Summary about Disease
Liver cirrhosis is a late-stage liver disease in which healthy liver tissue is replaced by scar tissue (fibrosis). This scar tissue blocks the flow of blood through the liver and slows down its ability to process nutrients, hormones, drugs, and toxins. Ultimately, it can lead to liver failure. Cirrhosis is a progressive disease, meaning it gets worse over time.
Symptoms
Many people with cirrhosis have no symptoms, especially in the early stages. As the disease progresses, symptoms may include:
Fatigue
Weakness
Loss of appetite
Nausea
Weight loss
Abdominal pain
Swelling in the legs, feet, or ankles (edema)
Swelling in the abdomen (ascites)
Jaundice (yellowing of the skin and eyes)
Easy bruising or bleeding
Itchy skin
Dark urine
Pale stools
Confusion, drowsiness or slurred speech (hepatic encephalopathy)
Spider-like blood vessels on the skin (spider angiomas)
Redness of the palms (palmar erythema)
In men, loss of sex drive, breast enlargement (gynecomastia), or testicular atrophy.
Causes
The most common causes of cirrhosis include:
Chronic alcohol abuse: Long-term excessive alcohol consumption.
Chronic viral hepatitis: Hepatitis B, C, and D infections.
Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH): Fat buildup in the liver not caused by alcohol.
Autoimmune liver diseases: Such as autoimmune hepatitis and primary biliary cholangitis.
Genetic liver diseases: Such as hemochromatosis and Wilson's disease.
Diseases of the bile ducts: Such as primary sclerosing cholangitis and biliary atresia.
Certain medications and toxins: Prolonged exposure to certain drugs or environmental toxins.
Repeated bouts of heart failure with liver congestion
Medicine Used
There is no cure for cirrhosis, so treatment focuses on managing the symptoms and complications, and slowing the progression of the disease. Medications used include:
Diuretics: To reduce fluid buildup in the abdomen and legs (ascites and edema).
Beta-blockers and nitrates: To reduce portal hypertension (high blood pressure in the portal vein).
Lactulose and rifaximin: To treat hepatic encephalopathy.
Antiviral drugs: To treat chronic viral hepatitis.
Corticosteroids or other immunosuppressants: To treat autoimmune hepatitis.
Medications to treat the underlying cause: Such as iron chelation therapy for hemochromatosis.
Antibiotics: to fight infections, common with the disease
Medication to treat itching:
Vaccines: to protect against hepatitis A and B, influenza and pneumonia
Is Communicable
Cirrhosis itself is not communicable. However, some of the underlying causes of cirrhosis, such as viral hepatitis (Hepatitis B, C, and D), are communicable. These infections can be spread through contact with infected blood or body fluids. NAFLD and alcoholic cirrhosis are not communicable.
Precautions
Precautions to prevent or manage cirrhosis include:
Abstain from alcohol: If alcohol is the cause of your cirrhosis.
Get vaccinated against hepatitis A and B: If you are not already immune.
Practice safe sex and avoid sharing needles: To prevent the spread of hepatitis B and C.
Maintain a healthy weight: To prevent or manage NAFLD.
Follow a healthy diet: Low in sodium and rich in fruits, vegetables, and lean protein.
Avoid certain medications: That can further damage the liver, after discussing it with your doctor.
Get regular medical checkups: To monitor the progression of the disease and screen for complications like liver cancer.
Avoid raw shellfish: which can cause serious infections in people with cirrhosis
How long does an outbreak last?
Cirrhosis is not an "outbreak" situation in the typical sense. It's a chronic, progressive condition. The duration of cirrhosis varies greatly from person to person. It can take years or even decades to develop. Once cirrhosis develops, it is usually a lifelong condition that requires ongoing management. Survival depends on the cause of the cirrhosis, the severity of the liver damage, and the overall health of the individual.
How is it diagnosed?
Cirrhosis is diagnosed through a combination of:
Medical history and physical exam: The doctor will ask about your medical history, alcohol consumption, medications, and family history of liver disease.
Blood tests: Liver function tests, complete blood count (CBC), and tests for viral hepatitis and autoimmune antibodies.
Imaging studies: Ultrasound, CT scan, or MRI of the liver to assess the size, shape, and texture of the liver and to look for signs of complications like ascites or liver cancer.
Liver biopsy: A small sample of liver tissue is removed and examined under a microscope to confirm the diagnosis and assess the severity of the damage.
FibroScan: A noninvasive test that measures the stiffness of the liver, which can indicate the presence and severity of fibrosis.
Timeline of Symptoms
The timeline of symptoms in cirrhosis can vary widely.
Early stages: Many people have no symptoms.
As the disease progresses (months to years): Fatigue, weakness, loss of appetite, and mild abdominal discomfort may develop.
Later stages: Jaundice, edema, ascites, easy bruising, hepatic encephalopathy, and other complications may occur. The progression can be gradual or rapid, depending on the cause of the cirrhosis and the individual's overall health.
Important Considerations
Early detection and treatment of the underlying cause are crucial to slowing the progression of cirrhosis.
Cirrhosis increases the risk of liver cancer, so regular screening is important.
Liver transplantation may be an option for people with severe cirrhosis and liver failure.
Lifestyle changes, such as abstaining from alcohol and maintaining a healthy weight, are essential for managing the disease.
Individuals with cirrhosis should consult with a hepatologist (liver specialist) for optimal care and management.
Complications: Portal hypertension, esophageal varices, ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, hepatorenal syndrome, liver cancer.