage fibroid fibers and it will try. Success will vary but some people have done very well. Up to 18% of Hepatitis C patients who are cured have seen at least one stage improvement in their fibrosis.
The message in this is that even with a cirrhosis diagnosis you are not helpless and there is a chance to improve your situation by learning how to stop the cycle of inflammation that is driven mostly by your diet. There are many ways to harm your liver but with our modern lifestyle fatty liver is one of the most common. If you want to follow this up here is a link to our view of a liver supportive diet.
As we look down the road to therapies, many of them focus on stopping that formation of the finished fiber or in finding ways to unwind it. We know that can be done because you can buy over the counter creams that will reduce scars, but getting that to work inside the liver is a hard thing to do.
One thing to keep in mind, no treatments will become available without clinical trials and there are not enough patients participating in trials today to test the number of potentials treatments. If you or someone you know might be interested here is a link to a tool to connect with the trial system.
We are also seeking patients who would be willing to tell their story in a short video interview. The patient voice is the most effectivel tool we have to improve education and understanding of the disease. If that interests you here is a link where you can enter your story so that TV producers who want to tell patient stories can find you.
We hope you are well.