Cirrhosis of the liver, Causes Diagnosis Cirrhosis of the liver
Cirrhosis of the liver is the liver disease characteristic by replacement of normal liver tissue by fibrous scar tissue and formation of regenerating nodules. The scar tissue blocks the blood flow to liver and prevents proper functioning of the liver. Cirrhosis of the liver is the leading cause of death by disease, and millions of people are dying because of Cirrhosis of the liver world wide. Fluid retention in the abdominal cavity is the main complication of cirrhosis of liver. Ascites is the term used for fluid collection in the abdominal cavity.
Causes of cirrhosis of liver
Number of factors causes Cirrhosis of the liver. Chronic alcoholism and hepatitis C are very common causes of liver cirrhosis in most of countries.
Alcoholic liver disease: Chronic alcoholism is the main cause of liver cirrhosis. Drinking of alcohol more than a period of 6 to 10 years has a high risk of development of liver cirrhosis. The nature and amount of alcohol consumption determines the development Cirrhosis of the liver. Nearly 15% of individuals who drink heavy alcohol for more than a decade are prone to have cirrhosis of the liver.
Autoimmune hepatitis: Autoimmune disease produces immune cells which attacks the liver and causes inflammation, damage and causes cirrhosis of the liver.
Chronic hepatitis C : The hepatitis C virus is also one of the major cause of chronic liver disease and cirrhosis of the liver. Infection and inflammation caused by the virus damages the liver and leads to cirrhosis of the liver.
Chronic hepatitis B and D: The hepatitis B virus is probably the most common cause of cirrhosis of the liver. Hepatitis B, like hepatitis C, causes liver inflammation and injury that over several years and causes cirrhosis of liver. Hepatitis D also causes cirrhosis of the liver.
Inherited diseases: Alpha-1 antitrypsin deficiency, hemochromatosis, Wilson disease, galactosemia, and glycogen storage diseases and other inherited diseases may alter the normal functioning of liver and liver functions such as storage of enzymes, proteins, metals and other substances are altered and may cause cirrhosis of the liver.
Non alcoholic steatohepatitis : Excess fat builds up in the liver and eventually causes scar tissue. This steatohepatitis is most of times associated with diabetes, protein malnutrition, obesity, coronary artery disease and steroid medications. This type of nonalcoholic hepatitis also causes cirrhosis of the liver.
Obstruction of bile ducts: Because of obstruction of bile ducts bile backs up and damages the liver tissue. The most common cause of bile obstruction is primary biliary cirrhosis, a disease characterized by inflamed, blocked and scarred bile ducts. This disorder may cause cirrhosis of the liver.
Untreated fatty liver disease also causes cirrhosis of the liver.
Drugs, toxins and infections: Prolonged usage of certain drugs, ingestion of some toxins mixed in the foods, exposure to environmental toxins, parasitic infection of liver, recurrent liver congestion can cause cirrhosis of the liver.
Cardiac cirrhosis: Cardiac cirrhosis is caused due to chronic right sided heart failure which causes liver congestion and causes cirrhosis of the liver rarely in some individuals with cardiac abnormalities.
Galactosemia also causes cirrhosis of the liver.
Glycogen storage disease type 4 and Cystic fibrosis may cause cirrhosis of liver.
any one of or combination of these may cause cirrhosis of the liver.
Symptoms of cirrhosis of liver:
Early symptoms of cirrhosis of liver are asymptomatic. Some clinical symptoms area manifested as follows. The scar tissue is replaced by healthy cells and liver function starts to fail and the following symptoms of cirrhosis of liver are felt by the patients.
- Loss of appetite due to altered liver enzyme level is the main symptom of liver cirrhosis.
- Fatigue because of low metabolism is the symptom of liver cirrhosis.
- Nausea may be related abdominal distension and liver congestion,
- Generalized weakness
- Exhaustion
- Weight loss related to poor metabolism of food by liver,
- Abdominal pain
- Hepatic encephalopathy is the symptom develops with the complicated liver cirrhosis disease.
- Spider-like blood vessels develop on the skin is also the symptom of cirrhosis of the liver.
- Vascular lesions consisting of a central arteriole surrounded by many smaller vessels in liver,
- Palmar erythema is an exaggeration of normal speckled mottling of the palm, due to altered sex hormone metabolism by the liver.
- Changes in nails such as clubbing of nails, paired horizontal bands separated by normal color are also the symptoms of liver cirrhosis.
- Chronic proliferative peritonitis along with pain in long bones.
- Flexion deformities of the fingers caused because of thickening and shortening of palmar fascia.
- Enlarged liver size or hepatomegaley is the symptom of cirrhosis of the liver.
- Splenomegaly or increased size of spleen is the symptom of cirrhosis of the liver.
- Ascites: Collection of fluid in peritoneal cavity is called as Ascites. Untreated ascites leads to flank dullness of stomach and abdominal distension is the main symptom associated with cirrhosis of the liver.
- Ictrus or jandice: Yellow discoloration of the skin, eye and mucus membranes due to increased bilirubin level in blood is the sign of liver cirrhosis.
- Asterixis: Bilateral asynchronous flapping of outstretched, dorsiflexed hands seen in patients with hepatic encephalopathy.
- Esophageal varices are developed with enlarged liver.
The nodules developed during cirrhosis of the liver are
The micro nodules: nodules are regenerated and not more than 3mm.
The macro nodules: Nodules sizes are larger than 3 mm
The mixed cirrhosis type: where the nodules are of different sizes.
Complications of Cirrhosis of the liver
Complications caused by cirrhosis of the liver are as follows
Edema and ascites: water accumulates in the legs (ankle edema) and abdomen (ascites).Bruising and bleeding. Decreased production of blood clotting proteins causes blue spots and the person will bruise or bleed easily. Palmar erythema, reddish and blotchy palms may develop as the complication of cirrhosis of the liver.
Jaundice: Decreased absorption of enough bilirubin by the liver causes Jaundice.
Itching: Increased Bile products are deposited in the skin and causes itching with cirrhosis of the liver.
Formation of Gallstones: Gallstones are developed when cirrhosis prevents bile to reach the gallbladder.
Toxins in the blood or brain: When liver fails to remove toxins from the blood, increased toxins accumulate in the blood and gradually reaches the brain may cause hepatic encephalopathy. These elevated toxins leads to poor mental functioning and causes personality changes, coma, and even death if cirrhosis of the liver is not treated. This is the complication developed in later stage of disease.
Portal hypertension: the portal vein carries the blood from the intestines and spleen to the liver. But cirrhosis of the liver obstructs the normal blood flow through the portal vein, which increases the pressure in portal vein and causes portal hypertension.
Insulin resistance and type 2 diabetes: Cirrhosis may cause insulin resistance by body tissues. Insulin hormone produced by the beta cells of pancreas, converts blood glucose into glycogen. When insulin resistance is developed, body muscles, fat, and liver cells do not use insulin properly. But the pancreas produces normal amount of insulin, which becomes more when not used.
Liver cancer: Hepatocellular carcinoma, a type of liver cancer may be caused by cirrhosis of the liver.
Diagnosis of cirrhosis of the liver
History collection reveals the history of alcohol consumption, and family history also helps in diagnosis of cirrhosis of the liver. Other diagnostic tests for cirrhosis of liver include
- Laboratory tests of blood and tissue sample,
- Physical examination of liver cirrhosis affected individual,
- X-ray tests to know the outline of liver damage.
- Ultrasound is also used know a days for diagnosis of liver diseases and cirrhosis of liver.
- Firboscan is the advanced technology used to know the stiffness of the liver and is determined by using of elastic waves. Firboscan is a non-invasive technique helps in assessment of extent of liver damage within some minutes. Firboscan is much preferred as it is a pain less procedure and provides result very fast.
- Computed tomography ( CT scan ) which shows the nature of liver cells and helps in easy diagnosis of cirrhosis of the liver.
- Magnetic resonance imaging (MRI): is done after injecting a dye for the confirmation of exact place of the liver affected and MRI scan gives the clear idea about cirrhosis of the liver. MRI test gives the clear diagnosis of the liver cirrhosis.
Liver biopsy: The sample tissue of liver is obtained for the study of hepatocytes and liver biopsy is the main test confirms the diagnosis of cirrhosis of the liver. Using a needle the tiny sample of liver tissue is taken by the surgeon during liver biopsy. Then the hepatic cells are diagnosed in laboratory.
This is the information about cirrhosis of liver, causes of liver cirrhosis, symptoms and complications. This information is only for the the purpose of improving knowledge. For the treatment of liver disease please consult the medical authorities and follow the advice.