Cirrhosis

Cirrhosis

Overview

Cirrhosis refers to liver’s extensive scarring, which usually occurs after repeated and long-standing liver damage over a period of several years. Generally, loss of liver function due to cirrhosis is permanent, and symptoms worsen over time.

Signs and symptoms

Early cirrhosis has no symptoms. However, as scarring increases, symptoms such as fatigue, lack of appetite, unexplained weight loss, and nausea begin to appear. The patient may also experience nose bleeds, jaundice, abdominal swelling, leg swelling, and disorientation. In very severe cases, the patient may vomit blood, develop jaundice, develop fluid accumulation in the abdomen, and become confused, forgetful and drowsy.

Causes and risk factors

Cirrhosis could be caused by any disease that causes liver damage. Chronic alcohol abuse, viral hepatitis infections and fatty liver disease are the prominent three causes of cirrhosis in adults today.

Complications

The complications of cirrhosis include excessive bleeding, jaundice, fluid accumulation in the body and infections. Cirrhosis could also cause portal hypertension (high blood pressure in the intestinal blood vessels), and enlargement of the spleen. Some people with cirrhosis experience lower bone strength and are more prone to fractures. Cirrhosis reduces the liver’s ability to filter the toxins out of the patient’s blood. The increased concentration of toxins in the blood can cause mental deficits, confusion and difficulty in concentrating. Cirrhosis also increases the risk of development of liver tumors such as hepatocellular carcinoma and cholangiocarcinoma.

Diagnosis

To diagnose cirrhosis, the doctor will start with a medical history, and a physical exam to look for signs such as jaundice and enlarged liver and spleen. A detailed panel of blood tests, liver function tests and ultrasound scans are also required. The doctor may also prescribe a CT scan, an MRI scan, an endoscopy and a liver biopsy.

Treatment and Surgical Interventions

The treatment of cirrhosis depends on the cause and the severity of the condition. Treatment of early cirrhosis is usually with medications and lifestyle modifications. Complications may need additional treatment such as antibiotics for infections, endoscopic procedures for bleeding and fluid removal from the abdomen for severe discomfort due to fluid accumulation. In case of severe cirrhosis or when a liver cancer develops on a background of cirrhosis, liver transplantation may be the only life-saving treatment.

Prevention

Most common causes of cirrhosis can be prevented completely by a healthy life style of diet and exercise, avoiding excessive alcohol and protecting against viral hepatitis with immunisation against hepatitis B.

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