What is Cirrhosis?

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Cirrhosis is the scarring of the liver which is caused by numerous forms of liver diseases and conditions, including chronic alcoholism and hepatitis. When your liver is injured, it tries to repair itself. Scar tissues form during this self-repair process. The scar tissue can gradually replace the healthy liver cells and prevents the liver from working properly (decompensated cirrhosis). Cirrhosis can lead to liver failure, a condition in which your liver stops working. Advanced cirrhosis can be fatal and life-threatening.

During the early stages of cirrhosis, you may not have any symptoms. The signs and symptoms of cirrhosis usually occur when the damage in your liver is extensive. As the damage of your liver gets worse over time, you may experience the following symptoms.

  • Weakness and fatigue
  • Lack of appetite
  • Nausea

Further symptoms can also occur as your liver becomes even more damaged. These symptoms are:

  • Your eyes or skin becomes yellow (jaundice)
  • Intense itching
  • Whitening of the nails or redness in the palms of your hands
  • Blood vessels that look like a spider web on your skin
  • A tendency to bruise or bleed more easily
  • Vomiting blood
  • Swollen tummy (ascites) or legs (edema) which is a result of fluid build-up
  • For women, loss or absence of periods that are not related to menopause
  • For men, breast enlargement, testicular atrophy (shrinkage in the testicles), or loss of sex drive
  • Fever
  • Brownish urine
  • Dark and tarry-looking poo
  • Confusion, problems with concentration or memory, slurred speech, and drowsiness.

Make an urgent appointment with your doctor if you experience any of the symptoms listed above. Bear in mind that you may not get all of the symptoms and the symptoms you notice can also be signs of other conditions. However, if it is cirrhosis or not, these symptoms are will need to be diagnosed by a doctor.

Cirrhosis occurs when you damage your liver over a long period of time and it takes years for the condition to reach its fatal stages. The most common causes of cirrhosis include:

  • Chronic alcohol abuses over many years
  • A long-term hepatitis infection particularly hepatitis C and B
  • Non-alcoholic fatty liver disease, which is a condition where a build-up of excess fat results in an inflamed liver. 

Some conditions can result in cirrhosis, including:

  • Cystic fibrosis
  • Wilson’s disease (copper accumulated in the liver)
  • Hemochromatosis (iron build-up in your body)
  • Biliary atresia (bile ducts that formed poorly)
  • Primary biliary cirrhosis (destructions of the bile ducts)
  • Deficiency of alpha-1 antitrypsin
  • Glycogen storage disease or galactosemia (inherited disorder of sugar metabolism)
  • Alagille syndrome (a genetic disorder of the digestive system)
  • Autoimmune hepatitis (a liver disease that is caused by the body’s immune system)
  • Infection, including brucellosis and syphilis
  • Medications, such as isoniazid and methotrexate

Some factors increase the risk of developing cirrhosis. The risk factors include:

  • Excessive alcohol consumption over many years
  • Being overweight or obese since obesity can increase the risk of conditions that lead to cirrhosis, such as non-alcoholic fatty liver disease
  • Viral hepatitis is the leading cause of liver disease around the world.

Other Complications are Portal hypertension, malnutrition; bone disease, hepatic encephalopathy, acute-on-chronic cirrhosis, and splenomegaly are some of the complications. Cirrhosis can also lead to liver cancer as a large number of people who have liver cancer have pre-existing cirrhosis. Depending on how severe your cirrhosis is, it can also have an effect on life expectancy.

Damaged to your liver caused by cirrhosis cannot be undone, but if the condition is diagnosed early and the cause is treated, you can restrict further damage. Because the symptoms of cirrhosis do not appear in its early stages, you may not find out that you have it unless you have a routine checkup. To diagnose cirrhosis, your doctor will ask about your alcohol use and medical history. Your doctor will also do some medical tests to check if your liver is larger than it should be or tender. If your doctor suspects cirrhosis, you will be ordered to do a blood test, MRI, or ultrasound. You may also need to undergo a procedure called biopsy to remove samples of your liver tissue to see how much damage has been done.

The treatment for cirrhosis depends on the cause and how damaged the liver is. Treatment is performed to slow down the progression of scar tissue, to treat symptoms, and to prevent complications of cirrhosis. If you have severe liver damage, you may need to be hospitalized. 

The first steps of treatment are to treat the underlying cause of cirrhosis to prevent any further damage. The treatments include:

  • Stop drinking alcohol immediately. If it is hard for you to stop using alcohol, your doctor will recommend a treatment program for alcohol dependency. Any amount of alcohol is toxic to the liver if you have cirrhosis.
  • If your cirrhosis is caused by non-alcoholic fatty liver disease, you can be healthier if you lose some weight and control your blood sugar levels.
  • Medications for hepatitis if you have hepatitis B or C. Medications can limit the damage of your liver cells.
  • Medications for other causes of cirrhosis can slow the progression of certain types of cirrhosis. For instance, if you have primary biliary cirrhosis that is diagnosed early, the progression of cirrhosis can be delayed significantly.
  • Medications to relieve certain symptoms, such as pain, fatigue, and itching. Your doctor may prescribe nutritional supplements to counter malnutrition and prevent osteoporosis.

Then, your doctor will also treat any complications of cirrhosis. These treatments are:

  • Medications and a low-sodium diet to prevent fluid build-up can help control swelling and ascites.
  • Blood pressure medications can control portal hypertension or increased pressure in the veins that supply your liver.
  • You may be given antibiotics if you have any infections. 
  • Periodic blood tests and ultrasound exams can be ordered by your doctor to look for signs of liver cancer.

If your case of cirrhosis has reached an advanced stage, you may need a liver transplant because your liver is ceasing to function. A liver transplant is a surgery to replace your damaged liver with a healthy liver from a deceased donor or with part of a liver from a living donor.  

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