What is
cirrhosis?
This is a chronic liver disease in which there is extensive
scarring of the liver and the liver cells are replaced by fibrous
tissue (cirrhosis in Greek, means a hard, brown liver). This
results in a progressive deterioration of liver function and
ultimately death.
What are the causes?
Excessive intake of alcohol over a prolonged period is the leading
cause of cirrhosis. In India, viral infections of the liver
(hepatitis - particularly hepatitis B and C) and disorders of bile
drainage due to obstruction in bile flow may also cause cirrhosis.
What are the symptoms?
Initially the symptoms may be vague, like weakness, weight loss,
indigestion, nausea and loss of interest in sex. Later features of
liver cell failure appear. These include jaundice, vomiting blood,
impotence, breast development in males and swelling all over the
body.
The increased collection of fluid in the body is due to a decrease
in body proteins. The veins in the oesophagus (food pipe) are
engorged due to increased pressure in the vein carrying blood to
the liver. When these engorged veins burst, blood is lost in the
vomit. Clotting of blood is also retarded because the factors
responsible for clotting are not produced in sufficient quantities
by the liver. The failing liver also is unable to remove poisonous
products that accumulate in the body and affect the brain leading
to drowsiness and, later, unconsciousness (liver encephalopathy).
How is it diagnosed?
The doctor will advise blood tests to determine the functional
status of the liver (Liver function tests - LFTs). Other tests may
be necessary to establish the underlying cause of cirrhosis. A
liver biopsy may be `necessary to confirm the presence of
cirrhosis. The biopsy is performed by piercing the liver with a
needle and through this needle taking a small piece of the liver
for examination. This procedure can be safely done without
anaesthesia with minimum discomfort to the patient.
How is it treated?
Cirrhosis is an irreversible change in the liver. It can and
should be prevented by restricting alcohol intake or by using
anti-virus medicines like lamivudine, interferon and ribavarin.
Once cirrhosis has set in, the complications and ultimate liver
failure can be delayed by a good balanced diet, adequate vitamin
supplementation, avoiding further insult to the liver and adequate
rest. Endoscopic therapy to prevent bleeding from engorged veins
in the food pipe has become an important treatment in the effort
to prolong life. However, once there are features of end stage
liver failure, the only treatment available is liver
transplantation where the diseased organ is replaced by a normally
functioning liver from a brain-dead or a live donor.
Cirrhosis of the Liver
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