Liver cirrhosis or liver shrinkage is a chronic progressive disease of the liver. It is also referred to as destruction of the liver which is mostly affected holistically. In particular, the liver lobules are destroyed and transformed into connective tissue. Furthermore, liver cirrhosis can be a final stage of other liver diseases. Mostly men are affected between the 50th and 60th year of life. The disease is less common in women, who are statistically less likely to abuse alcohol.
What is cirrhosis of the liver?
Cirrhosis of the liver is a disease of the liver. In this case, mainly the vessels and tissues of the liver are permanently destroyed. Mainly, cirrhosis of the liver results in shrinkage of the liver. In addition, the organ becomes increasingly sluggish. In the course of liver cirrhosis, the connective tissue of the liver changes into a scarred structure. This destruction of the liver, also known as shrunken liver, can lead to life-threatening complications. Medically, the liver in cirrhosis can be divided into three forms. There is a large nodular liver, a small nodular liver and a mixed form of the first two. If excessive alcohol consumption occurs, a small-nodular liver often develops, whereas a large-nodular liver is more likely to appear in hepatitis disease.
Causes
In cirrhosis, the lobules of the liver become scarred and converted to connective tissue. This process is called fibrosis. As a result, the function of the liver becomes extremely impaired. The liver now becomes hard and nodular. Finally, it shrinks for good. This subsequently results in inadequate blood flow to the liver, which can lead to portal hypertension. Commonly known causes of liver cirrhosis are:
- Alcohol abuse, 1/2 of all cases
- Hepatitis, B, C, D, 1/4 of all cases.
- Disease of iron, copper or fat metabolism.
- Biliary tract disease with biliary stasis
- Cardiovascular diseases, e.g. congested liver in chronic right heart failure.
- Toxins or drugs
Liver cirrhosis is the result of various liver diseases, which are based on a wide variety of causes. With over 60 percent, most of all cases of liver cirrhosis in Germany are due to alcohol abuse. In 20-30 percent of all those affected, hepatitis B, hepatitis C or hepatitis D causes the liver cirrhosis. Rarer causes of liver cirrhosis include various hereditary metabolic diseases. Likewise, tropical diseases, cholera, medications, and chemical alkalis may also be considered as causes.
Symptoms, complaints, and signs
Cirrhosis of the liver can persist for years without noticeable symptoms. As liver tissue shrinks, the efficiency of the organ decreases, resulting in various complaints. Initially, metabolic disturbances usually occur. Those affected then regularly experience gastrointestinal complaints or develop jaundice. Subsequently, blood clotting deteriorates, which can result in circulatory disorders, pain and cardiovascular problems. The diseased liver also has negative effects on hormone balance. As a result, hormonal complaints can occur, which are manifested in the form of mood swings and irritability, but also through physical changes (for example, the development of male breasts in women). In the advanced stage of the disease, symptoms such as dullness and weight loss also occur. In addition, sufferers sweat excessively frequently and suffer from pain in the upper abdomen. The skin is usually gray to yellowish and streaked with visible vascular spiders. Accompanying itching and redness may be noticed, especially in the area of the palms. Lacquer lips, i.e. red, smooth and excessively dry lips, are also characteristic. The symptoms take a gradual course and are reversible only with early treatment. However, any organ damage can have long-term consequences and greatly affect the patient’s quality of life.
Disease progression
Symptoms of liver cirrhosis may also indicate gallbladder inflammation or gallstones. Furthermore, gastritis disease should also be ruled out. In the further course of liver cirrhosis, liver cancer may also occur, so this disease should also be addressed. Overall, however, liver cirrhosis is dependent on the cause of the disease.In any case, liver cirrhosis should not be treated by oneself, but by a trained medical professional. Especially if liver cirrhosis is detected in time, serious complications can be avoided. However, once the damage is irreversibly present, complete recovery is no longer possible. If the liver cirrhosis remains untreated, its function is very likely to be reduced further and further, which can lead to a loss of quality of life or even death. The following complications and damage can then occur: Water accumulation in the abdomen, metabolic disorders, internal bleeding in the stomach, esophagus or intestines, and brain diseases due to lack of detoxification of the body by the liver.
Complications
Cirrhosis of the liver can cause several complications. For example, only parts in the liver are detoxified, which in turn has serious effects on the state of health. One of the most common sequelae of liver cirrhosis is hepatic encephalopathy. Because toxic degradation products derived from protein metabolism remain in the blood, damage to the brain occurs. Initially, the encephalopathy usually remains without symptoms. As the disease progresses, mood swings, concentration problems, prolonged reaction times, sleep-wake rhythm disturbances, pathological fatigue and loss of consciousness usually occur. Eventually, there is a threat of hepatic failure coma. Other complications include abdominal ascites. Fluid accumulates in the abdominal cavity and the patient suffers from symptoms such as breathing problems and abdominal pain. If kidney failure or infection of the peritoneum (peritonitis) occurs, the complications can have life-threatening consequences. Portal hypertension (high pressure in the portal vein) is also a cause for concern. In this sequela of liver cirrhosis, blood backs up in front of the scarred area of the liver, which in turn leads to an increase in portal pressure. This results in the formation of new blood vessels such as varicose veins, which trigger bleeding from hemorrhoids or from esophageal varices in the esophagus. The latter are considered life-threatening. Liver cirrhosis also increases the risk of liver cancer. Individuals in whom liver disease results from hemochromatosis or chronic hepatitis B are particularly affected.
When should you see a doctor?
People who consume alcohol regularly over a long period of time are advised to undergo a medical examination. If the person suffers from withdrawal symptoms, an inner restlessness or physical pain without the intake of alcohol, a visit to the doctor is necessary. If there is a pressure pain in the upper abdomen or below the ribs, a doctor should be consulted. Disturbances in digestion, a loss of weight or appetite are signs of an irregularity. A visit to the doctor is necessary so that the cause of the discomfort can be determined. If there is increased irritability, mood swings or changes in personality, medical attention is needed. Irregularities of the heart rhythm, changes in the appearance of the skin, a lack of personal hygiene, and itching of the skin are considered signs of a present disease. Yellowing of the eyes or skin are indications of liver activity disorders. A visit to the doctor is necessary so that medical care can be provided. Since cirrhosis of the liver can lead to organ failure and thus to premature death of the affected person, a doctor should be consulted at the first symptoms. A drop in usual performance, a feeling of illness or a general malaise should be presented to a doctor. If increased fatigue or sleep disturbances occur over several weeks or months, a physician is also needed.
Treatment and therapy
First, the cause of cirrhosis of the liver is examined by a physician. Usually these are an increased alcohol consumption or a hepatitis infection. Therefore, these causes should be addressed here first. Alcohol or other toxic substances must be avoided immediately. In the case of hepatitis, this is to be treated first. The damage caused by cirrhosis of the liver cannot be cured. Nevertheless, timely treatment can alleviate further complications and discomfort. Depending on the cause, drug therapy, e.g. diuretic drugs or liver transplantation can be successful in alcoholic patients.
Outlook and prognosis
The prognosis of diagnosed cirrhosis of the liver is unfavorable. It is a disease that leads to irreparable damage to the organ. Physicians focus their primary attention in a treatment regimen on halting the progression of the disease. In many cases, however, the patient’s cooperation is absolutely essential. If an alcoholic disease is present, only complete abstinence from alcohol consumption can lead to relief of the symptoms. Without medical care, the disorder will normally spread, leading to gradual disintegration of the liver. A spontaneous cure is not to be expected. Likewise, alternative healing methods are not effective. The functional activity of the liver is significantly disturbed, ultimately leading to organ failure and thus to a life-threatening condition. In many patients, only a transplantation of a donor organ can improve or alleviate the cirrhosis of the liver. Organ transplantation is associated with numerous risks, side effects and complications. If the surgical procedure proceeds without further abnormalities and the new organ is well accepted by the organism, recovery can take place. Nevertheless, the affected person is dependent on medication for the rest of his life and experiences impairments in coping with everyday life. Nevertheless, with a donor organ he has a prospect of extending his average expected lifespan.
Prevention
Abstaining from alcohol has been the best prevention against cirrhosis of the liver. Furthermore, vaccination against hepatitis can be preventive. Also, protection against various poisons, such as solvents, should be the primary object of any Verbeugungsmaßnamhem. General hygiene rules can also protect against causes of liver cirrhosis.
Aftercare
The form of aftercare possible in liver cirrhosis depends on the cause that led to the cirrhosis. In any case, the damaging influences must be treated and avoided. The severity of the disease is assigned to a specific stage by follow-up examinations. Accordingly, secondary diseases can be read off. If the liver cirrhosis is due to long-term alcohol abuse, the first most important starting point is lifelong, absolute abstinence from alcohol. In addition to chronic hepatitis, if autoimmune diseases are present, medication is a useful further treatment. However, these drugs cannot reverse liver cirrhosis, but only contain it and stop its progression as far as possible. Thus, the disease always leads to irreversible damage to the liver. In general, all patients with cirrhosis of the liver should abstain from alcohol for life, eat a healthy diet and engage in regular physical activity and exercise. The switch to a healthy diet can only be successful if it is long-term. Strengthening the immune system plays a key role in limiting and suppressing secondary diseases. If functions of the brain are already impaired by the disease, this is due to the proportion of toxins in the blood that the liver can no longer filter because of the damage. Here, a reduction of the toxins must be achieved through drug treatment. If secondary diseases such as ascites occur over time, they must be treated promptly to rule out complications as far as possible.
What you can do yourself
Cirrhosis of the liver is a very serious condition that should not be treated by yourself under any circumstances. Since the damage to the liver caused by cirrhosis is usually irreversible, a doctor should be consulted promptly if certain symptoms appear. The onset of liver cirrhosis may be heralded by a number of different symptoms, but the organ itself does not hurt. Signs may include, for example, loss of appetite, nausea, potency problems and jaundice. Since cirrhosis of the liver is due to excessive alcohol consumption in about half of cases and to hepatitis, which is usually not properly treated or has been carried over, in about 20 percent of cases, patients can also help improve their health themselves. As soon as alcohol-related cirrhosis is detected, the affected person must immediately stop or at least drastically reduce his or her alcohol consumption. Since the majority of patients are alcohol-dependent, the support of a physician is usually not sufficient for this.The best thing for those affected is to go to rehab and then start psychotherapy to prevent a relapse. Membership in a self-help group also helps many sufferers. There are free support services for alcoholics in almost every major city and on the Internet. If the liver cirrhosis is due to hepatitis, it is essential to treat this underlying disease. It is best for the patient to follow all the instructions of the doctor treating him. In addition, he or she can support the therapy by adopting a healthy lifestyle, especially by abstaining from alcohol and cigarettes as well as fatty foods.