Stage Child C | The stages of liver cirrhosis

Stage Child C

Stage Child C is the final stage for classification of liver function. There are already considerable deficits in the filtering and production function of the liver. In almost all criteria, which include the most important liver functions, severe limitations are present, which are accompanied by considerable symptoms, subsequent complaints and consequences.

Cirrhosis of the liver in stage Child C is a severe clinical picture that can be fatal at any time. Functioning liver cells are so limited that the vital functions can no longer be compensated, so that even the therapy of the underlying disease has no prospect of treating the liver disease. At this stage, only liver transplantation is still a promising therapeutic approach. The 1-year survival rate in stage C is about 35%.

Hepatic encephalopathy

Hepatic encephalopathy is a neurological disease caused by a lack of filtering function of the liver. Almost all metabolic processes in the body produce toxic substances that are metabolized and rendered harmless by chemical reactions in the liver. In advanced liver cirrhosis, however, toxic substances such as ammonia can accumulate in the body and lead to sometimes severe functional disorders in the brain.

This is a typical complication of a severely advanced liver disease, which itself can be divided into 4 stages. These stages result mainly from the severity of the neurological symptoms. Stage 1 is associated with only mild unspecific neurological symptoms.These manifest themselves mainly as The transitions to other stages of hepatic encephalopathy are fluid.

Symptom-free phases can occur in the meantime, which are only recognized by elevated ammonia levels. If necessary, aggravations to higher stages may occur. A coarse, irregular tremor is also typical with outstretched arms and hands, which typically correlates with the severity of the encephalopathy.

Stage 1 can usually still be treated on an outpatient basis, although the excretion of toxins must be increased by medication.

  • Tiredness,
  • Concentration problems and
  • Mood swings with irritability.

In stage 2, the neurological symptoms of hepatic encephalopathy may already be significantly more advanced. The symptoms of fatigue and concentration difficulties become more severe.

In addition to this, in-patient treatment is indicated from this stage onwards, as bleeding or inflammation caused by infections are often the cause.

  • Lethargy,
  • Apathy,
  • Complete numbness and
  • Confusion can come.
  • Also motor changes can appear in the form of increased tremor,
  • As well as a deterioration of the typeface noticeable.

Stage 3 of hepatic encephalopathy is already a significantly advanced clinical picture with life-threatening functional limitations of the brain, which can result in severe secondary damage. The disturbance of consciousness has often progressed to a distinct drowsiness, but the patients are still awake.

In addition, the transition to stage 2 can be fluid.

  • Significant speech disorders,
  • Motor limitations,
  • Strong confusion and
  • An increase in the gross tremor of the hands.

The most important distinction between stage 3 and stage 4 of hepatic encephalopathy is the disturbance of consciousness. Stage 4 is usually a coma, from which the affected person cannot be awakened either by speech or pain stimuli.

Initially, reactions such as untargeted defensive reactions or pulse acceleration can occur in response to pain stimuli. The prognosis for this stage can vary greatly, but the high blood levels of the toxic molecules can cause permanent damage.