CIRRHOSIS OF LIVER : DEFINITION, STAGES, CAUSES, SYMPTOMS AND MORE

WHAT IS CIRRHOSIS?

Cirrhosis is a chronic (long lasting) liver disease and in this a healthy tissue of liver is replaced by a scar tissue. It is also a late stage liver disease as the scar that is formed damages the liver permanently.

As liver is a regenerative organ, every time there is a damage to the liver, the liver repairs itself by forming tough scar tissue. When these tough scar tissues become too much on the liver, the organ’s functions are damaged.

Cirrhosis is a type of disease that worsens over a period of time majorly because of chronic alcoholism. Usually the damage caused to the liver cannot be cured, but if the disease is caught at an early stage, there are chances for the disease to get cured.

 

STAGES OF LIVER CIRRHOSIS

There are basically four stages of liver cirrhosis. But as cirrhosis is already a late stage of liver disease, before cirrhosis there a few more stages of liver disease.

Stages of liver diseases that eventually lead to cirrhosis:

• In the initial stages of liver disease, the inflammation of liver takes places (if this inflammation is due to viral infection, it is known as hepatitis.
• If the initial stage of inflammation is left untreated, it leads to another stage of liver disease that is known as scarring or fibrosis. If treatment is done at proper time, this stage can be cured.
• If the scarring stage is left untreated, then it leads to a late stage liver disease that is liver cirrhosis. When the liver comes at this stage, it is almost impossible for the liver to get cured.

Stages of liver cirrhosis

Stage 1

• This stage of liver cirrhosis comes with very few symptoms
• At this stage some scarring (fibrosis) of the liver can be seen
• In this stage there are no specific complications
• This stage is also considered as compensated cirrhosis

Stage 2

• This stage of cirrhosis comes with worsening portal hypertension
• In this stage the development of varices takes place

Stage 3

• In this stage the swelling in the abdomen and advanced liver scarring develops
• Stage 3 is marked as decompensated cirrhosis
• In this stage liver failure is possible

Stage 4

• This is almost the last stage of cirrhosis and is life threatening
• In this stage people usually develop an end stage liver disease (ESLD)
• End stage liver disease is fatal and usually requires a transplantation

 

SYMPTOMS OF LIVER CIRRHOSIS

The symptoms of liver cirrhosis occur because the liver is not able to do its functions like break down of toxins, purification of blood, production of clotting proteins, absorption of fats and fat – soluble vitamins, etc. properly. Usually there are no noticeable symptoms in the initial stages. Over a period of time as the disease progresses, the symptoms become noticeable. Some of the common symptoms are listed below :

• Bleeding of nose
• Weight loss
• Itching on the skin
• Weakness
• Spider shaped veins under the skin
• Jaundice (yellowing of skin and eyes)
• Loss of appetite
• Feeling of nausea
• Swelling of legs, feet or ankles (known as edema)
• Accumulation of fluid in the abdomen (ascites)
• Redness in the palms
• Irregular menstrual cycle in females
• Loss of sex drive, gynecomastia (breast enlargement), testicular atrophy in males
• Confusion
• Drowsiness
• Slurred speech (hepatic encephalopathy)
• Impotence
• Urine discoloration
• Enlarged spleen

 

CAUSES OF LIVER CIRRHOSIS

As cirrhosis itself is a late stage liver disease, it is very clear that it is caused as a result of other liver diseases. If the exact cause of liver cirrhosis is not treated at proper time, the liver may lose its function permanently.

To get treated with the right treatment at the right time, the exact cause of cirrhosis has to be known, below listed are some of the causes that eventually lead to liver cirrhosis :

• Alcohol abuse
• Fatty liver disease (non – alcoholic )
• Hepatitis B
• Hepatitis C
• Hemochromatosis that is iron build up in the body
• Cystic fibrosis
• Wilson’s disease (accumulation of copper in the liver)
• Biliary atresia (poor formation of bile ducts)
• Antitrypsin alpha – 1 deficiency
• Galactosemia
• Glycogen storage disease
• Alagille syndrome (genetic digestive disorder)
• Autoimmune hepatitis ( liver diseases that are caused by ones body’s immune system)
• Primary biliary cirrhosis (destruction of bile ducts)
• Infection
• Syphilis or brucellosis
• Scarring and hardening of the bile ducts
• Medications that include methotrexate or isoniazid
• Being over weight

 

DIAGNOSIS OF LIVER CIRRHOSIS

If the patient is suspected to have cirrhosis based on the symptoms or any other signs, the doctor usually prescribes him or her to undergo the following tests :

• Abdominal computed tomography (CT) scan : In this procedure the special X – ray equipment is combines with sophisticated computers so that multiple digital images or the pictures of liver can be produced.
• Elastography : In this examination the stiffness of ones liver is accessed and this examination helps in diagnosing the severity of the fibrosis in the liver ( it is knw=own as cystic fibrosis)
• Abdominal ultrasound : In ultrasound, sound waves are used to create pictures of the abdomen and pelvis including the liver that is present inside the patient’s body
• Biopsy : in biopsy, a part of liver tissue is examined to analyse the extent of the liver damage
• Body magnetic resonance imaging test (MRI) : In this imaging examination, powerful magnetic field is used to create pictures of liver and then the damage caused to the liver can be examined
• Liver function test : this is basically a kind of blood test that involves blood analization for particular enzymes that signal for the presence of liver damage.
• Magnetic resonance cholangiopancreotography (MRCP) test : This type MRCP is a special type of MRI test that is basically designed to examine a part of liver and gallbladder.

 

TREATMENT OF LIVER CIRRHOSIS

If the liver cirrhosis is detected in the early stage, there are medications and specific treatments available for its cure and to reduce the effect of the disease. But if the disease is detected in the later on stage there are no specific medications and treatment available for it, liver transplantation can be done in this case.

Some treatments for liver cirrhosis if diagnosed early are listed below :

• Weight loss
• Medications to control hepatitis
• Treatment to cure alcohol dependency
• Medications to cure other causes and symptoms of cirrhosis
• Avoid alcohol
• Quit or reduce smoking
• Regular exercise
• A proper diet