Patient: "Doctor, I've been taking liver-protective medication for years, but the condition keeps recurring and never seems to get better. Why is that?"

Me: "What was the underlying cause of your liver cirrhosis?"

Patient: "At the time, the doctor diagnosed me with alcoholic cirrhosis."

Me: "Have you stopped drinking alcohol since then? What medications are you currently taking?"

Patient: "I haven't completely quit drinking; I still have a little now and then. I’ve just been taking the liver-softening and liver-protecting medications prescribed by the doctor."

At this point, you probably already have a rough idea why this patient's condition keeps recurring and never seems to improve!

There are two reasons for its recurrent progression

First, failure to persist in quitting alcohol. The primary cause of alcoholic cirrhosis is long-term alcohol consumption, so we must address the root cause to halt the progression of cirrhosis. The most direct and effective method is to quit drinking.

Second, using only liver-softening medication can only soften the liver. Once cirrhosis sets in, the blood vessels and bile ducts inside the liver are damaged. With these pathways compromised, nutrient transport becomes uneven, and it’s difficult for drug components to penetrate the liver. Therefore, relying on a single medication alone is insufficient to resolve the issues of cirrhosis.

There are many causes of liver cirrhosis

such as viral, autoimmune, drug-induced, genetic factors, etc., can all lead to liver cirrhosis.

When liver disease occurs and persists over a long period, with repeated relapses, there is an increase in fibrous connective tissue within the liver. At the same time, the degradation activity is relatively or absolutely insufficient, leading to the deposition of large amounts of extracellular matrix, resulting in liver fibrosis. With prolonged or repeated damage, diffuse liver injury occurs, and the cycle repeats, ultimately leading to liver cirrhosis.

Liver cirrhosis is further divided into early, middle, and late stages. Early and middle-stage cirrhosis is considered compensated cirrhosis, while late-stage cirrhosis is decompensated cirrhosis. Regardless of the stage, commonly used clinical medications aim to protect and support liver function. However, relying on a single drug is unlikely to resolve the issue of cirrhosis. To prevent further progression of cirrhosis, the first step is to identify and address the underlying cause of liver hardening.

For example, if cirrhosis is caused by a virus, the virus needs to be suppressed; if it is caused by drugs or alcohol, medication should be discontinued and alcohol consumption stopped. This way, cirrhosis will not continue to progress. Relying solely on liver protection, support, or softening medications is unlikely to achieve this.

Only by understanding the process of liver fibrosis and cirrhosis can we comprehend the two directions in treating cirrhosis: one is to address the root causes that lead to cirrhosis, and the other is to block the progression of cirrhosis, with both aspects mutually reinforcing and complementing each other.

Therefore, patients with liver cirrhosis should not always rely solely on medication to alleviate the condition, thinking that continuous medication use negates the underlying causes of liver fibrosis—both are equally important!