Cirrhosis is a progressive disease that develops slowly over many years. It is the result of inflammation and chronic aggressions such as the attack of viruses (hepatitis AB, C) or abuse of alcoholic beverages. The accumulation of scar tissue can eventually stop liver function leading to liver failure.
Cirrhosis Development Conditions
For cirrhosis to develop, continuous liver damage must occur . When healthy liver tissue is destroyed and replaced with scar tissue, the condition becomes serious as it can begin to block blood flow through the liver.
The liver performs several essential functions such as processing nutrients and medications and removing harmful substances from the body . It also purifies the blood, manufactures proteins and vital nutrients, and also produces bile, which acts on digestion.
If cirrhosis is mild, the liver can make repairs and continue to function properly. If cirrhosis is advanced, the formation of scar tissue in the liver causes irreparable damage.
Liver tissue is replaced by fibrous scar tissue and regenerative nodules may also form . These are parts that appear when the liver tries to heal the damage.
Causes of Cirrhosis
Cirrhosis can happen due to several factors, but some are pointed out as the main causes by the large number of confirmed patients.
Common causes of cirrhosis are:
Long-Term Alcohol Abuse
Toxins, including alcohol, are broken down by the liver. However, if the amount of alcohol is too high, the liver will be overloaded and the liver cells can eventually become damaged.
Heavy, regular and long-term drinkers are much more likely to develop cirrhosis compared to other healthy people. Typically, excessive drinking should be maintained for at least 10 years for cirrhosis to develop.
In general, some stages are reached before alcohol-induced cirrhosis actually occurs, they are:
Liver fat – is an accumulation of fat in the liver cells, also called fatty infiltration or fatty liver disease.
Alcohol Hepatitis – About 35% of those who drink a lot will develop alcoholic hepatitis, where the liver cells swell and become inflamed.
Approximately 10% of compulsive drinkers will later develop cirrhosis.
Hepatitis C is a blood-borne infection, it can damage the liver and eventually lead to cirrhosis. Cirrhosis can also be caused by hepatitis B and D.
Non-Alcoholic Liver Steatosis (Fat in the Liver)
Liver Steatosis in its early stages is an accumulation of fat in the liver cells. This fat causes inflammation and scarring, resulting in possible cirrhosis later on, if not properly treated.
Hepatic Steatosis is more likely to occur in obese people , patients with diabetes , with high levels of lipids (fat) and people with high blood pressure ( high blood pressure).
The person’s own immune system attacks healthy organs in the body as if they were foreign substances. Sometimes the liver is attacked. Eventually, the patient may develop cirrhosis.
Hemochromatosis – iron accumulates in the liver and other parts of the body.
Wilson’s disease – copper accumulates in the liver and other parts of the body.
Blockage of bile ducts
Some conditions and diseases, like bile duct cancer or pancreatic cancer, can block bile ducts, increasing the risk of cirrhosis.
There is thrombosis (blood clots) in the hepatic vein, the blood vessel that carries blood from the liver. This leads to an enlarged liver and the development of collateral vessels.
Other diseases and conditions that can contribute to cirrhosis include:
Cystic fibrosis – genetic disease inherited from parents
Primary sclerosing cholangitis – hardening and healing of the bile ducts.
Galactosemia – inability to process sugars in milk.
Schistosomiasis – a parasite commonly found in some developing countries.
Biliary atresia – malformed bile ducts in babies.
Glycogen storage disease – problems in the storage and release of vital energy for cellular function.
Symptoms of Cirrhosis
Symptoms are not common during the early stages of cirrhosis . However, as scar tissue builds up, the liver’s ability to function properly is impaired. The following signs and symptoms may occur:
- Blood vessels become visible on the skin of the upper abdomen.
- Itchy skin
- Loss of appetite
- Loss of body mass
- Pain in the area where the liver is located
- Red or stained palms
Signs of More Advanced Cirrhosis
The following signs and symptoms may appear as liver cirrhosis progresses:
- The abdomen fills with fluid, giving the patient a large belly (ascites).
- Fast heartbeat
- Altered personality (toxins in the blood accumulate and affect the brain)
- Bleeding gums.
- Weight loss
- Difficulty for the body to process alcohol
- Difficulty of the body in processing other types of drugs
- Mental confusion
- Accumulation of fluid in the ankles, feet and legs (edema)
- Hair loss
- Tendency to form bruises with ease
- Jaundice (yellowing of the skin, whites of the eyes and tongue)
- Loss of libido (sexual desire)
- Memory problems
Other more common symptoms in more advanced cirrhosis are: more frequent stools (susceptible to infections), muscle cramps, nosebleeds, pain in the right shoulder, shortness of breath, black or very pale stools, dark urine (Coca-Cola color) ) and bleeding from the gastrointestinal tract.
Diagnosis of Cirrhosis
One of the main methods of diagnosis is through the blood test . Since symptoms are rarely present at the onset of the disease, cirrhosis is often diagnosed when the patient is undergoing tests for some other condition or disease.
The following exams can also be ordered:
Transaminases – these enzymes reside within the liver cells. But when the liver is in trouble, these enzymes are spilled into the blood stream. The test requested, verifies whether the levels of ALT or TGO (alanine transaminase) and AST or TGP (aspartate transaminase) are high.
Image exams – ultrasound, computed tomography or magnetic resonance scanning. In addition to seeing if the liver is enlarged, the doctor may also detect scars or nodules.
Endoscopy – a long, thin tube with a light and video camera at the end, goes down the patient’s esophagus to the stomach. There the doctor checks for swollen blood vessels ( varicose veins ), a distinct sign of cirrhosis.
Biopsy– a small sample of liver cells is extracted and examined under a microscope. Biopsy can confirm cirrhosis and its cause.
If cirrhosis is diagnosed early enough, the damage can be minimized by treating the cause that led to this condition.
Alcohol Addiction Treatment
It is important for the patient to stop drinking if his cirrhosis was caused by heavy, regular alcohol consumption over the long term. In many cases, your doctor will recommend a treatment program for alcoholism.
The patient can use medications to control the damage to liver cells caused by hepatitis B or C.
More severe cases of cirrhosis end up being referred for liver transplantation – the lost organ is replaced by another, from a donor. Doctors, however, try their best not to reach that solution. Hence the importance of early detection.
In the case of alcohol, excessive use should be avoided. Individuals who have cirrhosis should abstain completely from alcohol. Alcohol accelerates the progression of the disease.
Although only a minority of people who drink too much have cirrhosis, the risk increases proportionally to the amount and time of consumption. It is also known that lower doses of alcohol can cause cirrhosis in women.
The best prevention of cirrhosis of viral origin is through vaccination against Hepatitis B and the strict criteria for controlling blood used in transfusions.
It is necessary to treat patients with chronic hepatitis B and C, before they progress to cirrhosis. And in patients with early cirrhosis, to prevent them from reaching more advanced stages. Unfortunately, so far there is no vaccine for Hepatitis C.
See also: Fetal Alcoholism Syndrome
My name is Dr. Alexis Hart I am 38 years old, I am the mother of 3 beautiful children! Different ages, different phases 16 years, 12 years and 7 years. In love with motherhood since always, I found it difficult to make my dreams come true, and also some more after I was already a mother.
Since I imagined myself as a mother, in my thoughts everything seemed to be much easier and simpler than it really was, I expected to get pregnant as soon as I wished, but it wasn’t that simple. The first pregnancy was smooth, but my daughter’s birth was very troubled. Joana was born in 2002 with a weight of 2930kg and 45cm, from a very peaceful cesarean delivery but she had already been born with congenital pneumonia due to a broken bag not treated with antibiotics even before delivery.