• Rukmani Birla Hospital,Gopalpura Bypass Road, Near Triveni Bridge,Gopalpura,Jaipur – 302018.

CIRRHOSIS: SYMPTOMS, DIAGNOSIS, AND TREATMENT

Cirrhosis is a medical condition of the liver in which the healthy liver cells are replaced by scar tissue due to severe health conditions and diseases such as infection, Hepatitis, alcohol addiction, etc. Cirrhosis is a progressive disease, which intensifies with time and can be fatal.

The liver of the human body is a very essential organ about the size of a football. It is the primary organ responsible for removing toxins from the blood and producing enzymes, which help digest food, stores, sugar and nutrients. The liver also functions effectively to avoid any infections. Every time the liver is hurt, injured or damaged due to a health condition, lifestyle habit such as excessive alcohol – it produces scar tissue to repair itself. But when the liver is repeatedly injured or hurt, the production of scar tissue increases leading to critical problems in the proper functioning of the liver. Serious and long-term damage to the liver is the primary cause of cirrhosis, in which the liver cells are replaced with scar tissue. Too much production of scar tissue in the liver tends to impact the other healthy cells, thereby blocking the blood flow through the liver. This condition can be very severe and can prove fatal for the patient.

The damage caused to the liver due to the process of cirrhosis, cannot be undone; though the symptoms can be managed and the overall impact can be reduced, provided the problem is diagnosed early on the stages. For cases, where cirrhosis is not timely diagnosed or does not receive adequate medical treatment, the condition can be life-threatening.

Symptoms of Cirrhosis

A person might not experience any significant symptoms until the damage reaches an advanced stage. That said, in most of the cases, cirrhosis does not produce any symptoms until the final stage, which makes it difficult to control and treat. Yet, some symptoms that can help with early diagnosis of cirrhosis include:

  • Chronic fatigue and weakness
  • Loss of appetite
  • Unexplained weight loss
  • Nausea
  • Easy bruising and bleeding
  • Swollen legs and feet
  • Intense Itchy and red skin
  • Whitening of the nails
  • Jaundice causing paleness in eyes and skin
  • Accumulation of abdominal fluid
  • Spider blood vessels on the skin
  • Redness and patches in the palms of the hands
  • Skipped or irregular periods
  • Lack of interest in sex in men
  • Enlargement of the breast in men
  • Shrinkage in testicles in men
  • Extreme confusion and dizziness
  • Slurred speech
  • Concentration problem or memory issues
  • Insomnia

Some other symptoms that can be witnessed which indicate a higher stage of cirrhosis include:

  • Vomiting of blood
  • Chronic muscle cramps
  • Foul-smelling, brownish urine
  • Sudden and consistent fever
  • Enlarged spleen
  • Bone fragility
  • Accelerated heartbeat
  • Bleeding gums
  • Excessive hair loss
  • Bleeding from nose
  • Mobility issues

A person suffering from cirrhosis may or may not experience all of these symptoms since the condition impacts every patient differently. Also, the mere presence of symptoms does not confirm the conditions, unless it is diagnostically confirmed through a medical examination. In some cases, these symptoms can also indicate another health condition.

Diagnosis of Cirrhosis

As mentioned, patients with early-stage of cirrhosis might show any prominent symptoms, but the condition can be diagnosed with the help of routine blood test or check-ups. To confirm cirrhosis, the following tests might be performed by the doctor:

Lab Tests: A blood test may be conducted to check for liver malfunction signs such as excessive bilirubin, certain enzymes, etc. Moreover, creatinine levels may be determined to assess the kidney function and to check for any hepatitis virus. Several other indicators will be examined from the blood test. This is also used to know the underlying cause of cirrhosis.

Imaging Tests: The doctor might advise for an MRE to detect any hardening or stiffening of the liver; this test is non-invasive and provides an in-depth analysis of conditions. A few other imaging tests such as an MRI, CT, ultrasound, etc. can also be done.

Biopsy: In a biopsy, the doctor collects a sample of tissue from the liver to study the extent and cause of liver damage.

For a person, confirmed with cirrhosis, the doctor will be advice regular medical screenings to check for progression and other related complications such as liver cancer or esophageal varices.

Treatment of Cirrhosis

Cirrhosis has no definitive treatment, but the underlying cause can be cured to prevent any further damage to the liver. The treatment options include:

  • Weight loss: For patients that have cirrhosis caused because of non-alcoholic fatty liver, losing weight might be the ideal treatment. This will also control blood glucose levels and blood pressure.
  • Control Hepatitis: For cirrhosis caused by hepatitis infection, the doctor will prescribe certain medications which aim to limit further damage caused by the virus.
  • Treat alcohol dependency: For cases where cirrhosis is triggered because of excessive alcohol consumption, the patient will be asked to refrain from drinking alcohol. In any case, alcohol addiction programs may be included as therapy treatments.
  • Medications: For all other types of cirrhosis such as primary biliary cirrhosis, targeted medicines can be given to stop the progression of the disease into conclusive cirrhosis.

For any complications that arise out of cirrhosis, the following treatment options can be used:

  • Low sodium diet will be recommended for patients that suffer an accumulation of fluid in the body caused due to cirrhosis. This fluid causes ascites and swelling. In certain cases, surgery may be recommended to relieve pressure caused due to fluid accumulation.
  • Targeted blood pressure medicines may be given to control the increased pressure in the veins which are responsible for supplying the liver. This can also be used to prevent bleeding caused due to portal hypertension.
  • For patients who develop varices, medication will be directed to reduce the risk of bleeding. For cases, where the varices tend to bleed, the patients might need to undergo a procedure to stop the bleeding or reduce the further risk of more profuse bleeding.
  • For cases, where the patients develop infections due to cirrhosis, antibiotic treatment, vaccinations, etc, will be used to treat the problem.
  • In some patients, who have a risk of hepatic encephalopathy, the doctor might recommend medications to minimise the toxin build-up in the blood due to poor liver functioning.

For cases, which reach a severely advanced stage of cirrhosis, liver transplant surgery might be the only option left. In this stage, the liver fails and stops functioning, making the body extremely vulnerable and nearly fatal. In a liver transplant, the surgeon will replace the damaged liver with a matching donor, healthy liver. The donor could be a deceased person or a living person who agrees to donate a part of the healthy, living donor. Cirrhosis is one of the primary causes of liver transplant surgery.

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