Liver Cirrhosis

What is Liver Cirrhosis?

    Liver Cirrhosis signifies an advanced stage of liver disease wherein healthy liver tissue is progressively substituted by scar tissue. This condition typically develops as a consequence of prolonged, chronic hepatitis, which refers to inflammation of the liver caused by various factors. Persistent inflammation prompts the liver to undergo repair processes, resulting in the formation of scar tissue. However, excessive scarring impedes the liver's functionality. Eventually, this can lead to chronic liver failure, marking the end stage of the disease.

What are the causes of Liver Cirrhosis?

    Liver cirrhosis can stem from various causes, with chronic hepatitis infections and chronic alcohol misuse.

    1. Alcohol:

    According to a 2019 meta-analysis, the risk of liver cirrhosis escalates with any level of alcohol consumption among women, implying that even moderate drinking may pose some risk. Men's risk increases when consuming more than one drink per day. Nonetheless, individual susceptibility varies, and occasional consumption of wine with dinner typically doesn't predispose one to liver cirrhosis. Typically, alcohol-induced cirrhosis results from prolonged excessive drinking spanning many years. Several other health factors can also contribute to its development.

    2. Hepatitis:

    Hepatitis C, a viral infection, can induce liver inflammation and damage. Individuals at risk of contracting this form of viral hepatitis include those who engage in intravenous drug use, unprotected sexual activity or undergo kidney dialysis. If left untreated, both Hepatitis C and B can lead to liver cirrhosis.

    3. Non-alcoholic fatty liver disease and non-alcoholic steatohepatitis:

    Non-alcoholic fatty liver disease (NAFLD) entails the accumulation of fat in the liver, unrelated to heavy alcohol consumption. Non-alcoholic steatohepatitis (NASH), a more severe variant of NAFLD, involves liver damage, inflammation, and fat accumulation. Left unmanaged, NASH can progress to cirrhosis.

    4. Other causes:

    Additional causes of cirrhosis include hepatitis D, often observed in individuals with existing hepatitis B; autoimmune hepatitis, characterized by inflammation potentially leading to cirrhosis; bile duct damage disorders like primary biliary cholangitis; disorders affecting iron and copper metabolism such as hemochromatosis and Wilson's disease; and certain medications, both prescription and over-the-counter, including acetaminophen, certain antibiotics, and some antidepressants.

What are the risk factors of Liver Cirrhosis?

    Increased susceptibility to liver cirrhosis may be evident if you:

    1. Are aged 50 or above.

    2. Have a past of excessive alcohol consumption.

    3. Are afflicted with chronic viral hepatitis.

    4. Have metabolic syndrome.

What are the symptoms of Liver Cirrhosis?

    In many cases, symptoms of cirrhosis may not be apparent until the disease has progressed significantly.

    Symptoms typically emerge when liver scarring has advanced to the point where the organ's functions are compromised, including:

  • Purification of the blood
  • Breakdown of toxins
  • Production of clotting proteins
  • Assistance with the absorption of fats and fat-soluble vitamins

    Some noticeable symptoms of cirrhosis may include:

  • Decreased appetite
  • Fatigue
  • Unintentional weight loss
  • Mild pain in the upper right abdomen
  • Nausea
  • Vomiting
  • Enlarged or swollen veins (varices or varicose veins)

    More severe symptoms may include:

  • Yellow discoloration of the skin and eyes (jaundice)
  • Confusion and difficulty with clear thinking
  • Easy bruising or bleeding
  • Persistent itchiness of the skin
  • Darker than usual urine
  • Abdominal swelling (ascites)
  • Swelling of the legs (oedema)

What are the complications of Liver Cirrhosis?

    Complications stemming from cirrhosis can encompass:

    1. Portal hypertension: Cirrhosis impedes the normal blood flow through the liver, elevating pressure in the vein supplying blood to the liver, a condition termed portal hypertension.

    2. Oedema and ascites: Increased portal vein pressure can accumulate fluid in the legs (oedema) and abdomen (ascites). Additionally, insufficient production of certain blood proteins by the liver, such as albumin, can contribute to these symptoms.

    3. Enlargement of the spleen: Portal hypertension may cause the spleen to trap white blood cells and platelets, resulting in splenomegaly.

    4. Bleeding: Portal hypertension can redirect blood flow to smaller veins, increasing the risk of ruptures and severe bleeding. Enlarged veins, known as varices, in the oesophagus or stomach can also lead to life-threatening bleeding.

    5. Infections: Cirrhosis can compromise the body's ability to fight infections, potentially leading to bacterial peritonitis if ascites are present.

    6. Malnutrition: Impaired nutrient processing due to cirrhosis can result in weakness and weight loss.

    7. Hepatic encephalopathy: A damaged liver may fail to effectively remove toxins from the blood, leading to their accumulation in the brain and causing mental confusion and difficulty concentrating.

    8. Jaundice: Inadequate bilirubin removal by the diseased liver results in jaundice, characterized by yellowing of the skin and eyes and darkened urine.

    9. Bone disease: Some individuals with cirrhosis experience decreased bone strength and are at a higher risk of fractures.

    10. Increased risk of liver cancer: Many individuals who develop liver cancer have underlying cirrhosis.

    11. Acute-on-chronic cirrhosis: This complication, characterized by multiorgan failure, is observed in some individuals with cirrhosis. However, its precise causes remain unclear.

When to see the doctor

    Schedule a consultation with your healthcare provider if you experience any of the symptoms mentioned earlier.

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