Cirrhosis of the liver is a disease in which the liver undergoes a connective tissue and nodular remodelling. Cirrhosis of the liver is usually the result of a progressive destruction of the liver tissue. The destruction of healthy liver tissue can be triggered by a variety of factors.
Among the most important triggers of liver cirrhosis are viral hepatitis, toxic liver damage caused by alcohol and drugs and congenital liver diseases, with autoimmune hepatitis being the leading cause. Rare triggers of liver cirrhosis include diseases such as hemochromatosis (iron storage disease), Wilson’s disease (copper storage disease) and primary sclerosing cholangitis. According to this, congenital and acquired causes of liver cirrhosis can be distinguished.
Cirrhosis of the liver is the final stage of chronic and, in rare cases, acute liver disease. This means that the liver is no longer able to perform its many and varied tasks and thus important detoxification and synthesis processes can no longer be carried out. The liver is the central metabolic organ of our body and performs a large number of different tasks.
Among the most important tasks of the liver are In pronounced liver cirrhosis, all these tasks are disrupted. The connective tissue remodeling of the liver can also affect the cardiovascular system, since blood from the intestine (enterohepatic circulation) accumulates in front of the liver, resulting in the formation of varicose veins, which could lead to potentially life-threatening bleeding.
- The storage and supply of glucose,
- The production of coagulation active proteins (coagulation factors),
- The metabolism of urea,
- The detoxification of drugs and other foreign substances,
- The production of bile acid and the production of albumin, the body’s most important blood protein.
Causes of cirrhosis of the liver
The causes of liver cirrhosis are manifold and can be divided into congenital causes on the one hand and acquired causes on the other. Acquired causes are by far the most common causes. Acquired cirrhosis of the liver is usually the result of infectious events, such as hepatitis.
The hepatitis virus (A, B, C), especially the mostly chronic hepatitis C, gradually damages healthy liver tissue, resulting in a loss of liver function. The liver reacts to the chronic, i.e. prolonged, inflammatory processes by forming so-called pseudolobules and regenerative nodes. Regenerative nodes are formed when the liver tries to rebuild the lost liver tissue in order to counteract the loss of function.
These regenerative nodes consist of a coarse connective tissue that hardens the liver tissue and thus creates the typical nodular surface. Furthermore, liver cirrhosis can be caused by toxic substances such as drugs and alcohol. Alcoholic cirrhosis of the liver is the most common form of cirrhosis in the western world.
This means that more than 50% of cirrhoses are due to alcoholism. Cirrhosis usually occurs when the detoxification capacity of the liver is overtaxed, resulting in reactive toxins that damage the liver tissue. Responsible for the detoxification or metabolism of drugs is an iron-containing enzyme called cytochrome P450.
Some drugs manage to switch this enzyme off, which would result in a reduced detoxification function. Another form of cirrhosis is the so-called congestive cirrhosis. This is caused by a right heart failure.
Right heart failure causes blood to congest the liver in front of the right heart, compressing the liver tissue and destroying it. However, this form occurs very late, as the heart must already be very damaged and this is usually accompanied by a longstanding illness. A fatty liver is another liver disease that can lead to liver cirrhosis.
This can occur without any pre-existing conditions, e.g. due to incorrect nutrition, but can also be the result of years of alcohol abuse. Other complex genetic diseases, such as iron storage disease, can also lead to cirrhosis of the liver. and diet in the case of liver cirrhosis.
