Did you know that liver diseases including cirrhosis of the liver can affect anyone at any age starting from infants to the adults?
Moreover, you can be having a liver disease without even knowing because there may be no symptoms as such.
This guide will share a detailed overview about the cirrhosis of the liver starting from what it is to its symptoms as well as its treatment.
So, let’s start right away!
What is Cirrhosis of The Liver?
The severe scarring of the liver as well as poor functioning of the liver mostly during the terminal stages of the chronic liver disease is known as liver cirrhosis.
The scarring most often results from the long-term exposure to the toxins which include viral infections or excessive intake of alcohol.
Liver is one of the most vital organs of your body which is located in the upper right side of the abdomen below your ribs.
It plays various essential body functions which mostly include:
- Producing bile that helps in the absorption of dietary fats, vitamins A, E, D and K as well as cholestrol
- Storing vitamins as well as sugar for the body usage
- Helps in the purification of blood by removing certain toxins such as bacteria as well as alcohol from your system
- Creating certain proteins that help in the process of blood clotting
According to the National Institutes of Health (NIH), cirrhosis is one of the leading cause of death in US.
Moreover, it is more likely to affect men.
How Does Cirrhosis Develop?
The liver serves the function of regenerating the liver cells that have been damaged.
Usually, cirrhosis develops when the resulting factors (like, chronic viral infections) are present for a long duration of time and eventually lead to the damage of the liver.
Moreover, when this happens, there are the chances of liver becoming injured as well as scarred.
The liver having scar tissue doesn’t function properly and it ultimately results in cirrhosis.
Cirrhosis also causes the liver to become hard and it shrinks at the same time.
This makes it pretty hard for the nutrient-rich blood to flow from the portal vein into the liver.
Therefore, when the blood in unable to pass into your liver, the pressure in the portal vein starts to rise.
This eventually results in a very serious condition which we call as hypertension, which results in the high blood pressure inside the vein.
Moreover, there are unfortunate consequences of portal hypertension which include high-pressure system leading to a backup.
This eventually lead towards the esophageal varices such as, varicose veins which can further bleed as well as burst.
Causes of Cirrhosis of The Liver
The most common causes that lead to cirrhosis in the US include:
- Long-term hepatitis C infection
- Chronic alcohol abuse (over the course of 10 to 12 years)
- Exposure to blood having infection (through contaminated needles)
- Rigorous standards of blood bank screening can also cause cirrhosis
- Exposure to other blood products
- Exposure to blood infection through piercing, tattooing and needle sharing
- Hepatitis B can also lead to the inflammation of liver as well as damage that can lead to cirrhosis
- Hepatitis D can also become the cause of cirrhosis. It’s usually seen in people who have hepatitis B already
- Inflammation as a result of autoimmune disease which may have a genetic reason. As per an estimate, about 70% of people having autoimmune hepatitis are women.
- Damage to the ducts of bile which usually help in draining the bile such as, primary biliary cirrhosis
- Disorders that affect the ability of the body to handle copper as well as iron (such as, Wilson’s disease as well as hemochromatosis)
- Certain medications mostly including over-the-counter medicines as well as prescription like antibiotics, acetaminophen as well as certain anti-depressants can also lead to cirrhosis
- Fatty liver disease NAFLD can worsen to cirrhosis and liver failure.
Liver Cirrhosis Symptoms
The symptoms of cirrhosis occur because the liver is unable to purify your blood, break down the toxins, produce clotting proteins, and help with absorption of fats as well as fat-soluble vitamins.
Often there are no symptoms until the disorder has progressed. Some of the symptoms include:
- decreased appetite
- small spider-shaped arteries underneath the skin
- nose bleeds
- jaundice (yellow discoloration)
- weight loss
- itchy skin
Moreover, the other serious symptoms also include:
- abdominal swelling (ascites)
- confusion and difficulty thinking clearly
- swelling of the legs (edema)
- gynecomastia (when males start to develop breast tissue)
Stages of Cirrhosis
The stages of the liver cirrhosis are almost three.
Cirrhosis is graded on the scale which is called the Child-Pugh score in the following manner:
- A: Relatively mild
- B: Moderate
- C: Severe
Doctors further classify cirrhosis as either:
Compensated cirrhosis means that your liver can function in a normal manner despite any damage.
Furthermore, a liver with decompensated cirrhosis can’t perform its functions in a correct manner and usually leads to severe symptoms.
Usually, rather than being defined in terms of the stages, cirrhosis is most often seen as a final and last stage of the liver disease.
Diagnosis of Cirrhosis of the Liver
The diagnosis of cirrhosis usually begins with taking a detailed history as well as physical examination.
Moreover, your healthcare expert will take your thorough medical history.
The history might reveal that the exposure to hepatitis C, having a family history of autoimmune diseases as well as long-term intake of alcohol as well as other risk factors.
The physical examination can show certain signs such as:
- Yellow eyes (jaundice)
- Hand tremors
- Pale skin
- Enlarged spleen or liver
- Redness in your palms
- decrease in the level of consciousness
- Decrease in alertness
Tests may also reveal the extent of damage that has been done to your liver.
Some of the tests that we use for the evaluation of cirrhosis include:
- Liver function tests
- Coagulation blood tests (in order to see how quickly blood clots)
- Alpha fetoprotein (a screening for liver cancer)
- Complete blood count (for the purpose of revealing anemia)
- Albumin (in order to test for the protein in your liver)
Other than that, there are additional tests for the purpose of evaluating liver and mostly include:
- CT scan of abdomen
- Ultrasound scan of your liver
- Upper endoscopy (to check for esophageal varices)
- MRI of the addomen
- Liver biopsy
Moreover, the liver biopsy is considered to be the definite test for cirrhosis.
Treatment of Cirrhosis
The treatment procedure for cirrhosis varies on the basis of the causes as well as the extent of progression.
Some of the treatment procedures your doctor may prescribe include:
- Banding procedures (that are used for the purpose of controlling blood from the esophageal varices)
- Nitrates or beta blockers (for portal hypertension)
- Intravenous antibiotics (for treating peritonitis that may occur with ascites)
- Lactulose as well as a diet having low protein (for the purpose of treating encephalopathy)
- Hemodialysis (for the purpose of purification of blood)
- Lactulose as well as a low protein diet (in order to treat encephalopathy)
If all else fails, then we have the option of liver transplantation as a last resort.
All the healthcare experts highly recommend to stop the consumption of alcohol.
Medications, even the ones over-the-counter, shouldn’t be taken without a consultation with your doctor.
How to Reduce The Chances of Cirrhosis?
It is very important for the patients to stop drinking in case their cirrhosis was caused as a result of long-term and regular consumption of alcohol.
Moreover, in many cases, the doctors will be recommending a treatment program for treating the dependency of alcohol.
How to Control Pressure in the Portal Vein?
Blood can back up in the portal vein that usually supplies blood to the liver leading to high blood pressure in the portal vein.
Drugs are most commonly prescribed for the purpose of controlling the increasing pressure in your blood vessels.
The sole aim is to prevent the severe bleeding that may result from it.
Signs of bleeding can be easily detected through the procedure of endoscopy.
Moreover, if the patient vomits blood or passes stool having blood, they most probably have esophageal varices.
In such cases, urgent medical aid is often required.
The following procedures may then help:
- Injection sclerotherapy
- A Sengstaken-Blakemore tube having a balloon
- Transjugular intrahepatic portosystemic stent shunt (TIPSS)
Complications From Cirrhosis
If your blood doesn’t pass through your liver, it can create a backup through the other veins like those in the esophagus.
This backup is also known as esophageal varices.
These veins aren’t built for the purpose of handling high pressures.
These also begin to bulge from the extra flood flow.
Other complications mostly include:
- Kidney failure
- Bruising (due to the low platelet count as well as poor clotting)
- Bleeding (resulting from low clotting proteins)
- Liver cancer
- Sensitivity towards certain medications
- Insulin resistance as well as type 2 diabetes
- Hepatic encephalopathy
- Increase in the size of spleen
- Edema as well as ascites
- Esophageal varices
It is important to prevent cirrhosis to save yourself from the complications.
For that purpose it is recommended that all the infants as well as the adults at high-risk must have a vaccination against hepatitis B.
Moreover, quitting drinking as well as intake of the balanced diet can also help preventing cirrhosis.
Furthermore, getting adequate amount of exercise can also prevent or slow down the process of cirrhosis.
WHO reports that around 20 to 30 percent of the people infected as a result of hepatitis B will develop liver cancer or the cirrhosis.
Moreover, the NIH reports that around 5 to 20 percent of the people who are infected with hepatitis C will be developing cirrhosis over the time period of 20-30 years.
This pretty much sums all about cirrhosis, its causes, symptoms, treatment as well as the precautionary measures you may take to prevent it.
We, at Dr. Amal Al Qedrah also offer the services of individual laboratory tests which covers the liver tests as well.
For more updates as well as related information, stay tuned to our website Dr. Amal Al Qedrah.