About Liver Cirrhosis :
What is liver cirrhosis?
In simple words, liver cirrhosis is a chronic disease related to the liver because it takes a long time to occur and it starts with the accumulation of fat in the liver. When fat starts accumulating in the liver, it causes liver damage. This damage caused to the liver due to fat is known as fatty liver. In this condition the liver becomes tighter than normal and this condition continues.
Once a person is diagnosed with fatty liver, the journey to liver cirrhosis begins, which may take up to 10 years. During this, if there is any injury or swelling in the liver, then due to this the problem of liver fibrosis occurs. Liver fibrosis is the next stage of fatty liver.
After liver fibrosis occurs, the liver tissue starts repairing the defect in the liver. During this, scar tissue or scar tissue is formed in the liver. Gradually, this scar tissue starts destroying or replacing healthy tissue and partially blocks the blood flow to the liver. When this happens in the liver, it causes the healthy cells of the liver to die, resulting in a decline in liver function. During this, the scar tissue continues its work.
When this continues for a long time, it causes liver damage which is known as liver damage or liver cirrhosis. Fibrosis is the first stage of liver damage, as liver damage begins from here. If you get rid of fatty liver or fibrosis liver on time, then the liver does not get damaged. If this is not done then due to this the patient not only has to face serious conditions but may also have to undergo liver transplant. Apart from this, due to this serious disease, the life of the patient can also be lost.
What are the symptoms of liver cirrhosis?
In case of liver cirrhosis, its symptoms are not visible in the beginning. Its symptoms appear when this serious disease has increased a lot. The appearance of symptoms of liver cirrhosis means that the liver is no longer able to do its work or it is now able to do very limited work as compared to before.
As the scar tissue accumulates and due to this when the liver is not able to function properly, the following symptoms appear:-
fatigue
insomnia
itchy skin
loss of appetite
body weight loss
Nausea
pain or tenderness in the area where the liver is located
red or blotchy palms
weakness
Blood capillaries become visible on the skin of the upper abdomen.
As the problem of liver cirrhosis increases, along with these symptoms, other symptoms also appear: -
• fast heartbeat
• personality change
• Confusion
• dizzy
• bleeding gums
•Weakness of the body and upper arm
• Difficulties in processing drugs and alcohol
• Swelling of the ankles, feet and soles
• hair fall
• High susceptibility to injury
• Jaundice- During this, the skin and eyes of the patient become yellow, along with this the color of the eyes and tongue also starts changing.
• loss of sex drive
• memory problems
• Swelling in the upper abdomen
recurrent fever
• increased risk of infection or serious infection
muscle cramps
• nose bleeding)
• Right shoulder pain
• shortness of breath on sitting,
• stool becomes black or very pale
being constipated
• dark colored urine
• vomit blood
• Problems with walking and running
• abdominal bloating
• thinning of the skin
• itchy skin,
When the patient starts seeing the above symptoms due to liver cirrhosis, it means that now the physical condition of the patient has worsened and he needs to seek treatment as soon as possible. If the treatment is not received quickly, then the life of the patient can also be lost.
What is the cause of liver cirrhosis?
Following are the common causes of liver cirrhosis:-
• long term alcohol use
• Hepatitis B and C infection
• Fatty liver disease
• Toxic metals
• genetic disease
Let us tell you that hepatitis B and C together are considered to be the main cause of cirrhosis. Let us know in detail about the causes of liver cirrhosis below.
Regularly drinking a lot of alcohol:
Toxins including alcohol are broken down by the liver when we drink alcohol. However, if the amount of alcohol consumed is too high, the liver has to work beyond its capacity, which eventually damages the liver cells. Heavy, regular, long-term drinkers are more likely to develop cirrhosis than other healthy people. Typically, it takes at least 10 years of heavy drinking for cirrhosis to develop. Alcohol-induced liver disease generally has two phases:
Fatty Liver Fatty Liver:
Fatty liver Fatty liver: In this, fat is formed in the liver.
Alcoholic Hepatitis:
Alcoholic hepatitis: This occurs when liver cells become inflamed.
Hepatitis -
Hepatitis C is a blood-borne infection that can damage the liver and eventually lead to cirrhosis. Hepatitis C is a common cause of cirrhosis in Western Europe, North America, and many other parts of the world. Cirrhosis can also be caused by hepatitis B and D.
Non-alcoholic steatohepatitis (NASH) :
Non-alcoholic steatohepatitis (NASH), in its early stages, begins with an accumulation of too much fat in the liver. The fat produces inflammation and scarring, which can result in possible cirrhosis later on. Obese people, people with diabetes, people with high blood fat, and people with high blood pressure are more likely to develop NASH.
Autoimmune hepatitis :
The person's own immune system attacks healthy organs in the body as if they were foreign substances. Sometimes the liver gets attacked. Eventually, the patient may develop cirrhosis.
Genetic conditions :
There are some inherited conditions that can lead to cirrhosis, including:
Hemochromatosis Hemochromatosis:
Hemochromatosis Hemochromatosis: Iron gets deposited in the liver and other parts of the body.
Wilson's disease :
Wilson 's disease: Copper gets deposited in the liver and other parts of the body.
Obstruction of bile ducts:
Due to some serious conditions and diseases, the bile ducts become obstructed, due to which the risk of cirrhosis increases. These serious conditions and diseases mainly include cancer of the bile ducts, or cancer of the pancreas.
Budd-Chiari syndrome:
This condition causes blood clots in the liver vein, the blood vessel that carries blood to and from the liver. This leads to enlargement of the liver and development of collateral vessels.
Other diseases and conditions that may contribute to cirrhosis include:
Cystic Fibrosis.
Primary sclerosing cholangitis, or hardening and scarring of the bile ducts.
• Galactosemia, or the inability to process the sugar in milk.
• Schistosomiasis, a parasite commonly found in some developing countries.
Biliary atresia, or badly formed bile ducts in infants.
Glycogen storage diseases, or problems with the storage and release of energy, are critical to cell function.
Stages of liver cirrhosis:
Cirrhosis is graded on a scale called the Childs-Pugh Score as follows:
relatively light
medium
severe
Doctors also classify cirrhosis as compensated cirrhosis and decompensated cirrhosis.
Compensated Cirrhosis:
Compensated Cirrhosis : This is the asymptomatic stage. There may still be scarring on the liver, but it hasn't progressed far enough to cause many, or any, symptoms.
Decompensated cirrhosis:
Decompensated Cirrhosis: This is the stage where most of the symptoms like jaundice or ascites appear. This is a very serious condition. In some situations, if you are able to manage what caused the cirrhosis to begin (for example, heavy drinking), you may be able to revert your diagnosis back to compensation.
What are the complications of liver cirrhosis?
Cirrhosis can lead to a number of other conditions, some of which are life-threatening. These include:
Ascites or edema:
Ascites or Edema: When there is ascites, there is a build-up of fluid in the abdomen, and edema is a build-up of fluid in the legs. They can be treated with a low-salt diet and water-reducing pills. In severe cases, the fluid may have to be drained repeatedly. Sometimes surgery is needed.
Varicose and Portal Hypertension Varicose and Portal Hypertension:
Varis and Portal Hypertension Varis and Portal Hypertension: These are large, swollen veins in the esophagus and stomach. This can increase the pressure in a blood vessel called the portal vein that carries blood from the spleen and bowel to the liver. They are prone to rupture, which can lead to severe blood loss and clot formation.
Hepatic encephalopathy:
Hepatic Encephalopathy: This refers to high levels of toxins in the blood where the liver is no longer filtering them all successfully.
hepatocellular carcinoma:
Hepatocellular carcinoma: This is the most common type of liver cancer. It is the third leading cause of cancer mortality worldwide.
Hepatopulmonary syndrome (HPS) :
Hepatopulmonary syndrome (HPS) : Doctors define HPS as a combination of liver disease, dilated blood vessels in the lungs, and abnormalities in the exchange of gases. It has been linked to an increase in the death rate of people waiting for a liver transplant.
Coagulation Disorders:
Coagulation disorder: Cirrhosis can cause problems with blood clotting, which can lead to potentially fatal bleeding and clots.
During this, the following problems are also likely to occur-
malnutrition
kidney failure
• Liver cancer Liver cancer
sensitivity to drugs (changes in the way the liver processes drugs in the body)
• Gallstones (obstruction to the flow of bile can cause bile to harden and form stones)
Diagnosis of liver cirrhosis:
We talked about above that the symptoms of liver cirrhosis are rarely seen, so the diagnosis of liver cirrhosis is often made when the patient is being tested for some other condition or disease.
If you are suffering from the symptoms of liver cirrhosis mentioned above as well as the symptoms given below, then you should immediately talk to the doctor:-
fever with chills
• Difficulty in breathing
vomit blood
• Dark or tarry stools
episodes of drowsiness or confusion
If you have these symptoms, your doctor may ask you more questions, such as whether you drink alcohol or take any medicines. Apart from this, you may be asked about whether you have ever been suffering from liver related problems before or the reasons mentioned above can also be taken.
Once the relevant information is obtained, the doctor may suggest you to get the following tests done:-
blood test:
Blood test: This test measures how well the liver is working. If the levels of alanine transaminase (ALT), alanine transaminase (ALT) and aspartate transaminase (AST) are high, the patient may have hepatitis.
Imaging Tests:
Imaging test: An ultrasound, CT, or MRI scan may be used to see if the liver is enlarged and to detect any scars or nodules.
Biopsy:
Biopsy : In this test, a small sample of liver cells is removed and examined under a microscope. A biopsy can confirm cirrhosis and its cause.
Endoscopy :
Endoscopy Endoscopy : The doctor inserts a long, thin tube with a light and video camera on the end down into the esophagus and stomach. Doctors look for swollen blood vessels called varices than can be a sign of cirrhosis.
Treatment of liver cirrhosis:
Once liver cirrhosis is confirmed, doctors start treating it very quickly. But before starting the treatment, doctors keep in mind that due to which the patient has liver cirrhosis? What are the symptoms of liver cirrhosis the patient is experiencing? Most important is that how much liver cirrhosis has increased and because of this the patient has not started having any other physical problems? On the basis of all these, the doctors start treating the liver cirrhosis patient in the following ways: –
Medicines:
Medications : Depending on the cause of cirrhosis, your doctor may recommend certain medications, such as beta-blockers or nitrates (for portal hypertension). Doctors may also recommend antibiotics or medications to treat hepatitis.
Lifestyle Changes Lifestyle Changes:
Lifestyle changes Lifestyle changes: Doctors may recommend that patients lose weight if they consider it medically necessary. If patients are struggling with ascites, a low-sodium diet may also be recommended.
Treatment for alcohol dependence:
Treatment for alcohol dependence : If a patient's cirrhosis is caused by long-term, regular heavy alcohol consumption, it is important for the patient to stop drinking. In many cases, doctors will recommend a treatment program to treat alcohol dependence.
Controlling the pressure in the portal vein:
Controlling pressure in the portal vein: Blood can "back up" in the portal vein that supplies blood to the liver, causing high blood pressure in the portal vein. Medicines are usually prescribed to control increased pressure in other blood vessels. Its purpose is to stop severe bleeding. Signs of bleeding can be detected through endoscopy.
Surgery Surgery :
Surgery Surgery: If the doctor feels that now it is difficult to cure the patient with medicines or with the help of other measures, then such doctors advise them to get liver transplant done. Liver transplant is used as the last resort.
Immediate medical attention in case of esophageal varices:
If the patient vomits blood or passes bloody stools, it is likely that the patient is suffering from esophageal varices during this time. Being an esophageal varice, the patient needs immediate medical attention. Let us tell you that esophageal varices are enlarged veins in the esophagus. These are often caused by obstructed blood flow through the portal vein, which carries blood from the intestine, pancreas, and spleen to the liver. Esophageal varices are abnormal, enlarged veins in the tube that connects the throat and stomach (esophagus). The following procedures can help in immediate medical care during this time:
Banding: A small bandage is applied around the base of the varicose to control bleeding.
Injection Sclerotherapy: After endoscopy, a substance is injected into the veris, which triggers a blood clot and scar tissue to form. This helps in stopping the bleeding.
A Sengstaken-Blakemore tube with a balloon: A "Sengstaken-Blakemore tube" is a tube used in emergency medicine to stop bleeding in a patient's stomach or esophagus. The technique used to place the tube is called balloon tamponade. If endoscopy does not stop the bleeding if liver cirrhosis occurs, the tube is passed down the patient's throat and into their stomach. The balloon is inflated. This puts pressure on the varicose and stops the bleeding.
Transjugular Intrahepatic Portosystemic Stent Shunt (TIPSS) Transjugular Intrahepatic Portosystemic Stent Shunt (TIPSS): If the treatments described above do not stop the bleeding, a metal tube is inserted into the liver to join the portal and hepatic veins, allowing blood to flow through the liver. A new path is formed for him. This eases the pressure that the variety was causing.
There is a possibility of other complications due to liver cirrhosis, which we have already talked about above. In case of complications during this period, the patient can be treated with the following treatments:-
Infection: Antibiotics will be given for any infection the patient may have.
Screening for liver cancer Screening for liver cancer : The risk of liver cancer is very high in patients with cirrhosis. The doctor may recommend regular blood tests and imaging scans. In case of liver cancer, its treatment is started as soon as possible.
Hepatic encephalopathy, or high blood toxin levels: Medicines can help treat excessive blood toxin levels.
Kidney failure Kidney failure: Due to liver cirrhosis, patients often have kidney related problems and there is a possibility of kidney failure. In this case both are treated together.
How can liver cirrhosis be prevented?
By now you have come to know about how serious liver cirrhosis is and how many problems can be faced due to it. So it is best to prevent this disease before it occurs. So if you do not want that you ever come under the grip of any problem or disease related to the liver, then for this you can work on the following measures: -
Stay away from alcohol – If you drink a lot of alcohol then try to stop drinking it or take it only once or twice a month.
Lose weight – If you are very obese, then you should try to reduce your weight, otherwise, due to this you may have fatty liver problem.
Control High Triglycerides and Diabetes – If you are suffering from both these problems then you must keep them under control. If you do not do this, then due to this you may also have fatty liver problem, which can lead to liver cirrhosis in future.
Eat healthy food – Wrong eating habits can lead to liver problems. In such a situation, fresh food should always be taken.
Protect yourself from Hepatitis B and C, for which you can take the following precautions:-
Use condom while having sex.
Do not share injection needles used to do drugs.
Get vaccinated if infected with hepatitis B.
Apart from these measures, you can also consult a doctor for other special measures.