Cirrhosis is the term used to describe scarring of the liver tissue whilst the healthy parts of the liver have tried to regenerate and therefore created a nobbly appearance to the surface of the liver. Cirrhosis occurs when the liver has been chronically unwell for many years, typically 20-30 years and it does not relate to any particular cause of liver disease.
Cirrhosis is a condition that affects the liver. The liver weighs about 3 pounds and is the largest organ in the body. It is located in the upper right side of the abdomen, below the ribs. When specific diseases cause the liver to become permanently injured and scarred, the condition is called cirrhosis. The scar tissue that forms in cirrhosis harms the structure of the liver, blocking the flow of blood through the organ.
Cirrhosis of the liver is the end result of various insults on the liver. The insults could be poisons or viruses. It is a process wherein the normal liver tissue is replaced by non-functioning fibrous tissue. This alters the blood flow within the liver causing other pathways to open thus resulting in various complications.
The ideal treatment of decompensated cirrhosis is liver transplantation. Other forms of treatment like liver dialysis may serve as temporary supportive measures and as a bridge to transplantation.
Treatment of cirrhosis generally depends on the clinical manifestation and underlying liver function. The patient may require endoscopic banding/sclerotherapy of the esophageal varices if he has had vomiting of blood or black stools. He/she may need diuretics (medicines to increase urine output) for fluid collection in abdomen and swelling of feet. If the patient also has active viral hepatitis, he/she may require specific treatment (antiviral medication for hepatitis B, interferons for hepatitis C.
Cirrhosis of liver may lead to portal hypertension (increased pressure of the blood in portal circulation). This may result in vomiting of blood, black coloured stools, accumulation of fluid in the abdomen (ascites). There may be an alteration in levels of consciousness with tremors, forgetfulness (hepatic encephalopathy) because of the toxins which are not being cleared by the liver. As the liver is unable to synthesize proteins necessary for clotting, there may be increased bleeding tendency.
Cirrhosis is a chronic disease characterized by the presence of irreversible scarring of the liver and diffuse nodule (constituted of regenerating liver cells).
The doctor often can diagnosis cirrhosis from the individual’s symptoms and from laboratory tests. During a physical exam, for instance, the doctor could notice a change in how your liver feels or how large it is. If the doctor suspects cirrhosis, he or she will recommend that you have blood tests. The purpose of these tests is to find out if liver disease is present.
Cirrhosis is the final stage of chronic liver disease. Over a period of many years functional hepatocytes are replaced by collagenous connective tissue. Since the liver has great resources, symptoms first appear when over 80 per cent of its cells are already inoperative.
Is cirrhosis only caused by alcohol abuse?
It is a popular misconception that cirrhosis only affects people who drink too much alcohol over the years. In fact there are many children with liver disorders. However alcohol abuse is a common contributory factor.
Generally there are no symptoms of chronic infection, although gradually progressive fatigue and lack of energy may occur over several years. The symptoms of cirrhosis include progressive fatigue, jaundice (yellow skin), icterus (yellow eyes), dark urine (the color of cola), abdominal swelling, muscle wasting, itching, disorientation and confusion, loss of appetite, and easy bruisability.
Ethanol in alcohol causes inflammation of the liver cells (hepatitis). This can progress to a “fatty liver” where there is abnormal collection of fat, and this can eventually lead to cirrhosis.
Cirrhosis is the seventh leading cause of death in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The incidence of liver cirrhosis varies according to the prevalence of various types of viral and non viral hepatitis in a community.
The viruses known to cause cirrhosis are hepatitis types B, C and D. Hepatitis B &C virus may cause cirrhosis after many years of carriage of the virus. This occurs when babies and infants are infected and become carriers of the hepatitis B virus. Cirrhosis may appear some 30-40 years later. Hepatitis D virus infects only people who are already carrying the hepatitis B virus. In this situation, the infected person becomes very sick and cirrhosis may develop very rapidly.
Patients with chronic viral hepatitis had a 34-fold greater risk for liver cancer as compared with the general population. Patients with both chronic viral hepatitis and cirrhosis, however, had a much greater increase in the development of liver cancer–118-fold. Clearly, the combination of chronic viral hepatitis and cirrhosis has a very strong association with the development of liver cancer.
Complications are: Fluid retention causing large and distended abdomen. This retention of fluids with a reduction in the synthesis of proteins can lead on to swelling of the legs (Oedema). There can be Anaemia (low Haemoglobin) and susceptibility to infections. The blood flow through the liver could be blocked causing alternate pathways to open up. This leads to dilatation of veins especially in the lower end of the food pipe (oesophagus). These veins can rupture causing massive bleeding.
People with cirrhosis get an ultrasound screening twice a year. The more vigilant you are about getting these screenings regularly, the better your chances of catching cancer early, when treatment is most likely to be successful.
