Cirrhosis of The Liver

LIVER CIRRHOSIS

Introduction

The word cirrhosis (pronounced sɪˈroʊsɪs) is derived from the Greek word kirrhós which describes the orange-yellow color of the skin and sclera (white part of the eyes) in someone with jaundice. The condition was first described by Hippocrates in the 5th century but it was René Laennec who gave the condition its name in 1819.

Cirrhosis is a condition in which the liver’s functional capacity deteriorates due to long-term inflammation and scarring or fibrosis. Classically, the normal liver architecture is distorted and replaced by the formation of scar tissue. This not only results in a decline in the synthetic capacity of the liver but results eventually in an irreversible alteration in the blood (vascular) flow through the liver resulting in portal hypertension. This process takes place over many years.

Symptoms

There are often no symptoms in the early stages of scarring and even cirrhosis because of the liver tremendous ability to compensate. As cirrhosis progresses, one may become tired, weak, develop itch and swelling in the lower legs, yellowing of the skin, bruise easily, have fluid build up in the abdomen (known as ascites), or develop spider-like blood vessels on the skin. There is an increased risk of infection, especially of the fluid within the abdomen (known as spontaneous bacterial peritonitis) and also confusion (hepatic encephalopathy) due to a build-up of toxins in the body. Bleeding may also occur from rupture of dilated veins in the esophagus. Patients with cirrhosis are also at risk of developing liver cancer.

Causes

⠂Hepatitis B
⠂Hepatitis C
⠂Non-alcoholic fatty liver disease
⠂Alcoholic liver disease
⠂Autoimmune hepatitis
⠂Primary Sclerosing Cholangitis
⠂Primary Biliary Cirrhosis
⠂Metabolic causes such as Haemochromatosis and Wilson’s disease
⠂Other Hereditary Disorders

Diagnosis

⠂Fibroscan Liver Stiffness Measurement
⠂Serum Markers
⠂Medical imaging
⠂Liver biopsy.

Treatment

Treatment for liver cirrhosis in its early stages before decompensation depends on the cause of cirrhosis. Early treatment of hepatitis B, hepatitis C, and autoimmune hepatitis has been shown to reverse the progression of cirrhosis and prevent hepatic decompensation. However, once cirrhosis is firmly established and portal hypertension has set in, treatment of cirrhosis primary involves treatment of the various complications associated with portal hypertension including the management of ascites, hepatic encephalopathy, variceal screening, banding and surveillance, screening and surveillance for liver cancer and preparing patients for liver transplantation ultimately if they are suitable candidate candidates.

gutCARE has a comprehensive team of specialists and allied health services for the diagnosis, treatment, and management of patients with liver cirrhosis including Fibroscan liver stiffness measurement for the early detection of cirrhosis and specialized psychology and dietetics services to provide a holistic care for cirrhotic patients. We provide treatment for hepatitis B, hepatitis C and the whole spectrum of liver disease and assessment for liver transplantation and access to treatment for liver cancer.

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