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 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!

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 human body s ability to manage the fats consumed and the way the liver functions to handle this in the overall metabolism setting are dependent on choline. Choline, which is present mostly in the form of Vitamin B12, is available in plenty in most of the foods consumed by people regularly. The issue arises when the body system fails to absorb choline nutrient from the food consumed. There are also cases where the dietary intake does not possess adequate choline in it.

Natural Difficulty in Absorbing Choline
There are certain conditions in which the system finds it difficult to absorb choline though the diet may contain the nutrient. People who have just undergone a by-pass surgery or those who have had a kidney transplant done or if there is already a liver problem like cirrhosis face this issue. There are other reasons also which can lead to choline deficiency, such as the prolonged intake of anti-convulsant drugs and so on.

How to Detect or What are the Symptoms?
Some apparent symptoms can lead the GP to ask for more tests to establish that the person does have choline deficiency. In normal person, even high blood pressure could be caused due to choline deficiency. Then in many cases, a blood test for any other condition might reveal very low levels of VLDL (Very Low-Density Lipoprotein). This substance in the blood is used by the liver to transport fats and naturally, if VLDL is below a certain threshold the person is bound to be suffering from choline deficiency. High level of cholesterol is another symptom. It has to be understood that choline is also essential for the human brain to be functioning at its active best. Deficiency of choline can lead to an early setting in of dementia. Of course, any patient with liver and kidney related condition reaching the doctor will be checked for choline deficiency since these are closely related.

Where to Get Choline from?
The next obvious question is which foods can get you choline easily and you won t suffer from a deficiency. As mentioned there are plenty of food items of daily consumption which have choline in them. The most frequently recommended are the yolk of the egg. Pastured eggs are recommended and though even one egg can give some 115mgms of choline, you can make a couple of eggs a part of your daily breakfast menu. The other suggestion is raw liver as in beef liver which is quite rich in choline. Those who consume only vegetarian foods can always eat a lot of green vegetables like cauliflower, cabbage and also nuts and legumes (soaked) and milk and yoghurt are all good for choline intake.

Choline is an essential nutrient in the human body and is critical to the growth and development of cognitive functions and its deficiency can lead to many serious conditions, including liver impairment and brain disorders. There are plenty of foods rich in choline and should be consumed regularly.


Choline Deficiency - Signs You Are Suffering From It + Sources Of Choline!! 

Dealing with liver Cirrhosis largely depends on its stage. While it is good to know and read about Cirrhosis, referring to some qualified medical personnel is the best course of action. If a person is already undergoing medical treatment, there are simple ways to deal with this condition.

Get treated in the early stages: Liver being one of the most self-healing organs, a person has good chances of healing, if a donor donates partial-liver. A doctor eradicates the distorted portion of the liver and replaces the same with a partial transplant from the donor. For the donor, it takes about 3-4 months to grow back the donated portion of the liver, while the patient might take 10-12 months to fully recover. This is possible in the early stages of Cirrhosis.
Stop the catalyst of liver Cirrhosis: It is essential to stop the underlying cause of Liver Cirrhosis. Stuff like saturated fat, alcohol, salt, OTC pain relievers, excess sugar etc should strictly need to be avoided to ensure the progression of liver Cirrhosis is slow. Studies have shown that moderate consumption of coffee can help to deal with Liver Cirrhosis.
Sodium free food: It is advised by most doctors that Cirrhosis patients refrain from consuming sodium-rich food. It helps a cirrhosis patient to bypass edema and ascites. This is extremely challenging, since food without sodium tastes bland and unappetizing. It is therefore suggested that healthy herbs, paprika, pepper etc are consumed to make up for sodium.
A balanced diet: A liver Cirrhosis patient should be extremely careful when it comes to choosing the right diet. They should consume lots of fresh fruits and green vegetables. While consumption of animal protein is not advised, the quota of protein should be fulfilled from peas, tofu, quinoa, etc.
A good exercise regime: Patients with liver Cirrhosis should ensure that an adequate exercise regime is followed so that the muscles do not get wasted. Exercise for half an hour also helps to lose weight and negate the chances of water retention in the body. Exercise should also be followed by lots of sleep, so that the body gets enough time to recover from the stress of exercise.
Avoid NSAIDs: If a person is suffering from liver Cirrhosis, using drugs such as naproxen, aspirin, ibuprofen, acetaminophen etc should be strictly avoided for mild pain and inflammation. These drugs can be highly toxic for a person suffering from Cirrhosis. It is wise to consult a doctor before consuming any medication.
Stay away from infection: A patient with liver Cirrhosis suffers from a compromised immune system. It is therefore advised that a patient stays away from possible bacteria, viral and such other chronic infection. Any infection can result in inflammation of the bile duct that causes scarring of the liver tissue.

Liver Cirrhosis - 7 Ways To Deal With The Problem!

Recurrent pregnancy losses happen to a very small fraction of the population. Only 1% of couples are affected by it. Nevertheless, it is a very difficult and serious process to deal with due to the sensitivity of the issue. A woman is said to have recurrent pregnancy losses if she has lost 3 or more of her pregnancies. Although the exact reason for recurrent pregnancy losses are not known, there are several suggested reasons.

Reasons why it may happen 

Anomalies in the uterine lining such as polyps (abnormal tissue growth, usually in the cervix), or fibroid tumors can result in miscarriages if left untreated.
Hormonal factors such as thyroid malfunctions or pituitary problems can cause an imbalance in the luteinizing hormone (a hormone which triggers ovulation) resulting in miscarriage.
Age is also an issue one must keep in mind while addressing pregnancy losses. Women over the age of 35 are more likely to experience recurrent pregnancy losses. As women get closer to menopause, their bodies produce reduced levels of hormones and eggs which cater to a pregnancy. Therefore, due to the reduced levels of hormones, an older woman is susceptible to losing a baby as they have elevated levels of hormones and therefore are more fertile.
Lifestyle factors also have been linked to recurrent pregnancy losses. Constant exposure to toxic chemicals can result in pregnancy problems. Along with that, constant drug use, smoking and excessive consumption of alcohol are some of the lifestyle choices that can cause recurrent pregnancy losses.
Infections such as syphilis, malaria, measles, herpes simplex etc. can cause recurrent pregnancy symptoms if left untreated as they can obstruct and complicate the growth of the baby, resulting in premature development or pregnancy loss.
Management of Pregnancy Loss

Polyps and fibroid tumors are complicated disorders which should be given immediate medical attention. Although surgical methods are available, the best way to treat polyps and fibroid tumors is through the intake of progestin hormone pills which shrink the size of the polyps/cysts.
Eating a healthy diet to ensure the prevention of diabetes is highly recommended. Fruits, leafy green vegetables and whole grain cereals are a prerequisite for the complete growth of the baby as well as arming the body with the necessary strength it needs for pregnancy transitions as well as a stronger immune system.
A regular workout routine is also advised for pregnant women as it ensures a healthier and stronger immune system.
Although recurrent pregnancy loss is very emotionally debilitating for a woman and her partner, there are several means and measures to overcome this tragedy. One should not be disheartened by such an occurrence and get the required help needed.


Recurrent Pregnancy Loss - Possible Reasons Behind It!

Don't wait any longer, manage your Elbow Image online with a Lybrate doctor today

Consult for Elbow Image - Online and Easy!

FilterClear All

COMMON SPECIALITIES

COMMON ISSUES