Cirrhosis is a serious disease of the liver where scar tissue replaces normal healthy tissue, and affects the function and structure of the liver. Liver, which is the largest organ in the body, has a vital roles which are important to keep the body functioning well. Liver makes proteins and enzymes that regulate blood clotting. It also regulates cholesterol and stores the energy. In addition, the liver removes poisons from the blood. 30% of cirrhosis’s victims are diagnosed will remain alive for 5 years. Cirrhosis can be defined regarding its causes, symptoms, diagnosis, and treatment.
Cirrhosis has many causes, although the most common ones are alcoholism and chronic viral hepatitis B, and C. Cirrhosis can develop as a result of consuming alcohol varying from person to person depending on the amount and regularity of intake. Chronic viral hepatitis B and hepatitis C are also a major cause of cirrhosis, while the hepatitis A does not cause cirrhosis. Hepatitis B, which is the most common in Africa and Asia, causes inflammation and injury of the liver can lead to cirrhosis. Hepatitis C, which is the most common found in Europe and the U.S, works in the same manner as hepatitis B in damaging the liver. Further cause of cirrhosis is the primary biliary cirrhosis (PBC) which is commonly found in women. PBC is caused by disorder of the immune system. Normally, liver produces a bile, which is carried via the bile ducts to the intestines to digest food while in PBC the small bile ducts become inflamed, blocked, and scarred. Absence of bile causes intense skin itching, jaundice, and decrease absorption of calcium and vitamin D resulting in osteoprosis. Metabolism and genetics also participate in cirrhosis for example abnormal collection of iron (hemochromatosis) or copper (Wilson’s disease) in the liver causing injury, scarring and cirrhosis. Further cause of cirrhosis is the Autoimmune chronic active hepatitis that happens when the immune system attacks the liver and causes inflammation, damage, and cirrhosis. Drugs and chemicals also cause injury of the liver.
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Cirrhosis has a few symptoms varies among patients depending on the degree of injury. One of these symptoms is jaundice, which is characterized by yellowish skin and eyes because of an inability of the liver to remove bilirubin from the blood. Patient with cirrhosis also suffering from itching, due to deposited bile’s products in the skin. This patient also suffers from accumulation of fluid in legs that is called edema. As a result of the blockage of blood flow via the liver, fluid accumulation in abdomen which is worsen by the decrease in protein production. Other symptoms include fatigue, weakness, loss of appetite, weight loss and nausea. As the disease progress, complications may develop ,such as varices that happens with cirrhosis patient when the blood flow through the liver slows, so the blood from intestine go back to the vessels of the stomach and esophagus, these vessels are not meant to carry this much of blood so they dilate (varices), with increasing pressure these thin-walled vessels tend to rupture causing internal hemorrhage, vomiting blood, passing of black tarry stool, and even shock. Further complications of cirrhosis is accumulation of toxins in the blood, that passes to the brain causing confusion, drowsiness and coma.
Cirrhosis can be diagnosed in a number of ways. First of all, yellowish skin and white eyes can be detected by naked eye examination. Then, physical examination is done by feeling if the liver size is larger than usual. Laboratory tests are also required for further details of the disease. These tests include biopsy, which is Surgical removal of tissue for examination, and blood tests that show if there is change in the normal rate of proteins, bilirubin, and enzymes. Patient may be asked to do x-rays and ultrasound to confirm the diagnosis.
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The treatment is determined by the symptoms, which aims to stop further damage and reduce complications. Patient is asked to stop drinking alcohol and drugs to avoid more damage of the liver. Interferon is recommended as a medication if the cause is hepatitis B or C. Also, When the primary cause is hemochromatosis, bloodletting is required to diminish the excess amount of metal. Medications are prescribed to help eliminate urine for patient with wilson’s disease. If the autoimmune hepatitis is responsible for cirrhosis, prednisone and azathioprine are used. Water tablets (diuretics), which used to increase the urination, are used to treat ascites and edema. If the patient developed bleeding from ruptured veins into esophagus, propranolol is used in order to reduce the high pressure from the veins. When complications can not be controlled liver transplantation is necessary.
Cirrhosis of the liver is fatal disease that because 70% of victims will die after diagnosis. This disease has a number of causes, and can be treated by reducing the symptoms of the causes so the treatment is palliative not curative. Because of this, prevention is required to avoid getting this disease.