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Cirrhosis: Treatment, symptoms, advice and help

About cirrhosis

Cirrhosis is a serious disease of the liver which is a multifaceted organ located in the abdomen and performs varied functions. The normal liver is responsible for synthesis of clotting factors, metabolism of fat, carbohydrates, nutrients and hormones, storage of glycogen (energy source), detoxification of drugs, controlling infections and much more. Liver cirrhosis may result from several causes of which chronic alcoholism and chronic viral hepatitis are the commonest. This results in irreversible replacement of normal liver tissue with scarred tissue, which leads to its functional impairment.

Cirrhosis: Incidence, age and sex

Cirrhosis of the liver may be commonly seen in individuals who are chronic alcoholics. It is most frequently seen in middle aged individuals with a higher propensity towards men. It is rarely encountered in children.

Signs and symptoms of cirrhosis: Diagnosis

The clinical symptoms of liver cirrhosis generally appear late in the course of disease. Most of the symptoms are vague and non-specific and include feeling of tiredness, nausea, loss of appetite and weight loss. Further progression of the disease may manifest with features like yellowish discolouration of the skin and whites of the eye, called jaundice along with excessive itching all over the body. This itching is a result of deposition of bile products under the skin. Liver damage may result in inadequate synthesis of clotting factors which may exhibit as easy bruising or frequent nose bleeds. Some individuals may also have spider web shaped blood vessels on the skin which is a sign of portal hypertension. Moreover liver damage may impair detoxification of drugs in body resulting in decreased tolerance to medications.

A detailed history including risk factors and a comprehensive physical examination by a specialist may point towards the diagnosis of cirrhosis. However certain blood tests or imaging modalities may be needed in some individuals to establish the diagnosis.

Causes and prevention of cirrhosis

There are several disorders which have been observed to cause liver cirrhosis of which chronic alcoholism and chronic viral hepatitis are the most common.

Other causes include fatty liver seen in obese and diabetic individuals or primary biliary cirrhosis. Some hereditary disorders like Haemochromatosis, Wilson’s disease, Cystic fibrosis and Glycogen storage disease may also result in scarring of the liver tissue. Biliary atresia, characterised by occlusion of bile ducts is a congenital disorder responsible for liver cirrhosis in babies.

Cirrhosis: Complications

Liver cirrhosis is a grave condition which if ignored may result in potentially fatal complications. The most common and earliest complication is ascitis which results from excess retention of fluid in the abdomen and lower limbs. This may get infected with bacteria leading to a life threatening condition called peritonitis which is a surgical emergency.

Accumulation of toxic materials in brain can cause hepatic encephalopathy manifesting with memory loss, abnormal sleep patterns and personality changes. This may progress to hepatic coma and death. Other health concerns include excessive bleeding, portal hypertension, gall stones, enlargement of spleen and rarely liver cancer.

Cirrhosis: Treatment

This disorder which causes scarring of the liver tissue is an irreversible and incurable condition. The treatment aims to provide symptomatic relief and prevent further deterioration of the disease. The first step in treatment is to detect the underlying cause of cirrhosis and manage it. For example, strict abstinence from alcohol is needed in chronic alcoholism or removal of excess metal deposition (iron, copper) is mandatory in Haemochromatosis and Wilson’s disease. Individuals with viral hepatitis are managed with interferons. Healthy and nutritious diet is essential in patients with cirrhosis. Other medications like diuretics or beta blockers are advised in instances of ascitis or portal hypertension. Liver transplant may be considered in individuals where cirrhosis and its complications are not being controlled in spite of medications and appropriate diet.