Definition and causes
Cirrhosis or liver cirrhosis is not an independent disease, but is a relatively frequent result of a variety, especially chronic liver diseases. When damage from disease or toxic effects resulting in the characteristic and irreversible changes (scarring) in liver tissue with impaired function to follow, the state called cirrhosis. A cirrhosis can be reduced, but can also be magnified, despite the name.
Besides the direct causes symptoms state a number of complications and sequelae (described below). The liver is a vital organ, and when function is reduced sufficiently, the condition is fatal.
The causes of liver cirrhosis mentioned here with decreasing frequency:
- Excessive alcohol. This is clearly the leading cause of cirrhosis in the Western world and is responsible for approx. half of the cases in Denmark.
- Viral hepatitis(infectious hepatitis) may in some cases lead to cirrhosis. This is a frequent cause in the world but ranks lower down the list in Denmark, where hepatitis is not as frequently.
- Autoimmune hepatitis, Which is a rare form of hepatitis, where the body's own immune system attacks the liver.
- Primary biliary cirrhosis, Who also is an autoimmune disease where the immune system attack the small bile times in the liver, can lead to liver cirrhosis.
- Other reasons arerare metabolic diseases.
- Cryptogenic liver cirrhosisconstitute some cases and is the name of cirrhosis without known cause.
Liver cirrhosis is not rare and is diagnosed around 1,500 new cases each year in Denmark.
Symptoms of cirrhosis
The liver has many different functions, and therefore are the symptoms of hepatic dysfunction are manifold. However, liver cirrhosis develop gradually and can be present for extended periods without obvious symptoms, because there will be enough healthy liver to maintain the main features.
The symptoms of liver cirrhosis includes both direct symptoms of hepatic dysfunction as symptoms that are related to the complications and sequelae, as the gradual development of cirrhosis (see below). The latter is usually late stage (often after several years) and may be the only serious symptoms as cirrhosis of itself does not have to give obvious symptoms.
Upstreamcan be seen:
- Fatigue, decreased energy.
- General malaise.
- Loss of appetite, nausea and possible. vomiting and weight loss.
- Muscle cramps in the physician.
Later in history(and rarer) seen:
- Small red edderkoppelignende spots in the skin, especially on the upper and cheeks (calledspider naevi).
- Yellowing of the skin (jaundice).
- Increased tendency to bleeding and bruising because reduced production of blood størkningsproteiner (coagulation factors) in the liver.
- Itching due to the accumulation of waste in the blood, which usually cleaned by the liver and kidneys.
- Increased abdominal extent due to fluid in the abdominal cavity (ascites).
- Menstrual disorder in women.
- Impotence and development of breast tissue in men because of disruptions in hormone balance.
- Bloody vomiting due to enlarged veins in the esophagus.
- Symptoms of central nervous system as: behavioral, confusion, drowsiness, impaired memory, restlessness, irritability, impaired coordination of eye movements, shaking hands (tremors), difficulty in moving normally (ataxia). In the worst case seen deterioration in: said sleep tight and may eventually end up with convulsions and coma (unconsciousness). The symptoms may be very mild and hardly more than a few days to a week.
Complications and sequelae
Several of the late symptoms are caused by more or less inevitable sequelae, which gradually developed among people with cirrhosis. The most important are:
- High blood pressure in the liver (portal hypertension):Is the structural changes in liver tissue and lead to other conditions and symptoms asfluid in the abdominal cavity;(ascites)injuries in the stomach(gastropati)enlarged veins in the esophagus(oesofagusvaricer), which may cause severe (fatal) bleeding.
- Effect of central nervous system (hepatic encephalopathy):Defined as symptoms of central nervous system (see above) in liver illnesses. The normal brain function can almost always be restored and the condition persists usually not more than a day to a week's time.
- Malnutrition (hepatic malnutrition):The liver is important for the body's absorption and the formation of various nutrients and vitamins. Deterioration of these features gives malnutrition.
- Kidney Effect (nephropathy):Liver and kidneys are to some extent dependent on each other and impaired function of one, can also lead to impaired function of the other.
- Increased infection trend:Decreased production of so-called acute-phase reactants in the liver gives increased risk of infection because these proteins normally play an active role in the immune system.
- Cancer of the liver:Liver cirrhosis may eventually form the basis for the development of cancer nodules in the liver tissue (hepatocellular carcinoma), but it is a rare complication.
Precautions and diagnosis
The main measures is to prevent complications and boot prompt treatment, since the course and prognosis depends largely on this.
Did you see, for example. an excessive alcohol consumption (see prevention below), or have been liver with, for example. infectious hepatitis, and get some of the above symptoms should seek medical attention and be thoroughly studied for liver cirrhosis and sequelae. It should be mentioned that may have had infectious hepatitis without realizing it. Read more about the infection routes and symptoms in the article on the subject.
The suspicion of cirrhosis get the doctor on the basis of symptoms and information about possible causes. The diagnosis made so with an ultrasound examination and possible. a biopsy (tissue) from the liver. In addition, liver function assessed using blood samples, and exploring for the complications of other blood tests and various studies. Among gastroscopy (kikkertundersøgelse of stomach) and urine tests, as well as any. multiple image studies as CT or MRI.
- Has it been found cirrhosis (or other liver disease), it is crucial for disease outcome that we completely abstain from alcohol. Moreover, one should not take any medicine without asking a doctor first. If the liver is not functioning optimally and can incinerate drugs and alcohol, even small doses can be very toxic and sometimes lethal.
Treatment of liver cirrhosis
As mentioned, the liver damage caused by liver cirrhosis unfortunately irreversible. Liver cirrhosis in itself can not be treated, but it can be many complications, and this is very important for the progress and prognosis, that is life and life length.
First and foremost addressed the underlying disease or condition. It would, for example. say alcohol cessation, treatment of any. infectious hepatitis (see this) and medical treatment of any. autoimmune disease.
Additionally focuses referred to prevent and treat the complications, which is a specialist task. There may be various medical treatments with good effect on various symptoms such as fluid retention and stomach problems, etc. Proper nutrition is very important, and it usually nutrition therapy with diet and possibly planning. food supplements.
In advanced liver cirrhosis with severe loss of liver f