Cirrhosis – What it is, Causes, Symptoms and Treatments

Cirrhosis – What it is, Causes, Symptoms and Treatments  that many are unaware of. Additionally, Cirrhosis is a late stage scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions such as hepatitis and chronic alcoholism . The liver performs a number of necessary functions, including detoxifying toxic substances in your body, cleaning your blood, and producing vital nutrients. Cirrhosis occurs in response to liver damage. Every time your liver is injured, it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function.

Decompensated cirrhosis is the term used to describe the development of specific complications resulting from changes caused by cirrhosis . Decompensated cirrhosis is fatal. Liver damage caused by cirrhosis usually cannot be undone. But if cirrhosis of the liver is diagnosed early and the cause is treated, further damage can be limited and rarely reversed.

The formation of nodules and fibrosis in the liver characterizes a condition of Cirrhosis , a disease commonly associated with excessive alcohol consumption and some diseases, such as hepatitis C and hepatitis B . In a case of cirrhosis , liver cells are destroyed and the organ has its functions compromised or even paralyzed.

Causes of Cirrhosis:  A wide range of diseases and conditions can damage the liver and lead to cirrhosis . The most common causes are:

• Chronic alcohol abuse
• Chronic viral hepatitis ( hepatitis B and C)
• Fat accumulated in the liver ( nonalcoholic fatty liver disease )

Other possible causes include:

• Buildup of iron in the body (hemochromatosis)
• Cystic fibrosis
• Copper builds up in the liver (Wilson’s disease)
• Little known bile biossils (biliary atresia)
• Inherited disorders of sugar metabolism (galactosemia or glycogen storage disease)
• Genetic digestive disorder (Alagille syndrome)
• Liver disease caused by your body’s immune system (autoimmune hepatitis)
• Destruction of the bile ducts ( primary biliary cirrhosis )
• Hardening and scarring of the bile ducts (primary sclerosing cholangitis)
• Infection such as schistosomiasis
• Medicines like methotrexate

Symptoms of Cirrhosis:  Cirrhosis usually has no signs or symptoms until liver damage is extensive. When signs and symptoms do occur, they may include:

• Fatigue
• bleeding easily
• swinging easily
• itchy skin
• Yellow discoloration of the skin and eyes (jaundice)
• Accumulation of fluid in the abdomen (ascites)
• loss of appetite
• Nausea
• swell in your legs
• Weight loss
• Confusion, drowsiness, and slurred speech (hepatic encephalopathy)
• Spiderlike blood vessels on your skin
• Redness in the palms of the hands
• Testicular atrophy in men
• breast augmentation in men

When to See a Doctor:  Make an appointment with your doctor if you have any of the signs or symptoms listed above.

Complications of Cirrhosis:  Complications of Cirrhosis can include: Blood flow-related complications:

• High blood pressure in the veins that supply the liver (portal hypertension). Cirrhosis decreases the normal flow of blood through the liver, thereby increasing pressure in the vein that brings blood from the intestines and spleen to the liver.
• Swelling in the legs and abdomen. Portal hypertension can cause fluid to accumulate in the legs (edema) and abdomen (ascites). Edema and ascites can also result from the liver’s inability to make enough of certain blood proteins, such as albumin.
• Enlargement of the spleen (splenomegaly). Portal hypertension can also cause changes in the spleen. Decreased white blood cells and platelets in the blood can be a sign of cirrhosis with portal hypertension.
• bleeding. Portal hypertension can cause blood to be redirected to smaller veins, causing them to enlarge and become varicose veins. Stretched by the extra load, these smaller veins can burst, causing severe bleeding. Life-threatening bleeding usually occurs when veins sweeping the lower esophagus (esophageal varices) or stomach (gastric varices) rupture. If the liver cannot produce enough clotting factors, this can also contribute to ongoing bleeding. Bacterial infections are a frequent trigger for bleeding. Other complications:
• infections. If you have cirrhosis , your body may have a hard time fighting infections. Ascites can lead to spontaneous bacterial peritonitis, a serious infection.
• malnutrition. Cirrhosis can make it more difficult for your body to process nutrients, leading to weakness and weight loss.
• Buildup of toxins in the brain (hepatic encephalopathy). A liver damaged by cirrhosis is not able to clear toxins from the blood as well as a healthy liver. These toxins can then build up in the brain and cause mental confusion and difficulty concentrating. Symptoms of hepatic encephalopathy can range from fatigue and mild impairment in cognition to unresponsiveness or coma.
• Jaundice. Jaundice occurs when the diseased liver does not remove enough bilirubin, a waste blood product, from your blood. Jaundice causes yellowing of the skin and whites of the eyes and darkening of the urine.
• Bone disease. Some people with cirrhosis lose bone strength and are at greater risk of fractures.
• Increased risk of liver cancer. A large proportion of people who develop liver cancer that forms in the liver itself have cirrhosis.
• Acute and chronic liver failure. Some people end up experiencing a multi-organ failure. Researchers now believe this is a distinct complication in some people who have cirrhosis , but they don’t fully understand its causes.

Diagnosis of Cirrhosis:  People withearly cirrhosis of the liver usually have no symptoms. Often, cirrhosis is first detected through a routine blood test or examination. Your doctor may order one or more laboratory tests that could suggest a problem with your liver, such as cirrhosis . Laboratory tests:

• Liver function. Your blood is checked for excess bilirubin, which is a product of red blood cells breaking down, as well as for certain enzymes that can indicate liver damage.
• Kidney function. Your blood is checked for creatinine, as kidney function may decline in later stages of cirrhosis ( see Decompensated Cirrhosis) . 
• Tests for hepatitis B and C. Your blood is checked for hepatitis viruses.
• Coagulation. Your International Normalized Index (INR) is checked for your blood’s ability to clot.

Your doctor may order imaging tests and other tests to diagnose cirrhosis  again:

• Magnetic resonance elastography or transient elastography. These non-invasive imaging tests detect hardening or hardening of the liver and may eliminate the need for a liver biopsy.
• Other imaging tests. MRI, CT and ultrasound create images of the liver.
• Biopsy. A tissue sample (biopsy) is not necessarily necessary to diagnose cirrhosis . However, your doctor may use it to identify the severity, extent, and cause of liver damage.

If you have cirrhosis , your doctor will likely recommend regular diagnostic tests to monitor for signs of disease progression or complications, especially esophageal varices and liver cancer.

Cirrhosis Treatments:  Treatment for cirrhosis depends on the cause and extent of your liver damage. The goals of treatment are to slow the progression of scar tissue in the liver and to prevent or treat symptoms and complications of cirrhosis . You may have to be hospitalized if you have severe liver damage.

Treating the Underlying Cause of Cirrhosis:  In  early cirrhosis , it may be possible to minimize liver damage by treating the underlying cause. Options include:

• Treatment for alcohol dependence. People with cirrhosis caused by alcohol abuse should stop drinking. If you have cirrhosis , it is essential to stop drinking, as any amount of alcohol is toxic to the liver. If stopping drinking is difficult, your doctor may recommend an alcohol addiction treatment program.
• Weight loss. People with cirrhosis caused by nonalcoholic fatty liver disease may be healthier if they lose weight and control their blood sugar levels. It is important to maintain adequate protein intake when trying to lose weight in the cirrhosis setting .
• Medicines to control hepatitis. Medications can limit further damage to liver cells caused by hepatitis B or C by specifically treating these viruses.
• Medications to control other causes and symptoms of cirrhosis. Medications can slow the progression of certain types of liver cirrhosis . For example, for people with primary biliary cirrhosis (now known as primary biliary cholangitis) that is diagnosed early, medication can significantly slow progression to cirrhosis .

Other medications can relieve certain symptoms, such as itching, fatigue, and pain. Nutritional supplements may be prescribed to combat malnutrition associated with cirrhosis and prevent weak bones (osteoporosis).

Treatment for Complications of Cirrhosis:  Your doctor will work to treat any complications of cirrhosis , including:

• Too much fluid in your body. A low-sodium diet and medication to prevent fluid buildup in the body can help control ascites and swelling. More severe fluid buildup may require procedures to drain the fluid or other interventions to relieve pressure. Sometimes, a small tube — a transjugular intrahepatic portosystemic shunt (TIPS) — is placed into the vein inside the liver to reduce blood pressure in the liver and slow the rate of fluid accumulation.
• Portal hypertension.Certain blood pressure medications can control the increased pressure in the veins that supply the liver (portal hypertension) and prevent severe bleeding. Your doctor will perform an upper endoscopy at regular intervals to look for enlarged veins in your esophagus or stomach (varicose veins) that may bleed. If you develop varicose veins, you will likely need medication to reduce your risk of bleeding. If you are unable to tolerate medication and have signs that your varicose veins are bleeding or are likely to bleed, you may need a procedure (bandage ligation) to stop the bleeding or reduce your risk of further bleeding. In severe cases, a TIPS may be placed into a vein within the liver to reduce blood pressure in the liver and to prevent further bleeding.
• infections. You may receive antibiotics or other treatments for infections. Your doctor will also recommend flu, pneumonia, and hepatitis shots.
• Increased risk of liver cancer. Your doctor will recommend blood tests and ultrasound tests every six months to look for signs of liver cancer.
• Hepatic encephalopathy. You may be prescribed medications to help prevent toxins from building up in your blood due to poor liver function.

Liver Transplant:  In advanced cases of cirrhosis , when the liver stops working, a liver transplant may be the only treatment option. People often need to consider this option when they develop symptoms of cirrhosis , such as jaundice, significant fluid retention (ascites), bleeding varices, hepatic encephalopathy, kidney dysfunction, or liver cancer. A liver transplant replaces your liver with a healthy liver from a deceased donor or with part of a liver from a living donor. Cirrhosis is the most common reason for a liver transplant.

Liver transplant candidates undergo extensive testing to determine if they are healthy enough to have a good outcome after surgery. In addition, transplant centers typically require some period of alcohol abstinence for people with alcohol-related liver disease before they can receive transplants.

Future Future Treatments:  Scientists are working to expand current treatments for cirrhosis , but success has been limited. As cirrhosis has numerous causes and complications, there are many possibilities of approach. A combination of increased screening, lifestyle changes and new medications can improve outcomes for people with liver damage if started early. It may be possible in the future to lessen or even reverse the fibrosis that leads to cirrhosis , depending on the cause of the fibrosis. Some people who have received successful hepatitis C treatment or hepatitis B medication may have improvement in fibrosis.

Alternative Medicine:  A number of alternative medicines have been used to treat liver disease. Milk thistle (silymarin) is the most used and best studied. Other herbs used include licorice root (glycyrrhiza), schisandra and astragalus.

However, there is not enough evidence of benefit from clinical trials to recommend the use of any herbal product to treat liver cirrhosis . In addition, herbal medicines account for an increasing percentage of reported cases of drug-induced liver injury. Talk to your doctor if you’re interested in trying alternative medications to help you deal with cirrhosis.