Cirrhosis of liver is slow and gradual replacement of normal healthy liver tissue with scar tissue which results in poor liver function and blockage of flow of blood through liver which comes from intestines. As more scar tissue replaces normal healthy liver, liver begins to fail.

What causes cirrhosis?

Alcohol: Amount of alcohol which can cause liver damage varies from person to person, however those who consume alcohol for long in significant amount are more prone to develop liver damage.
Hepatitis B or hepatitis C: Caused by hepatitis B and C viruses, respectively, which are acquired by contact with contaminated blood (like needlestick injury, blood transfusion, injection drug abuser), sexual contact with infected person and from mother to child during childbirth.
Non-alcoholic fatty liver disease (NAFLD): Caused by presence of extra fat in liver (after excluding significant alcohol intake) which causes inflammation and scarring leading to cirrhosis. Usually seen in patients who are overweight or obese, having diabetes, high fat in blood, high blood pressure or metabolic syndrome.
Drugs causing liver injury.
Others: Autoimmune hepatitis (body`s own immunity acting against liver), Wilson disease (build up of copper in body), hemochromatosis (excess of iron in body), certain bile duct disorders, etc.
What are the symptoms of cirrhosis?

Early disease can present with nonspecific symptoms like weakness, fatigue (loss of energy), decrease wish to take food, vomiting or nausea, weight loss, etc.
Advanced disease can present with fluid accumulation in legs (edema) or abdomen (ascites), facial puffiness, yellowish discoloration of eyes or urine (jaundice), redness of palm (palmer erythema), decrease urine output, small red lesions on skin, easy bleeding following trauma, blood coming out of mouth/anus/other body site, black colored feaces, mental confusion, flapping tremors of hand, etc. In men it can cause impotence, breast enlargement and shrinking of testis.
What are the complication of cirrhosis?

Portal hypertension: It is a common complication of cirrhosis which is due to increased pressure in portal vein. Portal vein is main blood vessel which carries blood to liver from stomach, intestines, spleen, gallbladder and pancreas. Because of scar formation in liver the normal flow of blood from these organs to liver is hampered. As a result of blockage of blood flow to liver there are few complications which can arise like accumulation of fluid in abdomen (ascites) and legs (edema), formation of enlarged veins (varices) in food pipe (esophagus), stomach, etc., enlargement of spleen (splenomegaly), mental confusion/altered behavior/altered sensorium (hepatic encephalopathy), respiratory discomfort (hepatic hydrothorax or hepato-pulmonary syndrome) or decrease urine output/rise in creatinine (hepato-renal syndrome).

Increase risk of infection because of immune system dysfunction.
Development of liver cancer (Hepatocellular carcinoma)
Easy brusibility or bleeding following light trauma.
Gall bladder stone formation
Metabolic bone disease
What are the stages of cirrhosis?

Compensated cirrhosis: Liver damage is damaged but no abdominal swelling (ascites), blood in vomiting or black/red color feaces (variceal bleed), altered behavior/sensorium (hepatic encephalopathy), respiratory discomfort (hepatic hydrothorax or hepato-pulmonary syndrome) or decrease urine output/rise in creatinine (hepato-renal syndrome).
Decompensated cirrhosis: Presence of abdominal swelling (ascites), blood in vomiting or black/red color feaces (variceal bleed), altered behavior/sensorium (hepatic encephalopathy), respiratory discomfort (hepatic hydrothorax or hepato-pulmonary syndrome) or decrease urine output/rise in creatinine (hepato-renal syndrome).
How cirrhosis is diagnosed?

Your doctor will take good history and do proper physical examination. If there is suspicion of cirrhosis then he will subject you to some blood test, ultrasound abdomen, fibroscan/elastography, upper GI endoscopy and if needed CT scan or MRI of abdomen or liver biopsy.

Ultrasound of abdomen in cirrhosis may shows coarse liver echotexture, nodular liver surface, dilated portal vein or collateral, enlarged spleen or abdominal fluid (ascites).

How to prevent cirrhosis?

Best way to avoid development of cirrhosis from predisposing stage of liver illness is to recognize and treat early. Few advices to keep liver healthy are:

Dietary modification: Eat healthy balanced diet. Avoid high calorie food or drinks, saturated fat, sugar and refined carbohydrates. Keep yourself hydrated.
Lifestyle modification: Maintain healthy body weight. Avoid being overweight or obese. Aerobic exercise (like brisk walk 30-45min/day atleast 5days/week) regularly helps to lower liver fat.
Avoid: Avoid use of contaminated needles, sharing of items of personal hygiene (like shaving razors, toothbrush, nail clippers, etc), use of illicit drugs, self medication with over the counter drugs or using drugs beyond doctor`s advice.
Practice safe protected sex
Alcohol
Motivate others: to stop drinking and follow hand hygiene and doctor`s advice.
Hand hygiene: Wash hand with soap and water regularly before eating, after going to toilet and after touching dirty objects.
Vaccination: For hepatitis A or hepatitis B, if you are not vaccinated or not already infected or unsafe antibody titre. Transmission rate of hepatitis B from mother to child at birth can be reduced with vaccination and immunization of newborn starting within 12 hours of birth as well as by using antiviral drugs (if indicated).
Prevent others from getting infected from you if you harbor virus causing liver damage.

How to treat cirrhosis?

Treatment of cirrhosis is based on cause of cirrhosis and complication of cirrhosis. Main aim of treatment in early stage of cirrhosis is to slow the progression of cirrhosis and prevent complications development

Stop alcohol, antiviral drugs for hepatitis b or hepatitis C, proper sugar level if diabetes, steroid or other medications for autoimmune hepatitis, medications to reduce copper from body in patients with Wilson`s disease, etc.
Drugs to lower portal pressure (beta-blocker or nitrates), drugs to remove fluid from body (diuretics), drugs to lower ammonia level for encephalopathy (lactulose and others), drugs to improve kidney function (albumin, terlipressin and others).
Opt for liver ransplant, If cirrhosis is life threatening or treatment of cirrhosis complication is ineffective.
Low salt high protein diet
Stop alcohol intake even if you have other cause of cirrhosis.
Stop smoking
Avoid over the counter drugs (especially pain killers)
Vaccinate if not done already or infected

Cirrhosis Of Liver - A Complete Guide!

The term cirrhosis refers to liver scarring due to various diseases and conditions such as chronic alcoholism and hepatitis. Each time the liver gets injured, it tries to repair itself, resulting in the formation of the scar tissue. With the progression of cirrhosis, a number of tissues generate making the task of liver difficult. Since the liver is an important organ of the body due to its functionalities such as detoxification and nutrient generation, reduced function of liver poses a serious threat to the body.

Symptoms of liver cirrhosis:
Unfortunately, cirrhosis doesn t portray any conspicuous symptoms that can be easily identified until the scarring has reached a level of threat. Some of the common signs and symptoms of this disease include fatigue, nausea, itchy skin, drowsiness, enlarged breasts, testicular atrophy, fluid in the abdomen, bleeding from the mouth, leg swelling, redness in palms etc.

Causes of liver cirrhosis:
There could be an array of reasons for the occurrence of liver cirrhosis. The major causes include an accumulation of fat in the liver, chronic alcoholism and chronic hepatitis. Some of the other reasons include cystic fibrosis, bile duct deformation, Wilson s disease, hemochromatosis, schistosomiasis, continuous consumption of medicines such as methotrexate, a disease involving glycogen storage and Aalagille syndrome.

Complications involved in liver Cirrhosis:

High blood pressure: Cirrhosis results in slow blood movement through the passage of the liver resulting in an increased pressure on the vein that is responsible for carrying blood from the intestine to the liver. This increases the blood pressure in the body.
Swelling of abdomen and legs: Portal hypertension can result in accumulation of fluid in the leg and the abdomen due to the liver s inability to producing an important protein known as the albumin.
Spleen enlargement: Portal hypertension is responsible for changing the shape of the spleen. Decreased count of WBC and the platelets indicate towards portal hypertension and cirrhosis.
Bleeding: Portal hypertension doesn t let the blood flow in its normal path. It directs the blood to flow through smaller veins. The veins, in turn, swell and burst to cause a massive amount of bleeding.
Apart from these some of the other complications involve jaundice, liver cancer, infections, bone diseases and liver failure.

Diagnosis:
Liver cirrhosis doesn t get detected easily. It is often diagnosed with a routine blood test. Some of the lab tests that can help to identify cirrhosis include blood work to check organ function of liver and kidney. Your doctor might suggest other tests such as MRI scan, CT scan or liver biopsy.

Treatment:
Treatment for the underlying cause of liver cirrhosis is done to keep the disease under control. A doctor might treat you for weight loss, alcohol dependency, complications related to hepatitis, portal hypertension and hepatic encephalopathy. For advanced cases where the liver stops functioning, a doctor might suggest a patient go for a liver transplant.

Liver Cirrhosis - What You Must Know About It?

Pregnancy is a time when your body undergoes a plethora of changes, both emotionally and physically. In such a situation, an acute liver failure only triggers further complications, threatening to affect both the mother and the fetus. The ambit of liver diseases range from mild complications to those that can be life threatening. Acute liver failure or ALF, as it is commonly known as in medical parlance is a condition which is caused when then there is a sudden impairment of the ability of the blood to clot. In spite of the erratic nature of the ailment and its ability to affect anybody with a complete disregard of the individual, s pre-existing history of liver problems, there are certain causes that are said to propel it. Some of them are-

Eclampsia with liver infraction: This is an extremely rare condition. Generally, eclampsia refers to the occurrence of convulsions in pregnant women, mostly in those who suffer from high blood pressure. Those women who suffer from eclampsia along with liver infraction are more susceptible to have a liver failure.
Hepatic rupture: Much like eclampsia, hepatic rupture is also caused in women who have high blood pressure. This heightens the risk of an impending liver failure in pregnant women.
Fatty liver: Sometimes excess of fat develops in the liver deterring its functioning. This is not only detrimental to your health but also poses a great danger in triggering a liver failure.
In spite of these, there have been multiple treatments which have developed to manage and curb it. Some of them are-

Remedial measure for coagulation: The inability of blood to clot blood is known as coagulation which is extremely fatal and one of the primary causes that leads to liver failure. Therefore timely and potent intervention of medicine is important to prevent that and in turn diminish the possibility of liver failure.
Volume replacement: Volume replacement refers to the condition where fluids are resuscitated or replenished into the body, those that were lost but at the same time are mandatory for the proper functioning of the body.

Acute Liver Failure in Pregnancy

The largest internal organ in the body, the liver, is also one of the silent heroes, which performs close to 500 functions. It produces energy, fights infections, gets rid of wastes, and is a metabolic factory.

There are four major types of liver diseases out of which alcoholic liver disease accounts for about 40% of them. Other types include non-alcoholic liver disease, viral hepatitis and autoimmune (chronic) hepatitis.

Risk factors: The severity of drinking habit is directly proportional to the chances of developing alcoholic liver disease. People who consume more amount of alcohol are more likely to develop the disease. However, it is also not necessary that every person who consumes alcohol develops liver disease.

Following are obvious risk factors for developing alcoholic liver disease.

1. Alcohol dependency: While enjoying a drink is not barred, getting the body dependent on alcohol for regular functioning is definitely a no-no. The rate of developing the disease in people dependent on alcohol is as high as 70%.

2. Females: The way alcohol is metabolized in females could have an effect on the higher risk they face in developing alcoholic liver disease.

3. Obesity: Excessive weight puts additional stress on the metabolic effects of the liver and therefore has a higher tendency to develop alcoholic liver disease.

4. Family history: Strong familial history increases the risk of developing alcoholic liver disease.

Symptoms: The difficulty in diagnosing the disease lies in the fact that there are no clear-cut symptoms that can indicate the diagnosis. Initial general symptoms include fatigue, poor appetite, abdominal pain, nausea, weight loss, loss of energy, and red spider nevi (spider-like blood vessels) on the skin.

As the liver function continues to worsen, there are additional symptoms like swelling of the legs due to fluid accumulation, swelling of the abdomen, jaundice (yellow mucous membranes and skin), redness of palms, impotence, breast swelling, easy bruising, cognitive problems and clay-colored stools. This stage will see liver scarring and subsequent cirrhosis. The second set of symptoms is more diagnostic. An experienced practitioner will be able to suspect and diagnose the alcoholic disease with a detailed history and some liver function tests.

Treatment: If identified early and alcohol habits are reversed, the damages of the liver can be completely reversed. In addition, the following lifestyle changes are suggested:

1. Low-salt diet

2. Hepatitis vaccines (A and B)

3. Medications to manage fluid retention, spontaneous bleeding and infections as the case may be

4. Excessive fluid accumulation in the abdomen may require removal

5. Shunt in the liver to repair blood flow

6. If cirrhosis stage is reached, a liver transplant may be required

While there are many ways to manage alcoholic liver disease, prevention is the best way. Limiting alcohol consumption can definitely help in the prevention of the disease.

All About Alcoholic Liver Disease

The liver performs over 500 functions and is considered to be one of the most important organs in the human body. The functions liver perform include regulating cholesterol and blood sugar, filtering out blood toxins, storing energy and making hormones and proteins. There are many diseases which liver can catch and most prominent being alcoholic liver disease

When a person consumes alcohol in excess, it leads to building up of fats, inflammation and scarring of the liver   which results in alcoholic liver disease.

The damage that occurs due to this disease in the liver can affect the whole body. Since the liver is generally highly effective in repairing and regenerating itself so the damage takes longer to come into notice. It often becomes distinctive by the time the damage is already irreversible.

This disease usually takes place in people between 40 and 50 years of age. This disease is most commonly seen in men. Certain cases have been seen where people may have inherited the risk for the disease.

Liver disease related to alcohol consumption fits into following 1 of 3 categories:

Fatty liver: This takes place due to acute consumption of alcohol. This state is generally reversible if alcohol isn t consumed.
Alcoholic hepatitis: This is an acute type of alcohol-induced liver injury which takes place when alcohol is consumed excessively over a long period of time. It can lead to liver failure and death as well.
Cirrhosis: Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by over consumptions of alcohol. It can also occur due to other reasons as well.
Some Facts about Alcoholic Liver Disease

It is the main cause of chronic liver disease in Western nations and the third most common cause of liver transplants.
Staying away from alcohol is the only way to the patient s recovery.
Jaundice and tremors are the most common symptoms of this disease.
Medication, lifestyle changes, and surgery are some available treatments.
Early signs of the Disease
The early signs of alcoholic liver disease are not much noticeable and affect many systems in the body.

Pain in the abdomen
Nausea and vomiting
Diarrhea
Decreased appetite
If these signs are left unattended and the patient continues to consume alcohol, it can lead to a faster damage to the liver.

The symptoms of this disease become noticeable usually during the later stage of liver disease. The symptoms of this disease include:

Jaundice
Edema or swelling of the lower limbs
A build-up of fluid in the abdomen, known as ascites
Fever and shivering
Extremely itchy skin
Clubbing of fingernails
Loss of weight
General weakness
Blood in vomit and stools
Bleeding and bruising more easily
More sensitive reactions to alcohol and drugs
In most patients with the alcoholic liver disease, the illness is not severe. You may not require hospitalization immediately as long you take necessary precaution like stopping the consumption of alcohol, take good nutrition and follow the advice of the doctor. However, in more severe cases, the doctor may be able to suggest the best line of treatment.

Alcoholic Liver Disease - Know The Symptoms!

Uncontrolled alcohol consumption over a prolonged time can severely affect the liver, giving rise to Alcohol-Induced Liver Disease. The liver plays a significant role in digestion as well as filtering the toxins out of the body. Normally, the liver is capable of regenerating its damaged cells and tissues. However, unlimited alcohol consumption interferes with the functioning of the liver. With time, the ability of the liver to regenerate itself also gets affected (reduces) due to excessive drinking resulting in liver problems and disorders.

The stages of alcohol induced liver disease
Alcohol induced liver disease progresses through three stages, alcoholic fatty liver disease, alcoholic hepatitis, and finally cirrhosis.

Alcoholic fatty liver disease: The fatty liver is an early stage of Alcohol induced liver disease, characterized by excess deposition of fats (~ between 5-10% of the total liver weight) in the liver cells and tissues. People with fatty liver should give up drinking for good (or at least till the condition is improved and reversed). Fatty liver seldom exhibits any characteristic symptoms.
Alcoholic hepatitis: Alcoholic hepatitis mostly affects people who are heavily into drinking. More than often, the condition triggers damage and destruction of the liver. Further, there may be swelling and inflammation of the liver. A person with alcoholic hepatitis may experience
Abdominal pain
Fever
Nausea and vomiting
In some patients, the condition may trigger jaundice (excess build up of blood bilirubin resulting for improper functioning of the liver)
In extreme cases, alcoholic hepatitis may result in fatal consequences
Liver cirrhosis: This is the most severe form of alcohol induced liver disease that can give rise to serious and life threatening health complications. Cirrhosis is often an irreversible condition where there is maximum scarring of the liver cells and tissues. In addition to the symptoms associated with alcoholic hepatitis, a person with cirrhosis may also exhibit the following symptoms.
Esophageal varices: It is a condition characterized by bleeding of the esophageal veins
Ascites: In people with cirrhosis, there may be an excessive fluid accumulation in the stomach.
Portal hypertension: It is a condition when the blood pressure in the liver shoots up.
Cirrhosis may also affect the spleen, resulting in its enlargement. There may be mood swings and behavioral problems. A person with cirrhosis should waste no time and immediately consult a specialist to avoid further aggravation.

Factors contributing to alcohol induced liver disease
The following factors in combination with alcohol can wreak havoc, worsening the condition further:

Malnutrition: In some people, excessive drinking can result in malnutrition (alcohol often results in malabsorption of the essential nutrients). Malnutrition, in turn, can adversely affect the liver.
Obesity: Obesity, one of the common consequences of alcohol consumption, can spell doom for the liver and its normal functioning.
Alcohol: It acts as a poison for people suffering from Acute Hepatitis C (viral hepatitis), further damaging the liver. Some research suggests that women who are into heavy drinking are more likely to suffer from liver problems than their male counterparts.
Genetics: It may be responsible for the inability of the body to processes alcohol effectively, resulting in liver problems.

Alcohol Induced Liver Disease - Understanding It In Detail!

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