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What is Cirrhosis?

Cirrhosis, also called hepatic cirrhosis or liver cirrhosis, is an end-stage liver disease. This disease replaces healthy tissue with scar tissue known as fibrosis. It starts growing and stops the liver from functioning normally. Cirrhosis can be fatal if it progresses to the point where the liver malfunctions.

Alcohol misuse, fatty liver, biliary illness, chronic hepatitis, and other diseases can all lead to liver cirrhosis. The scarring makes the liver less capable of performing its regular functions. Additionally, cirrhosis causes the liver to become "stiff," which lowers blood flow to the liver and causes portal hypertension. Due to varices, dilated blood vessels that can potentially burst can cause an enlarged spleen, ascites, and serious gastrointestinal (GI) bleeding.

If liver cirrhosis progresses to an advanced state, the damage to the liver is irreversible. Although cirrhosis is often permanent, it's indeed treatable.

Cirrhosis Disease

Cirrhosis Symptoms

Depending on the extent of the liver cirrhosis symptoms may include:

When to see a doctor?

Call your general practitioner if you notice the liver cirrhosis symptoms. The doctor will suggest certain liver tests and if you do have liver problems the doctor will refer you to a gastroenterologist or hepatologist for further treatment.

What are the causes of Cirrhosis?

Liver cirrhosis can result from liver damage brought on by a variety of illnesses and conditions. Among the causes are:

  • Chronic viral hepatitis
  • Iron buildup in the body
  • Fatty liver
  • Copper in the liver
  • Cystic fibrosis
  • Alpha-1 antitrypsin deficiency
  • Poorly formed bile ducts
  • Genetic digestive disorder
  • Inherited disorders of sugar metabolism
  • Destruction of the bile ducts
  • Liver disease caused by your body's immune system
  • Hardening and scarring of the bile ducts
  • Infection, such as syphilis or brucellosis
  • Chronic alcohol abuse
  • Medications, including methotrexate or isoniazid

What are the stages of Liver Cirrhosis?

Liver Cirrhosis can be classified into four stages, each representing different levels of severity and damage to the liver.

  • Stage-1 (Steatosis): This initial phase involves inflammation of the bile duct or liver, often causing abdominal discomfort. If untreated, it can lead to further liver damage. However, symptoms and inflammation at this stage are usually treatable, helping to prevent disease escalation.
  • Stage-2 (Fibrosis): Scarring of the liver begins due to inflammation. Many individuals may not realize they have liver disease until Stage II or III, as initial symptoms can go unnoticed. Treatment can still aid in liver recovery and slow down disease progression.
  • Stage-3 (Cirrhosis): Represents a significant advancement, where healthy liver tissue is replaced by scar tissue, leading to permanent damage. The liver becomes hard and lumpy, impairing its function and causing complications like portal hypertension and spleen enlargement.
  • Stage-4 (Liver Failure): Also known as hepatic failure, this stage indicates severe impairment of liver function, requiring immediate medical intervention to prevent fatal outcomes.

Risk factors

Liver cirrhosis risk factors are:

  • Chronic liver disease (B and C)
  • Infections caused by bacteria, fungi, or parasites
  • Excessive alcoholism
  • Smoking
  • Unsterilised needles for body piercings and tattoos
  • A fatty liver condition
  • Autoimmune diseases such as primary sclerosing cholangitis, autoimmune hepatitis, and primary biliary cirrhosis.
  • Rare hereditary or genetically based diseases like Wilson's disease and hemochromatosis
  • Unprotected sexual intercourse
  • Diabetes
  • Obesity
  • High levels of triglycerides in blood

Other risk factors can include

  • Gender : Women are more prone to develop liver cirrhosis than males.
  • Age : People between the ages of 30 and 60 are often more vulnerable to experiencing liver disorders.
  • Genetics : A person's likelihood of developing liver disease increases if they have close relatives who have the condition.

Complications

Without medical care, liver cirrhosis can result in some potentially fatal consequences, like as

  • Bleeding from constricted blood vessels in the stomach or oesophagus.
  • Fluid accumulation in the abdominal cavity (Ascites ).
  • Contamination of the abdominal cavity's fluid
  • Liver failure
  • Brain dysfunction
  • Osteoporosis

Diagnosis of Cystic Fibrosis

CF cannot be prevented. However, genetic testing should be done in a couple with CF or a sick relative. The genetic test can determine the risk of CF in a child by examining a sample of blood or saliva from each parent. Women can also test if she is pregnant and is worried about the baby's risk.

Prevention

Take care of the liver to lower the chance of developing cirrhosis.

  • Do not drink alcohol if you have cirrhosis : If you have cirrhosis, you should not consume alcohol. Those who have liver disease but do not have cirrhosis should see their doctor about whether they should consume alcohol at all.
  • Eat a healthy diet : Eat a balanced diet that is plant-based and rich in fruits and vegetables. Choose lean protein sources and healthy carbohydrates. Reduce your intake of fried and fatty meals. Coffee with caffeine may offer protection against liver cancer and fibrosis.
  • Maintain a healthy weight : Having too much body fat might harm the liver. If you are obese or overweight, discuss a weight-loss strategy with the doctor.
  • Reduce the risk of hepatitis : Hepatitis B and C risks are increased by sharing needles and engaging in unprotected sex. See your doctor for hepatitis vaccines.

Diagnosis

One or more of the imaging tests listed below may be carried out if the doctor suspects patients have cirrhosis:

  • Abdominal computed tomography (CT) scan
  • Abdominal ultrasound
  • Elastography
  • Magnetic resonance imaging (MRI)
  • Magnetic resonance cholangiopancreatography

Other tests include :

  • Biopsy
  • Liver function test

Cirrhosis Treatment

The best course for treating liver cirrhosis depends on what caused it, what symptoms patients are now experiencing, and how far the condition has advanced. Medication, dietary modifications, and surgery are all forms of treatment.

Cirrhosis Medication

The doctor may prescribe certain drugs, including beta-blockers or nitrates, depending on the cause of the cirrhosis (for portal hypertension). Additionally, they can suggest taking antibiotics or other drugs to cure hepatitis.

Lifestyle changes

  • The doctor may suggest to stop drinking if the cirrhosis is caused by alcohol consumption.
  • Additionally, if they believe it is medically required, they could advise patients to lose weight.
  • A low-sodium diet could also be suggested if you have ascites.

Citations

https://www.niddk.nih.gov/health-information/liver-disease/cirrhosis
https://en.wikipedia.org/wiki/Cirrhosis
http s://www.nhs.uk/conditions/cirrhosis/
https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/cirrhosis
https://britishlivertrust.org.uk/information-and-support/living-with-a-liver-condition/liver-conditions/cirrhosis/
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Frequently Asked Questions

Is liver cirrhosis a stage that leads to death?

Yes, cirrhosis can be very serious and even fatal if untreated. It occurs when the liver is damaged and replaced by scar tissue, potentially leading to complications such as liver failure or severe bleeding.

What is the life expectancy for someone with cirrhosis of the liver?

It's tough to pinpoint because it varies based on factors like the cause and severity of cirrhosis, and whether it's treated. Serious cirrhosis can shorten life without good care, but with proper treatment, including a liver transplant, people can live longer and healthier lives.

How severe is stage 4 cirrhosis of the liver?

Stage 4 cirrhosis is critical, with severe liver damage causing issues like fluid buildup, confusion, and yellowing skin. Without proper care, it can lead to liver failure, but treatment such as medication or a liver transplant can improve the situation.

Can cirrhosis be cured?

Cirrhosis itself is generally irreversible, but the underlying causes can be managed to prevent further progression. Treating the underlying cause, such as stopping alcohol consumption or managing viral hepatitis, can improve the outlook and quality of life.

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