Cirrhosis is the twelfth leading cause of death by disease. Cirrhosis is a disease that causes the liver to slowly deteriorate and malfunction due to the chronic injury. When there is an injury in the liver the scar tissue replaces healthy liver tissue. This partially blocks the flow of blood through the liver. Because of the scarring the functions of the liver is greatly affected. Some of the crucial functions of the liver that are affected are, controlling infections, removing bacteria and toxins from the blood, processing nutrients, hormones, and drugs, making of proteins that regulate blood clotting and produce bile to help absorb fats including cholesterol and fat-soluble vitamins.
Even though a healthy liver is able to regenerate most of its own cells when they become damaged but with end-stage cirrhosis, the liver can no longer effectively replace damaged cells. In such a condition a liver transplant surgery may be necessary to replace the unhealthy liver with a healthy liver.
There are various causes for cirrhosis. Some of the common causes of liver cirrhosis are heavy alcohol consumption, chronic hepatitis C, liver diseases, infections, toxins etc.
Alcohol-Related Liver Disease : Not everybody who consumes alcohol suffer with damage to the liver. Damage to liver is caused due to heavy alcohol use over several years. The amount of alcohol it takes to damage the liver varies greatly from person to person.
Chronic Hepatitis C : The hepatitis C is the infection of the liver caused by hepatitis C virus. Hepatitis C virus is spread by contact with an infected person’s blood. Chronic hepatitis C causes inflammation and damage to the liver over a period of time. This can lead to cirrhosis.
Chronic Hepatitis B : Caused by hepatitis B virus, the hepatitis B is a liver infection that is spread by contact with an infected person’s blood, semen, or other body fluid. Like hepatitis C, hepatitis B causes inflammation of the liver and injury that can lead to cirrhosis.
Chronic Hepatitis D : Hepatitis D is another virus that infects the liver and can lead to cirrhosis. Hepatitis D occurs only in people who already have hepatitis B.
Nonalcoholic Fatty Liver Disease (NAFLD) : The fat build up in the liver can eventually cause cirrhosis. A Nonalcoholic fatty liver disease is associated with obesity, diabetes, protein malnutrition, coronary artery disease, and corticosteroid medications.
Autoimmune Hepatitis : This form of hepatitis is caused when the body’s immune system starts attacking liver cells and causes the inflammation and damage to the liver. This can eventually lead to cirrhosis.
Diseases that Damage or Destroy Bile Ducts : There are some diseases that can damage or destroy the ducts that carry bile from the liver. This causes bile to back up in the liver, which may over a period of time might lead to cirrhosis.
Inherited Diseases : Some inherited diseases like Cystic fibrosis, alpha-1 antitrypsin deficiency, hemochromatosis, Wilson disease, galactosemia, and glycogen storage diseases can result in cirrhosis.
Drugs, Toxins, and Infections : Drug reactions, prolonged exposure to toxic chemicals and parasitic infections can also lead to cirrhosis.
- Weight loss
- Abdominal pain and bloating when fluid accumulates in the abdomen
- Spiderlike blood vessels on the skin
- Loss of appetite
Complications may arise over a period of time as the condition of the liver starts deteriorating. Some of the common complications are as follows.
- Edema and Ascites
- Portal hypertension
- Esophageal varices and gastropathy
- Sensitivity to medications
- Hepatic encephalopathy
- Insulin resistance and type 2 diabetes
- Liver cancer
Cirrhosis may also increase the risk of infection. This is because cirrhosis can cause immune system dysfunction and can also cause kidney and lung failure, known as hepatorenal and hepatopulmonary syndromes.
The diagnosis of liver cirrhosis is done in the following ways.
- Physical examination, Risk Assessment and Medical history taking by the doctor,
- Blood tests as prescribed by the doctor, and
- Imaging-Computerized Tomography (CT) scan, Ultrasound, Magnetic Resonance Imaging (MRI), or Liver Scan
- Liver biopsy (sometimes if required)
The treatment options available to treat cirrhosis focus on slowing the progression of scar tissue in the liver and preventing or treating the complications of the disease.
Treatment option used for cirrhosis depends on the cause of the disease and whether complications are present.
If the patient has cirrhosis with serious complications then hospitalization may be required.
- A healthy diet is important in all stages of the disease since malnutrition is common in people with cirrhosis.
- People with cirrhosis are encouraged not to consume any alcohol or illicit substances, as both will cause more liver damage.
- Oral antibiotics may be prescribed to prevent infection. Severe infection with ascites will require intravenous (IV) antibiotics.
- The doctor may prescribe a beta-blocker or nitrate for portal hypertension. Beta-blockers can lower the pressure in the varices and reduce the risk of bleeding.
- Medications are given to treat various symptoms of cirrhosis, such as itching and abdominal pain.
- Liver Transplantation when complications cannot be controlled by treatment.
Liver transplant and Liver Cirrhosis
The doctors may consider a liver transplantation surgery is considered when the complications arising due to liver cirrhosis cannot be controlled by treatment.
In a Liver transplantation surgery, the diseased liver is removed and replaced with a healthy one from an organ donor. It is major surgery. Over a period of time due to improvement in the immunosuppressant drugs and the follow-up care the survival rates have improved.