Liver is one of the most vital organs of the body. It performs numerous functions like detoxification of metabolites, protein synthesis and production of biochemicals necessary for digestion. It is the only organ in the body, which can regenerate itself.
When there is an injury to the liver, its tissue tries to repair itself. During long-term illness or continuous injury, regeneration of liver tissues is incomplete and scar tissues start to develop. This buildup of scarred tissues in the organ leads to liver cirrhosis. These scarred tissues are unable to perform functions of normal tissue. According to the American Liver Foundation, liver cirrhosis is a life-threatening, irreversible disease.
Liver continues to function almost properly in the early stages of cirrhosis. Gradually, the scar tissue replaces healthy tissue, making the organ lumpy and hard, leading to liver failure.
A small percentage of people having liver cirrhosis develop liver cancer.
Liver cirrhosis is considered to be the 7th leading cause of death in the U.S. and the 3rd most-common cause for deaths of adults in the age group of 45-60 years. Men have 50% more chances of developing liver cirrhosis than women. It affects more than half malnourished chronic alcoholics in the world. In the U.S., it is estimated to kill approximately 31,000 people annually.
Depending on the causes of liver cirrhosis, it can be classified into following types:
Laennec’s Cirrhosis: In this, cirrhosis generally occurs due to chronic alcoholism. It is the most common form of liver cirrhosis and occurs in about 30-50% of the cirrhotic patients.
Biliary Cirrhosis: It arises from a slow, progressive injury to the bile ducts, which causes obstruction to the flow of bile and bile toxins.
Postnecrotic Cirrhosis: It is characterized by destruction of the whole lobules of liver along with the collapse of reticular framework, leading to formation of scars. It results from different types of hepatitis.
Pigment Cirrhosis: It arises in patients suffering from hemochromatosis, i.e., too much iron in the body.
Cardiac Cirrhosis: It is caused due to failure of the right side of heart.
Idiopathic Cirrhosis: Idiopathic cirrhosis occurs due to unknown reasons.
Liver cirrhosis does not show any symptom in the early stages of disease. It can only be detected in routine health check up. As the diseases progresses, following symptoms can be experienced:
There are two stages of liver cirrhosis: compensated and decompensated.
People, who are at a risk of developing liver cirrhosis are:
Age and gender also play a vital role in developing liver cirrhosis. Women between the age groups of 35-60 years are at a high risk of developing primary liver cirrhosis, whereas men in the age group of 30-40 are at a higher risk.
If you observe swollen and tender abdomen along with jaundice, changes in urine and stool color, irritated skin, increased nausea and vomiting along with fluid retention in the body, then there is a chance you might have liver cirrhosis. If you observe changes in your appetite along with confusion and drowsiness, then you should seek medical advice.
However, these symptoms are also indicative of other conditions like hepatitis, hypothyroidism or Crohn’s disease, which can only be diagnosed correctly by a doctor.
Following are the factors that can cause liver cirrhosis:
Other Causes:
While trauma or short-term injuries to the liver do not cause cirrhosis, it is only prolonged damage to liver cells that leads to cirrhosis.
The only way to prevent liver cirrhosis is to diagnose liver damage and take necessary steps to stop further deterioration of the organ
Following steps might be taken to prevent liver damage:
1) Decreased Alcohol Consumption: Alcohol-related liver cirrhosis occurs due to heavy intake of alcohol for ten years or more. Women, who indulge in heavy drinking are more likely to develop liver cirrhosis than men.
2) Protection Against Hepatitis: Hepatitis, caused by virus, leads to liver inflammation and damage. These infections in their chronic forms result in liver cirrhosis. Vaccination can be an option for people, who are at a high risk of developing the hepatitis infections.
3) Monitoring Diet: Fatty buildup in the liver can cause NASH, which might lead to cirrhosis.
4) Physical Exams: People living in areas, where hepatitis B and C are common, should have regular check-ups and be screened for cirrhosis.
Following tests are performed to diagnose liver cirrhosis:
Family and medical history is taken into consideration as the foremost thing for diagnosing liver cirrhosis.
Physical examination is performed to diagnose cirrhosis. A patient’s body is examined physically, and the sound from his abdomen is heard using a stethoscope. The medical health provider looks out for signs of hardness of liver or for presence of ascites, which might cause the abdomen to enlarge.
Blood test might be performed to analyze levels of liver enzyme and blood cell counts. It can be used to find the reason for liver cirrhosis like whether it is caused due to an infection of hepatitis B or C. It is also used for measuring the severity of cirrhosis by measuring the level of bilirubin (indicates the amount of bile pigment in the blood), creatinine (indicates the kidney function), and the international normalized ratio (determines the blood’s ability to clot).
These results are collectively used to calculating Model for End-stage Liver Diseases (MELD) score. It is used to predict 90-day survival rate of patients having an end-stage liver disease. It also determines whether the patient is eligible for liver transplant.
Imaging tests are used to determine the signs of advanced liver cirrhosis, such as deformities on liver surface, splenomegaly and gastric varices. It also helps in determining signs of complications like ascites and liver cancer.
It is used to create the image of the organ using sound waves to examine the liver.
In this test, X-rays and computer technology are used to create images of liver. For the test, the patient is made to drink a solution and an injection of a special dye is given to the patient.
In this test, images of liver are created using radio waves and magnets. It produces detailed image of a person’s liver.
It this test, ultrasound or MRI is used to determine stiffness of liver occurring due to scar tissue formation. It helps in determining the severity of scarring and its progression.
In this test, a tissue from the patient’s liver is taken and analyzed for damage. It is used to confirm liver cirrhosis.
In this test, a thin, flexible tube with a camera at its end is introduced through the patient’s mouth into his stomach. The images captured of esophagus and stomach are analyzed for swollen veins or varices, which indicate cirrhosis.
In the early stages of cirrhosis, treatment is aimed at slowing down the progression of disease. In the later stages, the treatment aims at managing the complications. The patient might even require hospitalization.
Treatment includes the following:
People with chronic alcoholism are suggested to stay away from alcohol or substance abuse as both are known to cause liver damage.
Patients suffering from cirrhosis should be vaccinated against hepatitis A and B as infection from any of these viruses can cause worsen the condition. Liver cirrhosis patients should be screened for hepatitis C as well.
Hepatitis B and C can be cured in some cases by using antiviral medicines. Auto-immune hepatitis is cured by using corticosteroids, that suppress the immune system. Hemochromatosis and Wilson diseases can be cured if they are detected in early stages. Liver diseases arising due to blockage or loss of bile ducts can be cured by prescribing ursodiol (UDCA) which is a nontoxic bile acid which can be taken orally. It replaces the toxic bile acids produced in the liver due to blockage of bile ducts.
Itching and Abdominal Pain: Itching and pain in the abdomen can be managed by taking medicines which help in relieving these symptoms. However, these should only be taken under medical supervision.
Liver cirrhosis does not show symptoms in the initial phases. Regular health check-ups is hence required for early diagnosis. Lifestyle changes, such as abstinence from alcohol and substance abuse should be done. People suffering from chronic alcoholism might require assistance to completely give up alcohol. People with a high risk of developing liver cirrhosis should take care of their liver and try to minimize the risk factors responsible for liver damage.
Over-the-counter medication is strictly prohibited in patients with liver cirrhosis. Any medication should be taken only under medical supervision.
For self-managing the disease, lifestyle changes should be employed. This may involve abstinence from alcohol and substance abuse along with prevention from viral hepatitis. Healthy diets should be taken, and weight should be managed effectively. Obese patients must try to achieve a healthy body mass index (BMI).
Patients suffering from liver cirrhosis should try to cleanse their liver regularly. Following foods can be included in the diet that helps in naturally detoxifying the liver:
Following are the liver-supporting vegetables:
Following supplements can be taken that help liver to produce proper bile and enzymes:
Liver cirrhosis is an irreversible condition that can be prevented by following a healthy lifestyle and protecting oneself from hepatitis-causing viral infections. Alcohol consumption should be monitored, and substance abuse should be avoided. People, who indulge in heavy intake of alcohol, should get their liver checked at regular intervals, so that liver damage can be diagnosed at an early stage. Weight management should be done by obese people.
Academician, Shelly's rich experience as an academic and research professional speaks volume. Her fields of interest are genetics, biotechnology and drug research. Shelly keeps herself abreast with latest scientific researches all around the globe and loves to write about the same.
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