Cirrhosis
Cirrhosis is a chronic liver condition characterized by the formation of scar tissue that disrupts the organ's normal functions. The liver, essential for digestion and detoxification, can sustain damage from various sources, predominantly toxins like alcohol and viral infections. As the liver becomes increasingly scarred, its structure changes, leading to complications such as portal hypertension and ascites, which can result in serious health issues. Symptoms of cirrhosis may include jaundice, fatigue, weakness, loss of appetite, and easy bruising, which can significantly affect a person's well-being. Diagnosis typically involves a comprehensive history, physical examination, laboratory tests, and sometimes liver biopsy. While cirrhosis has no cure and is often linked to high mortality rates, treatment focuses on managing complications and can include interventions like fluid removal or nutritional support. In select cases, liver transplantation may be considered. The prognosis varies, with milder cases showing a better outlook when sufficient healthy liver tissue remains.
Cirrhosis
ANATOMY OR SYSTEM AFFECTED: Liver
DEFINITION: The formation of scar tissue in the liver, which interferes with its normal function
CAUSES: Buildup of scar tissue in liver from toxins (alcohol, viruses)
SYMPTOMS: May include jaundice, fatigue, weakness, appetite loss, easy bruising
DURATION: Chronic
TREATMENTS: None
Causes and Symptoms
The liver is a large, spongy organ that lies in the upper-right abdomen. Regarded as primarily part of the digestive system because it manufactures bile, the liver has many other functions, including the synthesis of blood-clotting factors and the of such harmful substances as alcohol.
Cirrhosis describes the fibrous scar tissue (or nodules) that replaces the normally soft liver after repeated long-term injury by toxins such as alcohol or viruses. The liver may form small nodules (micronodular cirrhosis), large nodules (macronodular cirrhosis), or a combination of the two types (mixed nodular cirrhosis). Cirrhosis is a frequent cause of death among middle-aged men, and increasingly among women. While alcoholism is the most common cause, chronic hepatitis and other rarer diseases can also produce the irreversible liver damage that characterizes cirrhosis. The resulting organ is shrunken and hard, unable to perform its varied duties. Because of its altered structure, the cirrhotic liver causes serious problems for surrounding organs, as blood flow becomes difficult. The barrier to normal circulation leads to two serious complications: portal hypertension (the buildup of pressure in the internal veins) and ascites (fluid leakage from blood vessels into the abdominal cavity).
Treatment and Therapy
Diagnosis is usually made from a history of alcoholism. A physical examination may reveal jaundice; a large nodular liver or a small shrunken one, depending upon the stage; or a fluid-filled (ascites). Laboratory studies may show elevated liver enzymes released from damaged cells and low levels of products that the liver normally produces (protein, clotting factors). A definitive diagnosis can be made only by biopsy, although radiographic methods such as computed tomography (CT) scanning and can be quite conclusive.
The rate is very high, as the damage is irreversible. Deaths from internal vein rupture and hemorrhage (the results of portal hypertension) and from kidney failure are most common. Repeated hospitalizations attempt to control the variety of complications that arise with agents that stop bleeding, bypass tubes that relieve pressure, the removal of the ascitic fluid, and nutritional support for malnutrition. Eventually, kidney failure ensues or one of these control measures fails, and death rapidly follows. Liver transplantation is considered in some cases. Cases of mild cirrhosis, where sufficient normal tissue remains, have a clearly better course.
Bibliography:
“Cirrhosis.” National Institute of Diabetes and Digestive and Kidney Diseases. NIH, US Dept. of Health and Human Services, April 2014. Web. 28 Apr. 2016.
"Cirrhosis of the Liver." American Liver Foundation, 7 Mar. 2024, liverfoundation.org/liver-diseases/complications-of-liver-disease/cirrhosis/. Accessed 28 Mar. 2024.
Fishman, Mark, et al. Medicine. 5th ed. Philadelphia: Lippincott, 2004. Print.
Goldman, Lee, and Dennis Ausiello, eds. Cecil Textbook of Medicine. 23d ed. Philadelphia: Saunders, 2007. Print.
Lal, Subodh K., A.D.A.M. “Cirrhosis.” MedlinePlus. NIH, US Natl. Lib. of Medicine, 14 Aug. 2015. Web. 28 Apr. 2016.
Parker, James N., and Philip M. Parker, eds. The Official Patient’s Sourcebook on Primary Biliary Cirrhosis. San Diego: Icon Health, 2002. Print.
Parker, James N. and Philip M. Parker. The Official Patient’s Sourcebook on Cirrhosis of the Liver: A Reference Manual for Self-Directed Patient Research. San Diego: Icon Health, 2004. Print.
Wood, Debra. “Cirrhosis.” Health Library. EBSCO Information Services, 12 Sept. 2014. Web. 28 Apr. 2016.
Zelman, Mark, et al. Human Diseases: A Systemic Approach. 7th ed. Upper Saddle River: Pearson, 2010. Print.