Cirrhosis – Causes, Symptoms, Complications and Prevention

Cirrhosis or liver cirrhosis as it is often called is a common type of liver disease that often occurs when there is late stage fibrosis or scarring of the liver.

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Cirrhosis is often caused by many different liver diseases such as any of the forms of hepatitis(refer to a previous articles on hepatitis), or alcoholism.

The Liver more mostly considered as a self-repairing organ. This means that every time an injury or a tear is caused to the liver, the liver has the innate and natural ability to repair itself.

Therefore, anytime you injure your liver either by the excessive intake of alcohol or by disease or by any other cause, your liver will try to repair itself.

However, for every time it repairs itself, it forms scar tissue. Hence, as more and more injuries are formed, more and more scars are formed as well causing cirrhosis to occur.

As more scar tissues are formed and cirrhosis progresses, the liver begins to disintegrate causing impairment in liver function and as such causing decompensating cirrhosis of the liver.

Depending on the severity of the cirrhosis, this condition can go from being mild to situations which can be considered to be life-threatening.

Here is the twist, for every time the liver tries to repair itself and cirrhosis occurs, it can’t be undone. This means that the pat that becomes scarred can not become repaired again.

Causes

There are so many diseases that can cause damages to the liver and likewise, there are some lifestyle and behaviours that can cause the liver to begin to scar. These diseases include:

  1. Viral hepatitis: Untreated viral hepatitis which is mostly hepatitis B, hepatitis C and hepatitis D can become a cause for alarm and scarring.
  2. Fat accumulation: Fat accumulation in the hepatic arteries of the liver can cause a blockage of the flow of blood and as such cause, fibrosis to occur causing cirrhosis.
  3. Build up of iron in the body: Generally, the liver is known as a detoxing organ and as such, anything that enters the bloodstream and the body as a whole passes through the liver. Too much of iron in the body can begin to cause the liver to overwork and as such cause scarring of the liver.
  4. Accumulation of copper in the body can also cause scarring of the liver. There is a disease known as Wilson’s disease that often causes the body to accumulate copper.
  5. Biliary atresia: often occurs when the common bile ducts of the liver are not properly formed. This is a teratogenic disorder.
  6. Cystic fibrosis.
  7. Every inherited sugar disorder can cause scarring of the liver to occur. Disorders such as galactosemia or glycogen storage diseases can cause a faulty regulation of sugar metabolism in the body and as a result, lead to liver cirrhosis.
  8. Primary biliary cirrhosis: This condition is as a result of the destruction of the common bile ducts.
  9. Allagille syndrome: This disease is a digestive disorder disease that often causes the destruction of the patient’s bile ducts causing bile to build up in the liver and as such cause liver cirrhosis to occur.
  10. Alpha-1 antitrypsin deficiency.
  11. Autoimmune hepatitis: This kind of hepatitis is often caused as a result of your immune system attacking your liver and this can cause major scarring of the liver.
  12. Primary Sclerosing cholangitis: This disease is often caused as a result of the scarring and severe hardening of the bile ducts causing the accumulation of bile in the liver.
  13. Infections: Some infections such as syphilis, and brucellosis can travel all the way to the liver and cause the liver to become damaged.

Lifestyles that can cause the liver to become damaged include:

  1. Alcoholism: Constant abuse of alcohol causes the liver to begin to scar therefore causing liver cirrhosis
  2. Abuse of medications: having to constantly use drugs such as methotrexate and isoniazid can definitely make you highly susceptible to developing liver cirrhosis.

Symptoms

The symptoms of liver cirrhosis often do not occur until the damage done to the liver is extensive.

When that happens, the patient will begin to experience any of these symptoms and sometimes a combination of two or three all at once. The symptoms include:

  1. Fatigue: Once a patient has liver cirrhosis, the very first sign he would experience is tiredness even without doing anything strenuous.
  2. Easily bleeding: The patient will experience the skin easily tearing and be using and as such bleeding occurs easily.
  3. Loss of appetite
  4. Nausea and vomiting
  5. Jaundice: One of the major function of the liver is to remove excess bilirubin in the blood. Once there are traces of excess bilirubin in the blood due to the lack of a functioning liver, there will be a build-up and as such causing the yellow discolouration of both the eyes and the skin. This is a classic sign of jaundice.
  6. Oedema: The patient will experience swelling on both the hands, legs, ankles and feet.
  7. Sudden weight loss
  8. Itchiness of the skin
  9. Ascites: Ascites occur when there is fluid accumulation within the tissue linings of the abdomen and as such resulting to swelling of the abdomen.
  10. There will be an appearance of the blood vessels on the skin which will be in the form of a spiderlike web.
  11. Some women have been seen to present with the loss or absence of their menstrual cycle which isn’t related to menopause.
  12. Some men also have been seen to present with breast enlargement which is also known as gynecomastia, atrophy of the testicles, as well as reduced or complete loss of their sex drive.
  13. Hepatic encephalopathy which often presents with slurred speeches, drowsiness, lack of coordination and confusion.

Risk factors

There are some certain factors that will put you at the risk of developing liver cirrhosis and they include:

  1. Obesity: Being overweight or obese will cause your liver to overwork itself as such cause nonalcoholic steatohepatitis as well as non-alcoholic liver disease.
  2. Alcoholism: Taking too much alcohol will lead to your liver eventually developing cirrhosis.
  3. Infection: Viral hepatitis has been seen to be one of the causes of cirrhosis. However, it is not everyone who has chronic hepatitis that will develop liver cirrhosis.

Complications

There are some complications that may arise from the late treatment of liver cirrhosis and they include:

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Portal Hypertension:

Portal hypertension occurs when there is an increase in blood pressure in the hepatic veins that supply the liver. Normally when the liver has cirrhosis, there will be a reduction in the normal flow of blood that passes through the liver.

This will, in turn, increase the blood flow and pressure within the veins that bring blood from the spleen and intestines to the liver.

Oedema and ascites

Oedema simply means swelling in the legs. Once the liver begins to experience an increase in pressure within the portal vein, it will lead to the accumulation of fluid in the legs(oedema) and likewise, fluid accumulation within the abdomen causing Ascites.

However, liver cirrhosis is not the only cause of oedema and Ascites. Liver cirrhosis can also occur as a result of the inability of the liver to produce enough albumin which is a blood protein or any other blood proteins.

Splenomegaly

Splenomegaly occurs when there is an abnormal enlargement of the spleen. Portal hypertension causes the enlargement of the spleen as well as trapping of white blood cells and platelets.

Hence, the very first sign of cirrhosis you should take note of after severe fatigue is a decreased white blood cell and platelet count within your blood.

Severe bleeding

When there is portal hypertension, blood will be redirected to the smaller veins. Normally, these small veins transport little amount of blood and as such the pressure within them is low.

However, when blood is redirected to these smaller veins, it can cause an increase in pressure within them and as such, they can burst open hence causing bleeding to occur.

Asides serious bleeding, portal hypertension can cause blood to begin to pool within the veins and as such leading to the formation of varicose veins. Varices can occur within the oesophagus as well as the stomach region.

Some of the clotting factors are produced in the liver and any defect in the liver will affect the functionality of the liver and as such cause severe bleeding.

Infections

Having cirrhosis of the liver may cause your body to have a difficult time trying to fight off infections. The majority of ascites can cause a serious infection known as bacterial peritonitis.

Prevention

Taking the following steps will decrease your chances of ever developing liver cirrhosis. They include:

  1. Avoid taking alcohol especially if you are predisposed to having liver cirrhosis or if you already have the disease.
  2. Eat a healthy and balanced diet: Ensure that you take in a lot of foods that contain vegetables and fruits. For your carbohydrates, select whole-grain foods and for your protein, choose lean protein over red meat. Ensure that you reduce your amount of fatty foods as well as fried foods as this can cause fat deposits in the hepatic artery.
  3. Try to maintain a healthy weight: Your liver doesn’t need you to have excess body fat. If you are obese or overweight, speak to your physician to draw out a healthy weight loss plan for you,
  4. Reduce the risk of you having hepatitis. The more you share needles and have unprotected sex, the higher the chances of you developing hepatitis and invariably liver cirrhosis.

References;

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