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All you Need to Know about Cirrhosis of the Liver
Cirrhosis of the liver refers to a fatal condition where scar tissue slowly replaces healthy liver cells. This disease develops gradually over years, and when there is excess scar build-up, the liver stops functioning completely.
When your liver is injured, it repairs itself by forming scar tissue that causes the liver to fail when it builds up in excess.
The scar tissue inhibits blood flow in the liver and impairs the liver’s ability to process hormones, nutrients, and medication. Cirrhosis of the liver is caused by other liver diseases and it develops from chronic hepatitis, nonalcoholic fatty liver disease, and fatty liver disease.
Liver cirrhosis cannot be reversed, but when it is detected early, multiple treatment options can keep the problem in check.
Signs and Symptoms of Liver Cirrhosis
The symptoms of cirrhosis are very rare during the early stages. However, as the scar tissue continues to accumulate, the liver’s ability to function normally is undermined. Here are some of the symptoms of liver cirrhosis.
- Personality changes
- Dizziness, confusion, and fatigue
- Increased heartbeat
- Difficulties processing alcohol and drugs
- Loss of body mass, especially in the upper arms
- Fluid buildup on feet, ankles, and legs
- Problems processing alcohol and drugs
- Hair loss
- Increased susceptibility to bruising and bleeding
- Frequent fevers higher risk of infections
- Yellowish skin, whitish eyes, and tongue
- In men, low sex drive, testicular atrophy, and breast enlargement
- In women, loss of periods not related to menopause
- Spider-like blood vessels in the skin
- Brownish or orange color of the urine.
However, keep in mind that you might not get all the symptoms above and some of these symptoms are signs of other health conditions. If you notice any of these symptoms often, you should seek fast medical attention.
Causes of Liver Cirrhosis
There are multiple diseases and health conditions that lead to liver cirrhosis. Mostly, it develops as a result of another liver complication. If you don’t treat the main cause of your liver cirrhosis, it will get worse gradually and the healthy liver cells will be damaged completely.
It is crucial to know the main cause of your cirrhosis so that you can have the right treatment and prevent the condition from getting worse.
Here are the most common causes of liver cirrhosis:
Non-alcoholic fatty liver disease
If you have obesity r excess weight, your chances of having fatty liver disease are high. If your liver cirrhosis is caused by non-alcoholic fatty liver disease, you have to lose weight, control your blood sugar levels, and maintain a healthy lifestyle.
Alcohol Abuse
If you have a problem with alcohol abuse, it is essential to get help. Alcohol has a lot of calories and toxins that build up in the liver and kidneys, making the organs struggle when functioning. Alcohol harms your liver and when it becomes a habit, it leads to serious health complications.
Therefore, you should talk to your doctor or go for some therapy sessions.
Hepatitis B and C
Hepatitis B and hepatitis C can be serious when they are left unmanaged. There are medicines for this disease that stop the damage from happening to your liver.
Some other conditions that cause liver cirrhosis include:
- Iron buildup in the body
- Wilson’s disease (too copper accumulation in the liver)
- Cystic fibrosis
- Alpha-1 antitrypsin
- Poorly formed bile ducts
- Genetic digestive disorder
- Primary biliary cirrhosis (destruction of bile ducts)
- Infects, such as brucellosis and syphilis
- Scarring and hardening of bile ducts
- Bad reaction to certain medications.
Stages of Liver Cirrhosis
Having cirrhosis means the healthy liver cells in the liver have been replaced by scar tissue. If you have liver cirrhosis, your doctor will tell you which stage you are in. Depending on how your liver is working, your doctor will tell you whether the stage is compensated or decompensated.
1. Compensated Cirrhosis
When you have compensated cirrhosis, it means you have cirrhosis but the symptoms are not yet noticeable. In this stage, the liver can function well because there are healthy cells left to replace the damaged cells and scar tissue. Many people survive in this stage until the symptoms start showing.
2. Decompensated Cirrhosis
When your cirrhosis reaches this stage, it means your condition has completely worsened and the symptoms are noticeable. In decompensated cirrhosis, there is too much damage to the liver. Healthcare providers diagnose this cirrhosis stage based on physical, history, and laboratory findings.
When you have decompensated cirrhosis, you will notice the following signs and conditions:
Bleeding Varices:
Having varices means you have enlarged blood vessels. The signs of bleeding are tarry, bloody, and blacky stools or sometimes throwing up blood. If you notice these symptoms, you should get immediate treatment.
Ascites:
When you have this condition that occurs when fluids collect in spaces within your abdomen. Other than the abdomen, the fluid build-up can move into your chest and surround your lungs, where this is life-threatening.
The best way to control this condition is to eat a low-salt diet and water pills prescribed by your doctor.
Jaundice:
Jaundice is a critical condition that occurs when the liver is not able to get rid of bilirubin. Bilirubin is a yellowish bile pigment made during the breakdown of red blood cells. Jaundice can be caused by gallstones, hepatitis, and tumors. When you have jaundice, your skin and eyes can become yellow.
Hepatic Encephalopathy:
This is a nervous system disorder caused by severe liver disease and complications. When your liver doesn’t function well, toxins build up in the blood and travel to the brain. This makes you feel tired, confused, and find it hard to do daily activities.
When the episodes of hepatic encephalopathy develop rapidly, it can cause permanent brain damage. So, it is important to seek medical attention when you notice the symptoms.
Diagnosis
In it’s early stages, liver cirrhosis is hard to notice, but as it progresses, the symptoms become noticeable. Cirrhosis is diagnosed when you are being tested for another disease or condition. If you notice the following symptoms, you should seek immediate medical attention:
- Shortness of breath
- Dark or tarry stools
- Fever with shivering
- Vomiting blood or passing blood in your stool
- Episodes of confusion and drowsiness
After going to your doctor, they will examine you and ask about your medical history and lifestyle. Below are some of the tests doctors take:
Imaging test:
Some of the imaging tests of the gallbladder, biliary tract, and liver include radionuclide, ultrasound, computer tomography (CT), X-rays, magnetic resonance imaging (MRI), etc. These tests can help the doctor know whether your liver is enlarged and check for other problems.
Blood test:
Blood tests are meant to show how well your liver is working. For instance, the tests can tell if there is inflammation, liver cell damage, or other abnormalities in the liver. The doctors will check the levels of aspartate aminotransferase (AST) or alanine aminotransferase. (ALT) If the levels are high, you may have hepatitis.
Biopsy:
In this test, the doctor will take a sample of your liver and examine it under a microscope. After the test, your doctor will confirm if you have cirrhosis and if it’s the main cause.
Endoscopy:
In an endoscopy test, a long, thin tube with a light and video camera is inserted. The tube end goes through the esophagus and into the stomach. Your doctor will look for varices or swollen blood vessels. If there are any present, this can be a sign of liver cirrhosis.
Treatment
When liver cirrhosis is diagnosed early, you can reduce the damage by treating the underlying cause or complications that arise. The treatment of liver cirrhosis depends on how your liver is damaged. There are different methods and medications that can be used to control this complication. Check them below:
Treat Alcohol Dependency
If your liver-cirrhosis was caused by long-term, heavy alcohol consumption, you need to stop taking alcohol or regulate it. Treating alcohol dependency will save you from other serious health complications and prevent liver damage.
Doctors recommend treatment programs for treating alcohol dependency and they are helpful when followed consistently.
Lose Weight
Excess weight is one of the causes of fatty liver disease which leads to liver cirrhosis. Being obese increases your risk of diabetes, high blood pressure, and stroke. If your cirrhosis is caused by fatty liver disease, you should try to lose weight and live a healthy lifestyle.
Medications
If your liver cirrhosis is in the early stages, medications can help slow down further damage to the liver. If your problem is caused by hepatitis B or hepatitis C, your doctor will prescribe drugs that will control liver cell damage.
However, you should only take medications prescribed by your doctor because some medications can worsen the condition.
Control Portal Vein Pressure
An increase in portal vein pressure occurs when there is increased pressure in the vein that carries blood from the digestive organs to the blood. Liver cirrhosis is the main cause of portal vein pressure, but it can also be caused by thrombosis.
There are some drugs that are prescribed to control the pressure in the blood vessels. If you notice blood in your stools or vomits, you may have esophageal varices which require urgent medical attention.
Here are some other things you can do to treat liver cirrhosis:
- Ensure you take all your doctor’s appointments
- Get shots for pneumonia, flu, hepatitis A and B
- Ask for your doctor’s advice before taking over-the-counter drugs, such as ibuprofen, aspirin, and acetaminophen
- Normalize washing your hands often
- Ensure you are always hydrated
- Eat a low-salt diet and high-protein diet
- Take a water pill (diuretic) to manage ascites
- Ensure you take constipation medicines as prescribed.
Complications
Cirrhosis is a critical health condition and if it is left untreated, it leads to life-threatening complications. The complications include:
Swelling in the abdomen and legs
Portal vein hypertension causes fluid to accumulate in the legs (edema) and in the abdomen (Ascites). Still, edema and ascites can be caused by the liver’s inability to produce enough blood proteins, such as albumin.
You can treat the conditions with a low-salt diet. When it has reached severe levels, the fluid has to be drained repeatedly and surgery can be needed.
Portal hypertension
Portal hypertension occurs when there are swollen and large veins in the stomach and esophagus. The swollen veins increase pressure in the portal vein that takes blood from the spleen and bowel to your liver. When varices rupture, they cause blood clotting and blood loss.
Bleeding
When the portal vein is under pressure, the blood is redirected to smaller veins. The small veins are strained by excess pressure and they burst, leading to bleeding.
Still, portal high blood pressure can lead to enlarged veins in the stomach and esophagus, leading to life-threatening bleeding.
If your liver is not healthy enough to make sufficient clotting factors, severe bleeding will continue.
Hepatic Encephalopathy
This means there is build-up of toxins in the brain. When you have liver cirrhosis, it becomes hard for the liver to eliminate toxins from the blood. These toxins build up in your bloodstream and travel to your brain.
This causes confusion and poor concentration. When liver cirrhosis is not treated, hepatic encephalopathy advances to unresponsive coma.
Infections
For most individuals with cirrhosis, their bodies are very poor in resisting and fighting infections. For instance, ascites lead to bacterial peritonitis, abdominal pain, hepatorenal syndrome, and hernias.
Some other liver cirrhosis complications include:
- Malnutrition
- Jaundice increases the risk of liver cancer
- Bone disease.
Prevention
The best way to prevent liver cirrhosis is to live a healthy lifestyle. Some of the lifestyle changes that can help include:
Limit alcohol consumption
Excess alcohol consumption causes the liver to swell and gradually, it leads to cirrhosis. The damage caused to your liver by alcohol doesn’t happen overnight. It can be as a result of at least 10 years or more of excess drinking.
For women who are into heavy drinking, they are at a higher risk of cirrhosis than men.
To lower the risks of getting liver cirrhosis, you should take alcohol moderately. For men, you can take at least two bottles a day and 1 beer for women. After drinking, make sure you stay hydrated so that your liver will find it easy to flush out the toxins.
Watch what you eat
Eating foods with unhealthy and excess fats leads to fatty build up in the liver. Excess fat build up causes nonalcoholic steatohepatitis (NASH) that leads to liver cirrhosis.
NASH is highly linked to coronary artery disease, diabetes, obesity, and high cholesterol.
Eating a healthy diet and maintaining a healthy weight will help lower the chances of developing liver cirrhosis and NASH.
Stay hepatitis-free
Hepatitis is an infection that causes inflammation in the liver. Mostly, end-stage hepatitis B and hepatitis C cause cirrhosis. Hepatitis B can be passed from one person to another through body fluids. Hepatitis C is caused by blood contact and if you have hepatitis C, you are at a higher risk of liver cirrhosis.
If you want to lower the chances of getting hepatitis, you should do the following:
- Avoid unprotected sex
- Don’t share needles when injecting drugs
- Avoid getting your tattoos or piercings from unclean environments.
Here are other ways that can help prevent cirrhosis:
- Quit smoking alcohol
- Go for regular medical checkups
- Exercise regularly
- Get vaccinated against hepatitis B
- Avoid anti-inflammatory drugs.
In nutshell, liver cirrhosis cannot be reversed once it reaches the decompensated stage. However, prevention is the best treatment that can help reverse cirrhosis and prevent further damage. If you are at higher risk of liver cirrhosis, you should talk to your doctor about prescriptions and the available treatment options.