Cirrhosis of liver : Causes, Symptoms, Diagnosis, Treatment

Today in this blog, I will give you information regarding cirrhosis of liver. Liver cirrhosis also known as hepatic cirrhosis is irreversible liver damage in which liver can not function properly.As you can see in image that normal liver tissue is replaced in scar tissue in cirrhosis of liver.

Cirrhosis not develop within few days like fever or other diseases, it takes months to years to develop. In initial stage, there are often no symptoms. We learn this topic starting from causes, symptoms, diagnosis and treatment of cirrhosis of liver.

CIRRHOSIS OF LIVER CAUSES

• • Viral hepatitis B
  • Viral hepatitis C
  • Due to alcohol excess
    More than 2-3 drinks per day for many years
  • Non alcoholic fatty liver disease
    Occurs to who have high blood pressure,diabetes,high blood fat
  • Autoimmune hepatitis
  • Genetic
  • Certain medication
  • Billiary obstruction

SYMPTOMS

1. Introduction
2. Onset of symptoms
3. symptoms due to liver damage
4. symptoms due to portal hypertension
5. other symptoms
6. symptoms at advance stage

INTRODUCTION

If you want to learn cirrhosis symptoms, you must know the normal functions of liver.Because in cirrhosis liver is damaged and not work properly.So, most symptoms created due to disturbance in liver functions.

Here, I discussed important functions of liver as below.

1. Metabolic

   protein,fat,carbohydrate,vitamin,hormone

2. Storage

   vitamin A,folic acid, vitamin B12, vitamin D, glycogen,amino acids

3. Synthesis

   glucose,protein,clotting factor,hormone binding protein,steroid

Initially patient is asymptomatic in cirrhosis of liver.It means patient having no complain inspite of some problem created in liver.Diagnosis is made incidentally when do sonography or other reports for some other problem.

When compain starts, symptoms are simple and common which are present in many disease conditions.So, doctor don’t have doubt of liver problem.[GoTo symptoms]

ONSET OF SYMPTOMS

• Nausea,vomit,upper abdominal discomfort
• Loss of appetite,weight loss
• Weakness,tiredness
• Diarrhoea,mild fever,ankle swelling

After initial phase over, patients symptoms are due to local liver damage and due to portal hypertension.As you can see in image that liver receives blood supply from spleen,stomach,pancreas,intestine called portal vein.When liver is damaged, this blood supply to liver also disturbed.So, tension in portal vein increases called portal hypertension.

This way we learn further symptoms which run on two side, one is due to liver damage and second due to portal hypertension.[GoTo symptoms]

SYMPTOMS DUE TO LIVER DAMAGE

(1) Jaundice

Urine becomes dark,skin and sclera becomes yellowish.

(2) Ascites

It is collection of fluid in peritoneal cavity, as you can see in image.
It is due to
– low protein level because liver not synthesis and store protein due to internal damage
– portal hypertension
– increased lymphatic production

(3) Endocrine system
 Liver metabolite and synthesis some hormone.In liver damage hormonal level          disturbed and this causes endocrine symptoms as below.

• Male
  Gynaecomastia
  Testicular atrophy
  Loss of body hair
  Impotense

•  Female
   Reduce breast size
   Loss of sexual drive

• Spider naevi
  

  

(4) Hematological

Anaemia,purpura

(5) Fetor hepaticus 

breath has musty smell due to increasing dimethyl sulphate which can not excrete by liver.[GoTo symptoms]

SYMPTOMS DUE TO PORTAL HYPERTENSION

When portal hypertension occured, this pressure may effect oesophagus,spleen or abdomen and causes below symptoms.

(1) Oesophageal varices

(2) Spleenomegaly

(3) Caput medusae 

[GoTo symptoms]

OTHER SYMPTOMS

• Nail changes eg. clubbing of nail
• Palmar erythema
  
  

  

• Deputrens contracture
  Difficult to move finger[GoTo symptoms]

SYMPTOMS IN ADVANCE STAGE

• Bruising
• Hepatic encephalopathy
  

  due to increase ammonia or related substance in blood, there is disturbance of brain
  functions.Patient may go in comma.

• Kidney damage
• Cachexia or muscle wasting

This way many symptoms arise in cirrhosis of liver.It is somewhat complicated topic to understand.But here we learn it categorically, so we can remember it easily.First onset of symptoms starts than due to liver damage,portal hypertension,other symptoms and last in advance stage.[GoTo symptoms]

CIRRRHOSIS OF LIVER DIAGNOSIS

• CBC report shows neutropenia & thrombocytopenia.Low WBC and platelet occurs in many conditions like fever and other viral infections.But this indicates something wrong in body.

• Enzymes – SGPT,SGOT,alkaline phosphate will increases in this condition.

• Serum billirubin level – may be high

• Protein level – low because liver is not capable for synthesis and storage of protein.

• Prothrombin time – increases because clotting factors not synthesise by liver.

• USG, CT SCAN, MRI also helpful

• Biopsy is gold standard test for confirmation of cirrhosis.But it only indicated if other test not suggest liver cirrhosis.

CIRRHOSIS OF LIVER TREATMENT

• Rest – avoid more physical work
• Diet – must be light,avoid fried-spicy-oily
• Antibiotic for any infection
• Avoid medicine on their own
• Lactulose for constipation
• Treatment of underlying cause like
  hepatitis B, hepatitis C, alcoholic hepatitis or other causes
• Liver transplant is last option

This way cirrhosis of liver is very important topic.We learn here A to Z information regarding this topic. Hope you understand all over topic. If you have any kind of query kindly mail me, I will try my best to guide you.