Medical condition characterized by poor functioning liver due to replacement of healthy liver tissue by scar tissue is termed as Cirrhosis. Cirrhosis symptoms develop due to gradual blocking of blood supply to the liver by the scar tissue. Disease generally develops due to increased alcohol consumption, infection with Hepatitis C virus, fatty liver, blocking of bile duct, repeated heart failure with fluid accumulation in liver and any other injury causing damage to the liver. Inherited diseases such as glycogen storage diseases, cystic fibrosis and deficiency of the liver enzyme antitrypsin also result in cirrhosis. Not all people who drink excessively develop cirrhosis. Few people develop the disease as a reaction to certain prescription drugs or due to increased exposure to environmental toxins.
Symptoms of Cirrhosis
Various processes carried out by the liver such as detoxification and substances secreted such as bile play crucial role in maintaining a healthy body. Hence, any damage to liver tissue impairing normal functioning results in serious complications. In the initial stages of cirrhosis termed as compensated cirrhosis body functions continue to proceed normally despite of scarring of the liver tissue. Cirrhosis symptoms may or may not be present. Serious complications develop as the scarring progresses. Second stage of cirrhosis is termed as decompensated Cirrhosis.
Early cirrhosis symptoms
- Delayed processing of hormones, nutrients, drugs and other toxins.
- Slower anabolic reactions such as production of proteins and other substances.
- Bleeding in either the esophagus or stomach.
- Reduced or complete loss of sex drive.
- Changes in menstruation cycle in women due to impaired hormone secretion and their metabolism.
- Enlargement of spleen.
- Loss of appetite.
- Weight loss.
- Yellowing of skin and white portion of the eye.
- Itchy skin.
- White colored stools with blood due to reduced secretion of bile.
- Brownish tint in the urine.
Complications of Cirrhosis
- Edema: As cirrhosis gets worse kidney starts to retain water and salts in the body. These accumulated salts and water initially get deposited in the legs and ankles due to gravity. As the condition becomes severe more of these salts and water are retained in the abdominal region. Edema develops in the abdominal region causing swelling and discomfort of the abdomen.
- Spontaneous bacterial peritonitis: Accumulation of fluids in the abdomen increases the risk for bacterial infections of the abdomen. It is very complicated and may even cause death. It is generally characterized by symptoms such as fever, abdominal pain, diarrhea and chills. However, few patients remain asymptomatic.
- Variceal bleeding: Blockage in the liver increases pressure in the veins of esophagus and stomach. When the pressure becomes very high the veins rupture resulting in Variceal bleeding.
- Hepatic encephalopathy: Damaged liver fails to process the toxins which get accumulated in the body. When the accumulated toxins such as ammonia enter the bloodstream they reach the brain and exert toxic effects on brain. As a result brain functioning starts to cease resulting in confusion, reduced ability to concentrate and irritability. It may also cause the person to enter in to coma and finally death.
- Hepatorenal syndrome: Poor functioning of the liver results in accumulation of toxins. These toxins in turn reduce the functioning of the kidneys, a condition termed as Hepatorenal syndrome. Kidneys start to function normally if the diseased liver is replaced successfully.
Other complications that develop due to cirrhosis include loss of muscle mass, breast enlargement in men, diabetes, increased bleeding, diabetes, change in blood cell counts and liver cancer.
Treatment of Cirrhosis
Mild form of cirrhosis is repaired by liver without any loss in functioning of the organ. However, chronic liver cirrhosis cannot be treated. Treatment aims at preventing further liver damage and regulation of cirrhosis symptoms. Diagnosis of the disease and initiation of treatment prevents complications. Liver transplantation is the last measure used to treat cirrhosis and associated complications. However, it is a very expensive procedure with limited success.
To confirm the case of cirrhosis the doctor may perform few tests along with general physical examination. A cirrhotic liver generally swells and will be felt irregular rather than smooth to touch. In an attempt to replace the damaged cells healthy liver cells divide repeatedly and form clusters of new cells under the scar tissue. These clusters result in Irregularity of the liver when touched. Blood tests, CT scan and ultrasound scanning may be performed to know the presence of any other liver disease. In few cases laparoscopy and liver biopsy are done to examine the liver.
Treatment plan is made depending on the extent of liver damage, complications and the underlying cause. If cirrhosis is due to viral infection then drugs are used to control Hepatitis B or C virus. For patients addicted to alcohol, treatment aims at controlling alcohol intake. Natural antioxidants such as S-adenosylmethionine can be taken to promote liver ability to get rid of toxins. It even helps to normalize secretion of certain liver enzymes and bilirubin.
Treating cirrhosis complications
- Fluid accumulation: To bring edema under control, physician may recommend taking low sodium diet and reduce the fluid intake. Diuretics, drugs that increase excretion of salts and water can also be used. Surgical procedures are used if fluid buildup cannot be controlled with low sodium diet and drugs. Through surgery accumulated fluid is drained to reduce pressure.
- Rupture of blood vessels due to increased pressure: In the initial stages of bleeding drugs such as propanol may be used to control bleeding. Stent may be placed in the portal veins if necessary to reduce pressure buildup and prevent severe bleeding.
- Antibiotics and appropriate medications are used to treat infections.
- Hepatic encephalopathy is controlled by giving lactulose. It prevents the intestines from forming ammonia and hence, reducing ammonia levels in the blood stream.
Measures to be taken to regulate cirrhosis symptoms after diagnosis of the disease
- Intake of balanced diet and a daily dose of multivitamins especially the fat soluble vitamins D and K as diseased liver fails to absorb them.
- Stop drinking alcohol to improve the condition to some extent.
- Do not take any drugs without doctor’s advice as certain prescription medicines such as aspirin and ibuprofen can further irritate the liver. Non steroidal anti inflammatory diseases worsen kidney and liver functioning.
- Reduce sodium intake in diet to prevent fluid accumulation in legs and abdomen.
- To reduce the risk of infections follow the immunization schedules.
- Take regular checkups for the presence of enlarged veins in the abdomen and liver cancer.
- If autoimmune hepatitis is observed then take measures to suppress immune system and prevent further liver damage.