Thursday, August 11, 2011

CIRRHOSIS



Cirrhosis is a condition of the liver resulting from its non-reversible damage or scarring and leads to blockage of blood flow through the liver. This prevents metabolic and regulatory processes normally carried out by the liver.




Cirrhosis is primarily caused by various reasons like chronic alcoholism, viral infections caused by chronic viral hepatitis B, C and D, diseases like Wilson’s disease and hemochromatosis which are inherited. Biliary cirrhosis is caused due to diseases such as primary biliary cirrhosis (PBC) and primary sclerosing cholangitis (PSC). Toxic hepatitis due to prolonged exposure to environmental toxins or severe reactions to prescribed drugs can be a cause of Cirrhosis. Even repeated bouts of heart failure with liver congestion can cause Cirrhosis.

Some early symptoms of Cirrhosis are loss of appetite, loss of weight, nausea, fatigue, weakness and exhaustion.




Does Cirrhosis affect babies? Can they be treated?

Biliary atresia is the most common cause of Cirrhosis in babies and may be caused by the lack of or injury to the bile duct. Such babies are jaundiced after they are a month old as a result of accumulation of bile in the liver. In certain cases a new bile duct may be surgically formed which restores normal secretion of bile. In few other cases, transplantation may be required.

What are the effects of reduced liver functioning?

With a decrease in liver function, fewer proteins like albumin are produced resulting in fluid accumulation in the legs or abdomen. Cirrhotic patients may bleed and bruise easily as a result of low levels of proteins that are required for blood clotting. Intense itching due to deposition of certain products under the skin may also be seen

What is the impact of later stage Cirrhosis?

In advanced stages of Cirrhosis, occurrence of jaundice and gallstones is very common as lesser bile reaches the gall bladder. Blood toxin levels go up as the liver doesn’t filter them out and this in turn has an adverse effect on mental function leading to personality changes and even coma. In early stages of toxin accumulation in the brain we may observe habits like neglect of one’s appearance, forgetfulness, lack of concentration and altered sleeping habits. As the liver is not performing its function of filtering as it normally would, drugs are not adequately filtered and the patient may exhibit increased sensitivity to drugs and their side-effects.

Blood from the intestines and the spleen is pumped into the liver via the portal vein. In case of Cirrhosis, this flow is blocked leading to a swollen liver and potentially a swollen spleen. Artificial blood veins called varices then get formed as a result of the blood forcing its way from the intestine to the liver. Varices normally form in the stomach and esophagus which may rupture due to thin vessel walls and portal hypertension or high blood pressure at the portal vein, thus causing bleeding in the upper stomach or esophagus.




How can Cirrhosis be detected?

Cirrhosis can be detected by various medical analytical methods like few identifiable symptoms, physical examination, CAT scan, ultrasound, radio isotope liver/spleen scan or liver biopsy. Immediate treatment is advised once Cirrhosis is determined

Cirrhosis is treated by stopping or slowing down its progress, minimizing lever cell damage and reducing complications. In case of alcoholic cirrhosis, it is very essential to give up drinking. Cirrhosis resulting from viral infection may be treated with anti-viral drugs to minimize lever cell injury. Symptoms of cirrhosis can be controlled by medication like diuretics, which remove excess fluid and prevent recurrence of edema and ascites. Diet and drugs therapy administered together improves altered brain function. Eg. Decreased dietary protein results in less formation of toxins in the dietary tract. Lactulose, a laxative, may help absorb the toxin and accelearate their removal from the intestines. A serious fallout of Cirrhosis is bleeding as a result of portal hypertension.

Complications in Cirrhosis can usually be well treated. In case of bleeding from varices of the esophagus or stomach, these veins are injected with a sclerosing or hardening agent. Rubber bands wrapped around the veins by means of an endoscope also help. When the case gets critical, a liver transplant shunt also called portacaval shunt may be used to reduce the pressure in the portal vein and the varices

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