When Hepatitis C Worsens

You can live many years with hepatitis C and not even know you have it. But without treatment, you could start getting symptoms and have complications of cirrhosis (liver scarring).

What to Expect if You Get Cirrhosis

In the early stages of hepatitis C, your liver still has enough cells to do its many jobs. But with time, more cells die, and pressure builds up in the vein leaving the liver.

When that happens, symptoms of cirrhosis like jaundice may show up.

These are some possible complications of cirrhosis:

  • Swelling in your legs and abdomen, which can lead to a serious bacterial infection.
  • Enlarged blood vessels in your esophagus or stomach, which can burst and cause serious internal bleeding. This requires immediate medical attention.
  • Enlarged spleen , which may lead to a low white blood cell or platelet count.
  • Gallstones , from bile (fluid made by the liver) not flowing freely to and from your gallbladder.
  • Greater sensitivity to drugs because your liver can’t filter them from your blood.
  • Resistance to the hormone insulin , leading to type 2 diabetes.
  • Kidney and lung failure.
  • Problems fighting infection.

Two other serious complications of cirrhosis are liver cancer and a buildup of toxins in your brain. The latter can interfere with your thinking, and can lead to coma.

You’ll need to see your doctor more often to manage these complications. You’ll have tests to see how your body is reacting. Your doctor may try a new combination of medications.

Managing Symptoms When Hepatitis Gets Worse

Your doctor will help you manage specific symptoms like itchy skin or pain. You can also make lifestyle changes that can help you feel better and might stop further damage to your liver.

Eat a balanced diet. No matter how advanced your cirrhosis, a well-balanced, nutritious diet is one of the best ways to stay healthy. If you have fluid buildup, your doctor may tell you to cut back on salt.

Avoid alcohol and certain medications, supplements, and herbs. Ask your doctor what's safe for you.

Treating Specific Complications

It’s important to be under a doctor’s care for hepatitis and any conditions you get because of it. Some can be life-threatening. Here are treatments for common complications:

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Fluids in your belly (ascites): Your doctor may prescribe diuretics, drugs that help remove fluids from your body. He might use a needle to withdraw large amounts of fluid, if needed. Fluid buildup makes you more likely to get an infection, so you may also need oral or intravenous (IV) antibiotics.

Pressure in a portal vein leaving your liver: You’ll probably take beta-blockers, which may help reduce blood pressure in this vein and elsewhere in the body.

Bleeding in your esophagus: Your doctor will check for enlarged blood vessels in this tube that connects your mouth and stomach. He can use a device to compress the vessels or put rubber bands around them and stop any bleeding. Medication can prevent further problems.

Toxins in the brain : You might take a laxative. In addition to what it’s best known for, this medication can also clear your blood of the toxins that cause brain fog. Lower the amount of protein you eat to take some stress off your liver. Your doctor may give you antibiotics.

Liver cancer: You and your doctor will discuss what type or combination of treatment might work best for you, such as chemotherapy, radiation, or surgery.

You may reach a point where liver damage can't be reversed and you have liver failure. Your doctor will work with you to control your symptoms and get on a list for a liver transplant.

WebMD Medical Reference Reviewed by Jennifer Robinson, MD on November 25, 2018

Sources

SOURCES:

Sulkowski, M. New England Journal of Medicine, May 2013.

Department of Veterans Affairs: "Cirrhosis: A "Patient's Guide."

National Digestive Diseases Clearinghouse: "Cirrhosis."

UpToDate: "Patient information: Hepatitis C (Beyond the Basics)."

American Liver Foundation: "What Can Happen -- Complications of Hepatitis C."

American Cancer Society: "How is liver cancer treated?"

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