Fibrosis, which is often referred to as sclerosis, is a hardening of tissues and organs due to an overproduction of collagen fibers. Frequently affected by fibrosis are the lungs, liver, kidney, heart or skin. Fibrosis is not a disease in its own right, but rather a symptom that can be caused by various underlying diseases.
What is fibrosis?
The term fibrosis comes from the Latin “fibra” which translates to “fiber” in German. The term thus refers to a pathological increase in the body’s tissue fibers, which can affect the function of the organ affected by fibrosis. Fibrosis of the lungs, for example, can manifest itself in shortness of breath, while fibrosis of the liver can manifest itself in high blood pressure and in impaired brain function, even coma. The simplest way to think of fibrosis is as scarring. In a healthy person, after the wound heals, more connective tissue develops at the injured site, which becomes visible as a scar. In fibrosis, there is also damage to the affected organ, which can have a wide variety of causes and to which the body responds by scarring.
Causes
The causes for the onset of fibrosis are extremely varied. They range from normal aging processes and long-term medication use to circulatory disorders, infections, alcohol abuse, and chronic inflammation such as hepatitis. However, harmful environmental influences such as gases, vapors and organic dusts, for example from molds or house dust mites, can also cause allergy-related fibrosis in the long term. Autoimmune diseases can also lead to fibrosis. The starting point of fibrosis is always damage to the organ, whether due to wear and tear, inflammatory reactions or an excessive lifestyle, to which the body must react with progressive scarring. If the underlying disease is not treated appropriately, the organ tissue becomes increasingly interspersed with scar tissue that cannot take over the function of the healthy tissue cells.
Symptoms, complaints, and signs
Fibrosis can occur in different regions of the body, usually leading to different symptoms. If fibrosis occurs directly on the skin, the skin usually becomes thick and wrinkled. This also leads to reduced aesthetics, so that most patients with these complaints do not feel well and suffer from inferiority complexes or significantly reduced self-esteem. Furthermore, there are also restrictions of movement and inflammation of the joints. These can further spread to the internal organs if not treated properly. Likewise, patients with fibrosis of the skin often suffer from difficulty in swallowing. In the worst case, fibrosis of the liver can lead to inflammation and cirrhosis. If this is not treated, the affected person dies due to the symptoms. Furthermore, this leads to high blood pressure. Fibrosis can also occur in the lungs, with patients suffering from pneumonia and severe breathing difficulties. The patient’s life expectancy is extremely limited as a result, and the quality of life is also significantly reduced. Since the disease spreads to neighboring regions of the body, immediate treatment by a physician is necessary in this case. Symptoms of fibrosis of the liver (scleroderma):
- Cirrhosis of the liver
- Liver inflammation
- Hypertension
Symptoms of fibrosis of the lung (pulmonary fibrosis):
- See the article ⇒ pulmonary fibrosis.
Diagnosis and course
Existing fibrosis is diagnosed by means of a tissue sample, which the physician can examine under a microscope for changes typical of fibrosis. Imaging techniques, such as x-ray, ultrasound, and computed tomography, may also be used. X-ray examination is a commonly used method, especially when pulmonary fibrosis is suspected, while the liver is better examined with ultrasound. Fibrosis of the liver, also called cirrhosis, can also be detected by palpation of the organ. A discussion between doctor and patient is also important for a comprehensive diagnosis, in order to be able to link any previous illnesses to the fibrosis.The diagnosis also includes functional tests of the corresponding organ. If the hardening of the tissue can be stopped in time, life is possible without or only with minor restrictions. If the disease is already so advanced that the affected organ is no longer functional, organ failure occurs.
Complications
A number of complications can occur as a result of fibrosis. Depending on the severity of the disease, the organs and tissues become harder and less elastic as the disease progresses. This can lead to functional disorders and pain, especially in the hands and fingers. Joint inflammation also frequently develops. Swallowing difficulties may occur, as the esophagus loses its elasticity and virtually freezes. In later stages, the entire gastrointestinal tract may lose its function, and shortness of breath and other symptoms occur. The increased pulmonary pressure can cause enlargement of the right ventricle and, in the long term, cardiac insufficiency. If the kidneys are affected, chronic deficiency symptoms can cause oxygen deficiency and high blood pressure. In advanced stages, fibrosis can cause kidney failure. If the disease is not treated by then at the latest, the other organs will also gradually fail and the patient will die. During treatment, complications may arise due to the prescribed medication. In a possible transplant, there is a risk that the organism will reject the donor organ and life-threatening infections will occur.
When should you go to the doctor?
A visit to the doctor should take place as soon as the affected person feels that something is wrong inside his body. If there is a feeling of pressure, a diffuse feeling of illness or a decrease in the usual performance, a doctor should be consulted. If swallowing difficulties or pain occur over several days, a doctor should be consulted. If the complaints increase in scope and intensity or if there are further symptoms, it is advisable for these to be clarified by a doctor. A medical examination is also necessary as soon as shortness of breath sets in. If there are problems with breathing in for no apparent reason, or if there is palpitations, this is considered a cause for concern. If sleep disturbances set in, blood pressure rises and a permanent feeling of warmth can be perceived, a visit to the doctor is necessary. In the case of persistent functional restrictions of various kinds, it is advisable for the affected person to see a doctor. If there are disturbances of the gastrointestinal tract, an unwanted decrease in weight or irregularities in urination, these observations should be examined more closely and, if necessary, treated. This is especially true as soon as they recur unabated. Unusual and sudden changes in the appearance of the skin should also be clarified by a doctor. Thickening of the skin, a dry skin sensation as well as a feeling of tension, should be discussed with a doctor.
Treatment and therapy
Depending on the cause of the fibrosis that occurs, the treatment options turn out to be diverse. Treatment of fibrosis depends on the underlying disease. For example, if the fibrosis is inflammatory, the primary goal is to stop the inflammatory process. This can be done by means of cortisone preparations or immunosuppressants. If toxins or alcohol abuse are the cause of fibrosis, avoidance of the causative substances is essential. Symptomatic treatment, such as oxygenation in the case of fibrosis of the lungs, is also conceivable. Fibrosis cannot be completely cured, pre-existing damage remains, which is why early treatment is of particular importance. If fibrosis is already in the final stage, there is the option of organ transplantation. If fibrosis is not treated, it is fatal.
Outlook and prognosis
Fibrosis is a change in tissue that often affects the lungs. However, the prognosis for such fibrosis does not look very good and usually cannot be cured. In fact, in numerous cases fibrosis leads to death. However, this disease can be delayed with appropriate treatment and the right medications. Affected individuals with fibrosis can positively influence their outlook and prognosis through coordinated self-management. In addition, the prognosis depends on many different factors that can also positively influence the overall course of the disease.Among the said factors, for example:
- The start of treatment (the earlier treatment is given, the better).
- From the damage already done to the lungs
- The speed at which the disease is progressing.
- The effectiveness with which the treatment is effective in the affected person.
Fibrosis is a serious condition that requires medical treatment. However, in most cases, the prognosis is far from positive. Often, this disease is fatal. Only delaying this disease is possible. With appropriate treatment, severe complications can be avoided.
Prevention
Fibrosis can be prevented by a healthy lifestyle, such as moderate alcohol consumption and refraining from smoking. In addition, vaccination against the inflammatory disease hepatitis B is useful. The body should be exposed to toxins and harmful substances as little as possible. A normal body weight, a healthy diet and sufficient exercise strengthen the body and immune system and should not be underestimated for the prevention of fibrosis.
Follow-up
In the case of fibrosis, there are usually no special measures or options for aftercare available to the affected person. In any case, the affected person is thereby dependent on an early diagnosis and recognition of this disease, so that further complications or complaints can be avoided. It is not possible for this disease to heal on its own. Furthermore, in the case of fibrosis, the diagnosis of the underlying disease is also very important in order to limit it and then also to treat the complaints causally. It is also possible that the fibrosis reduces the life expectancy of the affected person. However, life expectancy and further progression depend strongly on the underlying disease, so that no general course can be given. Fibrosis is usually treated by taking medication. The affected person should ensure that the medication is taken regularly and in the correct dosage so that the symptoms can be properly alleviated. Without treatment, fibrosis usually leads to the death of the affected person. The patient also depends on the help and care from friends and from his own family for this disease.
This is what you can do yourself
Fibrosis, synonymous with sclerosis, does not establish its own clinical picture, but describes a symptom that can be the expression of several different diseases. All causes of fibrosis have in common that functional tissue in certain organs is increasingly replaced by collagenous connective tissue. As a result, the tissue of the affected organs becomes harder (sclerotic) and the organ increasingly loses functionality because the built-in connective tissue – quasi as replacement tissue – cannot take over any of the original organ functions. In many cases, the fibrosis is only mild and does not require any further treatment, so that there is no need for adjustment of behavior in everyday life and self-help measures. If important organs such as lungs, liver and others are affected, it is important to find out the cause of the sclerosis in order to be able to start a root cause treatment. The fibrosis of the affected organ that has occurred by then is irreversible. This means that although fibrosis can be stopped if its causes have been successfully eliminated, the disease cannot be reversed. In some cases, self-help measures are urgent. For example, environmental conditions in dusty environments (coal mining, aluminum processing, flour processing plants) can be triggers for pulmonary fibrosis (pneumoconiosis). A change of occupation, or at least a change of workplace, can be considered as a self-help measure in this case. If the onset of liver cirrhosis can be traced back to excessive and chronic alcohol consumption, the self-help measure is to abstain from alcohol consumption, which can be achieved by a withdrawal cure if necessary.
