Cirrhosis - Symptom, Treatment And Causes

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.

1. 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.
2. 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.
3. 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.
4. 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.
5. 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.
6. 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.
7. 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.

In case you have a concern or query you can always consult an expert & get answers to your questions!

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:

1. 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.
2. 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.
3. 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.
4. 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. If you wish to discuss about any specific problem, you can consult a gastroenterologist.

Swollen breast tissues in men or boys caused by hormonal (testosterone and estrogen) imbalances is called gynecomastia. Both breasts or one breast, can be affected by gynecomastia. At any point in life, from birth to puberty, even in adulthood, you might develop gynecomastia. Most of the times, gynecomastia is caused by hormonal imbalances, but there might be some underlying causes as well.
Gynecomastia is normally not a serious condition, but it can be difficult to deal with the pain and embarrassment.

It can be cured with surgery or medication, if it doesn't go away on its own.

Symptoms and signs of gynecomastia include:

• Enlarged glands in the breast tissue
• Tenderness in the breast

The causes that trigger gynecomastia include:

1. Hormonal changes: Testosterone and estrogen control the sexual development in men and women respectively. Estrogen is not a hormone that only women produce; men produce it too. When the production of testosterone and estrogen are thrown out of balance, gynecomastia occurs.
2. Medication: Certain medications such as anabolic steroids, androgens, HIV/AIDS medicines, antibiotics and chemotherapy can cause gynecomastia.
3. Drugs and alcohol: Substances such as alcohol, marijuana, amphetamines, heroin and methadone cause gynecomastia.
4. Health condition: Certain factors, such as aging, hypogonadism (hormonal disorder), hyperthyroidism (overactive thyroid gland), tumors, kidney failure, cirrhosis, liver failure, malnutrition and starvation can lead to gynecomastia.
5. Herbal products: Essential oils derived from plants such as lavender or tea tree, used in lotions or shampoos, have weak estrogenic actives. They have been said to cause gynecomastia.

Gynecomastia can be cured either with medication or surgery. Surgical options for gynecomastia are, however, limited.

Treatment

There is no definitive medical treatment. The main answer for Gynecomastia is -SURGERY. It is a daycare procedure in most situations. It is done by a Surgeon, usually, a Plastic surgeon does a better job.

Anesthesia- Either Local or General anesthesia is given to make it painless.

Procedure-Through a small incision in the areola, the swelling is removed by both Liposuction of the Fat part and Excision (removal) for Breast gland part. As the incision is through the areola, the final scar is hardly visible. In extensive swellings, skin also needs to be removed, where in a scar around the areola border is visible.

Recovery- usually can go back to work in 2-3 days time. If you wish to discuss about any specific problem, you can consult a Cosmetic/Plastic Surgeon.

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?

1. 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.
2. 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.
3. 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.
4. Drugs causing liver injury.
5. 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?

1. Early disease can present with nonspecific symptoms like weakness, fatigue (loss of energy), decrease wish to take food, vomiting or nausea, weight loss, etc.
2. 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).

1. Increase risk of infection because of immune system dysfunction.
2. Development of liver cancer (Hepatocellular carcinoma)
3. Easy brusibility or bleeding following light trauma.
4. Gall bladder stone formation
5. Metabolic bone disease

What are the stages of cirrhosis?

1. 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).
2. 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?

1. 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.

2. 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:

1. Dietary modification: Eat healthy balanced diet. Avoid high calorie food or drinks, saturated fat, sugar and refined carbohydrates. Keep yourself hydrated.
2. 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.
3. 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.
   1. Practice safe protected sex
   2. Alcohol
4. Motivate others: to stop drinking and follow hand hygiene and doctor`s advice.
5. Hand hygiene: Wash hand with soap and water regularly before eating, after going to toilet and after touching dirty objects.
6. 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

1. 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.
2. 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).
3. Opt for liver ransplant, If cirrhosis is life threatening or treatment of cirrhosis complication is ineffective.
4. Low salt high protein diet
5. Stop alcohol intake even if you have other cause of cirrhosis.
6. Stop smoking
7. Avoid over the counter drugs (especially pain killers)
8. Vaccinate if not done already or infected

   If you wish to discuss about any specific problem, you can consult a gastroenterologist.

An immune system disorder distinguished by dry mouth and dry eyes is known as Sjogren’s Syndrome. It can also cause dryness in places that require moisture, such as throat, nose and skin. Sjogren’s syndrome is often linked to other diseases such as rheumatoid arthritis and lupus (disease in which the immune system destroys its own tissues and causes inflammations). Sjogren’s syndrome normally affects people over the age of 40, and it mostly affects women.

Symptoms 
Sjogren’s syndrome has mainly two symptoms, and they include:

1. Dry eyes: You feel like there is sand in your eyes as it burns and itches
2. Dry mouth: You have difficulty speaking or swallowing

Sometimes, you might experience other symptoms as well, such as:

1. Joint pain, stiffness and swelling
2. Inflamed salivary glands
3. Dry skin or skin rashes
4. Vaginal dryness
5. Continuous dry coughs
6. Sustained fatigue

Causes
The exact cause of Sjogren’s syndrome is not known, but research strongly suggests that the autoimmune disease could be caused by genetic factors; especially if the illness has been found in more than one member of the family. Also, families with members suffering from type I diabetes, lupus and autoimmune thyroid disease can cause one or more members of the family to develop Sjogren’s syndrome.

Complications
The complications of Sjogren’s syndrome include:

1. Dental cavities: Saliva protects the teeth from harmful bacteria that cause cavities. Since your mouth is dry, you become more susceptible to develop cavities.
2. Yeast infections: Oral thrush, an oral yeast infection, is likely to develop if you have Sjogren’s syndrome.
3. Vision problems: Dry eyes can cause corneal ulcers, sensitivity and blurred vision.
4. Problems in the lungs, liver or kidneys: Inflammations can lead to bronchitis or pneumonia in your lungs; may cause cirrhosis or hepatitis C in your liver; and may lead to kidney malfunctions.
5. Lymphoma: Some people with Sjogren’s syndrome might develop lymphoma, or lymph node cancer.

Peripheral neuropathy: Another complication of this illness is peripheral neuropathy, which is a tingling, burning and numbness sensation felt in your feet and hands.

Treatment
Sjogren’s syndrome is either treated with drugs, or with surgery. Doctors may prescribe drugs to increase the production of saliva and to treat inflammations. Alternatively, surgery is done to either seal the tear ducts or insert silicon or collagen plugs to close the ducts temporarily. If you wish to discuss about any specific problem, you can consult a doctor.