Cirrhosis: Understanding your Health

Anatomy & Function of the Liver

The liver is a large organ that sits in the right upper abdomen, just under the right lung. It performs many different functions at the same time. The liver makes proteins, eliminates waste material from the body, produces cholesterol, stores and releases glucose energy and metabolizes many drugs used in medicine. It also produces bile that flows into the intestine to help digest food. This remarkable organ also had the ability to repair and regenerate itself if it is injured or partially removed. The liver receives blood from two different sources-the heart and the intestine. All of this blood flows through the liver and returns to the heart. It is no wonder that the ancient Chinese viewed the liver, not the heart as the center of the body.

What is Cirrhosis?

Cirrhosis is slowly progressing disease in which healthy liver tissue is replaced with scar tissue. Many types of chronic injury to the liver can cause scar tissue to form. This scarring changes the normal structure and disrupts the regrowth of liver cells. Eventually, the scar tissue blocks blood flow through the liver and prevents the liver from accomplishing its important jobs.

What are the signs and symptoms?

Cirrhosis takes years to develop. During this time, there are usually no symptoms, although fatigue, weakness and decreased appetite may occur and worsen with time. When cirrhosis has fully developed a number of signs may be present:

*Fluid retention in the legs and abdomen: the liver produces a protein, called albumin, that holds fluid in blood vessels. When the blood level of albumin decreases, fluid seeps out of the tissues into the legs and abdomen, causing edema (fluid accumulation) and swelling.

*Jaundice: the liver produces bile that normally flows into the intestine. In advanced cirrhosis, bile can back up in to the blood, causing the skin and eyes to turn yellow and the urine to darken.

Intense itching: certain types of cirrhosis, such as chronic bile duct blockage can produce troublesome itching.

Coagulation (clotting) defects: the liver makes certain proteins that help clot blood. When these proteins are deficient, bleeding can be excessive or prolonged.

Mental function change: the liver processes and filters toxins. When these toxins escape into the bloodstream in severe cases of cirrhosis, they can travel to the brain and affect mental function.

Esophageal vein bleeding: in advanced cirrhosis, intestinal blood bypasses the liver and flows up and around the esophagus (connects the throat to the stomach) to the heart. The veins in the esophagus expand and may rupture, causing significant bleeding.

Diagnosis and Liver Biopsy:

The physician may suspect cirrhosis from the patient’s medical history and physical examination. In addition, certain blood tests or ultrasound can provide helpful information. To make a definite diagnosis, however, a liver biopsy (tissue sample) may be necessary. This is performed by anesthetizing the skin and inserting a thin needle into the liver. A specimen of tissue is removed and examined under a microscope.

What is the Course of Cirrhosis?

When cirrhosis is diagnosed, the patient and physician begin a plan of action designed to preserve the remaining liver cells and correct the complications mentioned above. By following this plan, many patients can lead long, productive lives.

Treatment:

Often, the only required treatment for cirrhosis is removing the offending cause:

*Alcoholic patients must permanently stop consuming alcohol.

*Diabetics should work closely with their physicians to control their blood sugar

*When iron is being retained in the body, having blood drawn frequently can eliminate large amounts of iron.

*Medicines that modulate the immune system can treat autoimmune hepatitis and prevent potential complications such as cirrhosis.

*Restricting salt ad using fluid pills (diuretics) reduce

*Toxins and drugs that damages the liver must be avoided.

*Using certain laxatives or antibiotics can improve changes in mental function.

*Bleeding veins in the esophagus can be closed with small rubber bands.

*Ursodiol (Actigall) and other drugs may be helpful in treating primary biliary cirrhosis.

What causes Cirrhosis?

Cirrhosis can be caused by many things including:

*Alcohol: excess alcohol use is one of the most common causes of cirrhosis.

*Fatty liver disease: this is often associated with diabetes but can develop in people without diabetes as well.

*Chronic viral hepatitis: Hepatitis B and Hepatitis C and perhaps other viruses can infect and damage the liver, eventually causing cirrhosis.

*Chronic bile duct blockage: this condition can occur at birth or develop later in life and the causes remain unknown. The two most common blockages are primary biliary cirrhosis and primary sclerosing cholangitis. Primary sclerosing cholangitis is often associated with Ulcerative Colitis, a chronic ulcerative condition of the colon.

*Abnormal storage of copper (Wilson’s Disease) or iron (Hemochromatosis): these metals are present in all body cells. When abnormal amounts of them accumulate in the liver, scarring and cirrhosis may develop.

*Drugs and Toxins: prolonged exposure to certain chemicals or drugs can scar the liver.

*Autoimmune Hepatitis: this chronic inflammation occurs when the body’s protective antibodies and white cells don’t recognize the liver as part of the body’s own tissue. The antibodies and cells attack the liver cells as though they were foreign cells.

*Cystic Fibrosis: thicken mucus secretions in patients with this inherited disorder can block the bile ducts, leading to swelling, inflammation and eventually scarring.

*Alpha 1 antitypsin deficiency: an inherited absence of a specific enzyme in the liver.

Liver Transplant:

Liver transplantation may be an option for certain patients with severe cirrhosis.

Prevention:

Most cirrhosis is caused by excessive alcohol consumption, fatty liver disease or hepatitis viruses. To reduce the risk of cirrhosis, limit alcohol consumption to no more than 1 or 2 drinks per day. There is a vaccine against Hepatitis B recommended for children and certain high-risk groups such as: health care professionals, persons traveling to Third World countries, homosexual men, intravenous drug users and prosititues.

Summary:

Cirrhosis of the liver is a common disorder that has many causes. With early diagnosis, much can be done to prevent serious complications. Treatments depend on the cause of the liver injury and what complications are present. Ongoing medical research could provide advances in treating cirrhosis in the future.

Disclaimer: This information was taken a pamphlet from GI Supply and I give them full credit for this information. Please check out their website http://www.gi-supply.com for more information.

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