Cirrhosis

What is cirrhosis?

Cirrhosis is a disease in which the liver gradually deteriorates due to chronic injury. The liver, which has the ability to repair itself, gradually scars and wounds healthy tissue, partially blocking blood circulation through the liver.

Cirrhosis arises as a response to liver damage, since each time the organ is injured, it tries to repair itself by its own means, forming scar tissue during the process. As cirrhosis progresses, more and more of this tissue forms.

As a rule, the liver damage caused by cirrhosis is irreparable, although early diagnosis of liver cirrhosis can limit or even reverse the damage.

There are different types of hepatitis:

• Alcoholic liver cirrhosis: it is caused by excessive alcohol consumption and is the most frequent cause of cirrhosis.
• Cirrhosis linked to hepatitis: it is caused by the hepatitis virus, inflaming the liver.
• Cryptogenic cirrhosis: refers to cirrhosis when the cause is unknown.
• Primary biliary cirrhosis. The immune system causes cirrhosis by mistakenly attacking healthy liver cells, which are then replaced by scar tissue.
• Secondary biliary cirrhosis: there is an obstruction in the bile ducts.
• Sclerosing cirrhosis: the bile duct narrows and prevents bile from moving.

Prognosis of cirrhosis

Cirrhosis is an incurable disease which, if it progresses without an accurate and timely diagnosis, can lead to serious and serious complications:

• Portal hypertension: high blood pressure in the veins of the liver. Blood flow is reduced by increasing the pressure in the vein that carries blood from the intestine to the liver.
• Swelling in the legs and abdomen: portal hypertension can lead to edema and ascites, i.e. fluid formation in the legs and abdomen respectively. Both can also be the result of the liver’s inability to generate the necessary amount of protein in the blood.
• Splenomegaly: enlargement of the spleen: the decrease of white blood cells and platelets in the blood may be a sign of cirrhosis.
• Bleeding: portal hypertension can cause blood to go into small veins, which will increase in size and may burst and cause severe bleeding. This bleeding is life-threatening when veins in the lower esophagus – esophageal varices – or stomach – gastric varices – rupture.

Other complications are mentioned below:

• Jaundice: the skin turns yellowish due to an inability of the liver to eliminate bilirubin.
• Malnutrition: cirrhosis can make it difficult to absorb nutrients, resulting in weakness and weight loss.
• Infections: cirrhosis hinders the ability to fight infections.
• Hepatic encephalopathy: it consists of the accumulation of toxins in the brain, which can create mental confusion.
• Osteoporosis: there are cases in which patients with cirrhosis lose strength in their bones and are more prone to bills.
• Increased risk of liver cancer
• Acute and chronic liver failure.

On the right of the image, a liver in a normal state;
on the left, a liver affected by cirrhosis.

Symptoms of cirrhosis

One of the main complications of cirrhosis is that it often has no signs or symptoms until the disease is quite advanced and liver damage is significant. Some of the most common symptoms of this disease are:

• Tiredness
• Bleeding easily
• Itchy skin
• Jaundice
• Ascites
• Easy bruising
• Loss or lack of appetite
• Nausea
• Swelling in the legs
• Drowsiness
• Weight loss
• Breast enlargement in men
• Atrophy of the testicles
• Redness of the palms of the hands

Can cirrhosis be prevented?

The best way to prevent cirrhosis is to maintain liver care. Thus, the best thing to do is the following:

• Do not drink alcohol
• Eat a healthy and balanced diet
• Maintain a healthy weight
• Reducing the risk of getting hepatitis

Treatments for cirrhosis

Treatment for cirrhosis varies depending on the cause of the disease, as well as whether there are complications. The goal of treatment is to slow the progression of scar tissue in the liver. In the event of complications, hospitalization may be necessary. The main treatments are:

• Eating a nutritious diet
• Avoid alcohol and other substances that can affect liver function.
• Diuretics are recommended for edema and ascites.
• For portal hypertension, beta-blockers may be prescribed to lower blood pressure.
• Hepatic encephalopathy is treated by cleansing the bowel with luctulose.
• Those with cirrhosis with hepatorenal insufficiency should undergo hemodialysis.
• Liver transplantation: In advanced cases of cirrhosis where the liver stops functioning, liver transplantation may be the only treatment option. The transplant replaces the diseased liver with a healthy one from a deceased donor or a part of the liver from a living donor.

What specialist treats cirrhosis?

The specialist in charge of diagnosing and treating cirrhosis problems are the Digestive Tract Doctors.