Cirrhosis of the Liver

Located in the upper right side of the abdomen, the liver weighs about three pounds and is one of the largest organs in the body. Cirrhosis is a condition that occurs when chronic diseases cause the liver to become permanently scarred and injured. The scar tissue that is formed can harm the structure of the liver, blocking bloodflow throughout the organ and slowing down the processing of nutrients, drugs, hormones, and toxins. This also can inhibit the production of proteins that are need for the body to function properly. 

What are the major causes?

cirrhosisCirrhosis is the 11th leading cause of death by disease in the U.S. Half of these cases are due to alcoholism. It can also be caused by hepatitis (types B, C and D) or from indirect injury caused by inflammation or obstruction to the bile ducts. Cirrhosis can also be caused by cystic fibrosis, Wilson’s disease, and galactosemia, however this is less common. 

In babies, the most common cause of cirrhosis is from blocked bile ducts caused by biliary atresia. This disease causes bile to back up in the liver.

How is Cirrhosis Diagnosed?

The doctor typically diagnoses cirrhosis from symptoms and lab tests. A doctor may perform a physical exam or a CAT scan or ultrasound so that they can take pictures of the liver. A biopsy is another way to determine if cirrhosis is present.

What are the Treatments of Cirrhosis?

The goal in treating cirrhosis is to stop scar tissue from developing in the liver and to prevent future complications. Patients must avoid all substances, habits and drugs that cause damage to the liver. This means abstaining from alcohol and not taking some non-prescription drugs such as acetaminophen or vitamin A which can precipitate liver failure. Raw seafood, which often contains some dangerous bacteria, should also be avoided. A patient with cirrhosis is also at risk of contracting other infection that may be more severe than they would be in healthy patients. Immunizations for hepatitis A and B, influenza and pneumococcal pneumonia are also administered.

How are the Complications of Cirrhosis Treated?

An abnormal accumulation of fluid that causes swelling in the ankles (edema) and abdomen (ascites) can occur. Thus, it is recommended that patients reduce the amount of fluid and salt in their diet or use drugs called “diuretics” to mobilize and excrete fluid through the kidneys. When the liver is unable to efficiently cleanse the body of toxins and drugs, the mental state of patients may change dramatically and lead to coma, which is called Hepatic Encephalopathy. To treat this complication, protein is reduced in the diet, laxatives are used, and sedatives/pain meds are avoided.

Another complication is bleeding that can occur in the esophagus or stomach because of abnormal veins. This is a life-threatening emergency that could lead to hospitalization. This type of bleeding is usually controlled by the use of an endoscope to inject clotting agents in the veins.

Liver failure is one of the extreme complications of cirrhosis. It is the end stage of liver disease and survival is limited. Anyone who has complications from cirrhosis are considered to be at risk for developing liver failure. If matters become too severe, your gastroenterologist may recommend a liver transplant to avoid liver failure.

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