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Cirrhosis is a stage of liver disease. It means that your liver has heavy scarring from trying to repair itself. When the liver has so much scar tissue that it struggles to function, it’s called decompensated cirrhosis.

Exercise can’t reverse the scarring on your liver, but it can help liver disease patients get stronger and potentially avoid or delay decompensated cirrhosis.

What We Know About Exercise for Liver Cirrhosis Patients

Frailty is linked to ill health in general — and, more specifically, to falls. Falls can be especially dangerous for people with cirrhosis because these individuals don’t heal as quickly. Exercise helps build strength, which reduces frailty and chance of injury.

People with cirrhosis can also develop something called hepatic encephalopathy. This condition happens because the liver can’t filter toxins, so they travel to the brain. People with hepatic encephalopathy can feel disoriented and confused.

Exercise is beneficial in the fight against hepatic encephalopathy because it helps build skeletal muscle. Skeletal muscle can help clear out blood ammonia — the substance mainly responsible for hepatic encephalopathy in advanced liver disease.

Finally, exercise can reduce portal hypertension, as found in a 2016 study.

Portal hypertension is high blood pressure in the veins that lead to the liver. It can cause cirrhosis to turn into decompensated cirrhosis. Portal hypertension can also cause bleeding, swelling in the abdomen, and hepatic encephalopathy.

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Liver Disease Patients Should Start With Walking

People who are candidates for liver transplant are frequently prescribed exercise to get them strong enough for surgery. This is called prehabilitation. UPMC has special expertise in prehabilitation for liver transplant candidates.

Walking is one of the best exercises you can do if you have liver disease. At UPMC, we have the frailest patients in our prehabilitative program aim for 1,000 steps a day and encourage them to work up to 2,500 to 3,000 or more steps per day.

For less sick patients, we suggest at least 5,000 steps a day. And for those who are strong enough, we recommend getting at least 7,500 steps per day.

But you’re not limited to walking. Both aerobic and anaerobic exercises can help improve physical function and liver disease.

In other words, you can add strength training or strength classes to your cardiovascular activity — as long as you are careful.

More Exercise Considerations for People With Liver Disease

For people with cirrhosis who want to begin an exercise program, there are two main considerations.

First, start low and go slow.

Cirrhosis greatly affects a person’s capability for exercise. For example, people who used to be able to run long distances may find they can only walk a few blocks before feeling fatigued. If they used to lift heavy weights, they may now only be able to lift a few pounds before their muscles give out.

Cirrhosis can also affect your ability to build up strength and muscle mass. This is because liver disease weakens your body’s ability to adapt to new challenges.

Secondly, avoid lifting heavy weights. Cirrhosis patients lifting heavy weight are more prone to exercise-related injuries. We recommend starting with weights as little as one to three pounds and suggest adding repetitions instead of adding weight.

Finally, it’s critical for cirrhosis patients to be under the care of a liver specialist. The UPMC Center for Liver Diseases cares for people who have all stages of liver disease. To schedule an appointment, call 412-647-1170.

About Center for Liver Diseases

The UPMC Center for Liver Diseases provides complete care for a variety of liver conditions. Our expert hepatologists manage and treat patients using cutting-edge practices and therapies. We research and evaluate new treatments to provide the best care possible. We manage your care and, if necessary, can help you make the transition to subspecialists, including transplant surgery and oncology.