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Liver Cirrhosis

Liver cirrhosis is the chronic liver scarring, greatly reducing the liver function. This is the end stage of chronic liver disease resulting in a variety of other liver disorders. The main factors which contribute to liver cirrhosis are hepatitis B and C, alcohol abuse, cystic fibrosis, biliary atresia and fatty liver. However any other disorders which damage the liver may cause cirrhosis. These disorders may include chronic viral exposure, and Alpha 1 antitrypsin deficiency.

Pathophysiology

Liver cirrhosis is actually the advanced stage of liver fibrosis i.e., change in alteration of normal wound healing resulting in abnormal continuation of connective tissues and deposition, thus rupturing the normal vasculature of liver.

In cirrhosis, the blood-liver cells relation is almost demolished. The liver cells called hepatocytes may have very poor or no blood supply, affecting the function of liver to remove/add nutrients to the blood. In addition to that, there is obstruction of blood flow to liver creating ‘’blood back-up’’ in the portal vein, resulting in increase of blood pressure in the portal veins. This phenomenon is known as portal hypertension. The obstructed blood in the portal veins goes into other veins, thus bypass the liver and go to the heart.

The other condition which contributes to the liver cirrhosis is the change in the pathway of bile flow. The relation between hepatocytes and canaliculi is demolished.

The bile can’t flow into small intestine for the digestion. This also reduces the digestion of food to some extent.

Signs and symptoms

A patient suffering from liver cirrhosis has signs and symptoms of weakness, anorexia, itching, jaundice and ascetics. Ascetics and lower abdominal edema are common, mainly due to congestive heart failure; however patients having history of viral hepatitis have worse prognosis of disease. The lower edge enlarged liver due to cirrhosis can be palpated. Some patients may have telangiectasias. Patients having cirrhotic liver by Wilson’s Disease are basically due to genetic disorder, which results in the abnormal accumulation of copper in whole body.

Diagnosis

The liver cirrhosis is usually diagnosed by MRI, CT scan and ultrasound examinations of the abdomen. Laboratory tests show increased levels of albumin and elevation of liver enzymes (ALT and AST).

Treatment

The treatment of liver cirrhosis is to avoid further destruction for the liver, and treat the complications. Ultimate effort is the liver transplantation.

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