Being the largest internal organ of our body and the body’s metabolic factory, the liver performs essential body functions: bile production, chemical detoxification, drug metabolism, blood coagulation factors’ production, and glycogen synthesis. Cirrhosis is a condition in which the liver cells deteriorate and fail to function due to chronic injuries. Though the liver cells have immense potential to regenerate, due to severe damage and scar tissue (scarring of the liver cells is known as fibrosis) regeneration becomes impossible. Liver shrinkage will prevent the nutrient-rich blood flow into liver and cause portal hypertension followed by bursting and bleeding of esophageal varices.
Besides excessive alcohol abuse, a wide range of diseases and conditions can cause liver cirrhosis. Over the years Chronic Hepatitis C (caused by viral infection where liver becomes inflamed, swollen and damaged) can lead to liver cirrhosis. In a condition called nonalcoholic fatty liver disease (NAFLD), fat builds up in the liver and cause damage to liver cells. Other possible causes of liver cirrhosis include:
1. Autoimmune diseases
2. Inherited disorders of sugar metabolism
3. Hemochromatosis (Iron buildup in the body)
4. Cystic fibrosis
5. Poorly formed bile ducts
6. Wilson’s disease (Copper accumulation in the liver)
7. Hardening and scarring of the bile duct
8. Drugs, toxins, and infections
9. Cardiac cirrhosis
In the initial stages, patients with liver cirrhosis may or may not have symptoms; but with the advancement of the scarring and liver damage, the symptoms become more evident. Some of the common symptoms are,
1.Jaundice due to bilirubin accumulation
3. Ascites (fluid accumulation in the abdomen)
4. Loss of appetite
6. Weight loss
7. Edema (swelling due to fluid buildup in ankles, feet or legs)
8. Spider angiomas (spider-like blood vessels)
Diagnosis of liver cirrhosis involves:
1.Liver function test- checks the level of bilirubin and liver enzymes
2.Kidney Function test - checks the creatinine level as the kidney function may decline in the advanced stage of liver cirrhosis.
3.Ultrasound, MRI, and CT scan to look for internal damages
4.Liver Biopsy - to identify fibrosis and scarring
5.Laparoscopy - A tiny camera inserted through a small hole made in the stomach to view the liver clearly.
6.Tests for Hepatitis B and C
7.Blood coagulation test - INR (International Normalized Ration) is checked to evaluate the blood clotting time.
Treatment options are decided based on the underlying causes and extent of progression of the disease. Early stage treatment aims at slowing down the progression of tissue scarring. Some treatment methods are:
Self-care at home involves, 1. Treatment for alcoholism
2. Avoid medications harmful to liver
3. Eat balanced diet
4. Weight loss programs
The doctor may suggest the following to medications to treat the underlying causes.
5. Low sodium diet and medication to prevent excess fluid accumulation in the body
6. Over-the-counter medications
7. Beta-blocker to lower the portal hypertension
8. Diuretics to remove excess body fluids
9. Vitamin supplements
10. Eradicate hepatitis B and hepatitis C virus by using anti-viral medication
11. Surgical procedures to bring back the blood flow
12. Lactulose and a low protein diet
Advanced stages of liver cirrhosis are irreversible; hence liver transplantation is the last resort when other treatments fail.