Apr 14, 2020 in Medicine
Cirrhosis of the Liver

The liver is the largest organ located in the abdominal cavity of the human body, which performs a number of vital functions. It removes toxins and harmful substances from the blood, stores the vitamins, proteins, and sugar glucose, produces bile that is necessary for digestion of fats, as well as engages in the metabolic activities and the destruction of old red blood cells. Toxins, medications, and diseases have a harmful effect on the liver tissue. Although the liver has the ability to restore its damaged cells, long lasting injury can disrupt this process, and regeneration will be incomplete. It results in appearance of scar tissue that entails cirrhosis. The last stage of the liver cirrhosis refers to the life-threatening condition and inevitably leads to fatal outcome. Early diagnostic and proper treatment allow slowing disease progression and maintaining liver function.

Cirrhosis of the liver occurs when the organ produces scar tissue in response to chronic or constant injury. With the passage of time, scar tissue expands and supersedes healthy liver tissue, which hinders the blood from flowing through the liver. Scar tissue forms slowly and gradually. Alcohol abuse and chronic hepatitis C represent the most common causes of the above-mentioned disease. Liver inflammation caused by hepatitis C virus damages the organ’s tissue, which entails scarring of the liver. Alcoholism, in its turn, also destroy the liver. Due to excessive alcohol consumption over several years, the human liver undergoes significant injuries that disrupt its function. Another cause of cirrhosis is nonalcoholic fatty liver disease. It leads to amassing of fat in the liver that is detrimental to the organ and eventually results in cirrhosis. People with obesity and diabetes are more likely to develop a nonalcoholic fatty liver disease. High blood pressure also contributes to the amassing of extra fat.

 
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The early stage of cirrhosis is asymptomatic. However, with the disease progression, the human health condition significantly worsens. A person experiences fatigue and weakness. He/she losses appetite, and his/her skin and eyes become yellow in color, a condition known as jaundice. Other common symptoms are nausea, weight loss, inability to metabolize drugs, and hypoalbuminemia.

As the liver fails to perform its function, various complications ordinarily develop, which may be the first signs of cirrhosis. Portal hypertension, a common complication of liver cirrhosis, is connected with the disruption of the blood flow in the liver caused by scar tissue. Thus, the pressure in the portal vein increases and therefore, portal hypertension arises. This condition leads to spleen and blood vessels enlargement, as well as a fluid accumulation that entails ascites and edema. Hepatic encephalopathy also refers to a complication of cirrhosis. Since the liver cannot detoxify the human blood, harmful toxins collect in the brain. Due to hepatic encephalopathy, a person undergoes deterioration of mental function and may fall into a stupor or even coma. A damaged liver cannot produce sufficient amount of proteins that engage in blood clotting. As a result, bruising and bleeding appear.

Although the symptoms of cirrhosis are absent in the initial stage, a health care provider may detect the disease based on the presence of the above-mentioned conditions. A medical history, laboratory tests, physical examination, and imaging tests help to confirm the diagnosis. In order to diagnose cirrhosis, a health care provider should learn a medical history of the patient. A physician also can perform a physical examination. He/she examines a patient’s body, taps on its certain areas, and listens to sounds in the abdomen via a stethoscope. Laboratory tests allow finding the cause of cirrhosis and its severity. Thus, blood test helps identify the hepatitis viruses. The creatinine blood test checks kidney function that tends to decline in later stages of the disease. The bilirubin blood test shows the presence of liver injury. Lastly, international normalized ratio checks whether a patient’s blood are able to clot. A liver biopsy is also used to diagnose cirrhosis. During this procedure, a doctor takes a piece of liver tissue by inserting the biopsy needle. Then, this tissue sample is examined under the microscope for the signs of disease.

Imaging tests, such as computed tomography (CT), ultrasonography (US), and magnetic resonance imaging (MRI), enable to detect early the morphological changes of the liver. CT combines computer technology and x rays to produce images. This diagnostic tool is the most sensitive. US represents a safe and painless tool that creates the image of the liver’s structure with the help of sound waves. MRI, in its turn, allows obtaining a detailed picture of the liver tissue using magnets and radio waves.

Cirrhosis belongs to the irreversible disease. The treatment can only slow the disease progression. Therefore, it is critical to diagnose the liver cirrhosis as early as possible and start treatment. When a health care provider prescribes treatment, he/she should take into account the cause of cirrhosis and the presence of complications. In the initial stage of the disease, the treatment aims to prevent scarring of the liver and avert possible complications. The late stage of the liver cirrhosis requires additional treatment.

A person with cirrhosis should avoid consuming alcohol and other illegal substances, since they destroy the liver rapidly. Cirrhosis decreases the liver’s ability to remove toxins and other substances from the human blood. Therefore, a patient should not take new medication without a health care provider’s prescription. Moreover, complementary and alternative medications, for instance, herbs, are not recommended for individuals with cirrhosis.

Vaccination against hepatitis A and B is necessary for the patients, who suffer from cirrhosis. Hepatitis A and B viruses ordinarily accelerate the disease progression. If hepatitis is the cause of the liver cirrhosis, a doctor should prescribe antiviral medications.

When the symptoms and complications of cirrhosis appear, a doctor should treat them. A beta-blocker or nitrate are effective medications from portal hypertension, which lover blood pressure and widen the blood vessels, respectively. If edema and ascites develop, a doctor should prescribe diuretics that eliminate fluid in the body. Another complication is hepatitis encephalopathy that requires lactulose to cleanse the bowel. In addition, a patient should undergo screening tests regularly to detect whether liver cancer develops. Cirrhosis may entail liver failure. In this case, a doctor should consider a liver transplant. The surgery is also recommended, if the treatment for complications does not improve the patient’s health.

In conclusion, cirrhosis develops in response to constant liver damage by hepatitis C virus or excessive alcohol dose. Instead of health liver tissue, scar tissue appears that prevent the blood from flowing through the liver. Scarring of the liver is the slow and asymptomatic process. Such symptoms as nausea, fatigue, weight loss, and yellowing of the skin and eyes ordinarily arise in the late stage of disease that is difficult to cure. Physical examination and blood tests helps diagnose cirrhosis. Imaging tests that include computed tomography, ultrasonography, and magnetic resonance imaging can confirm the diagnosis in the early stage of disease. The main goal of the treatment is to slow the disease progression, since cirrhosis represents an irreversible process.

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