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CIRRHOSIS OF LIVER
Cirrhosis Of Liver
Liver, the largest internal organ, is the metabolic factory of the body. It performs many essential body functions such as production of proteins, factors for blood coagulation, glucose, bile and cholesterol, breakdown and elimination (metabolism) of various drugs, detoxification etc..It also has the ability to regenerate itself if it is injured or partially removed.
Cirrhosis is a condition where normal liver tissue is replaced by scarred (fibrosis) tissue. The liver cells fail to function due to a variety of chronic liver diseases. The liver tries to repair itself in response to damage. While doing so, scar tissue is formed. If the causative injury continues, cirrhosis progresses, more scarring occurs and liver fails to function adequately (decompensated cirrhosis). Liver damage due to cirrhosis, though irreversible,can be further limited if diagnosed early.
Cirrhosis is a condition where normal liver tissue is replaced by scarred (fibrosis) tissue. The liver cells fail to function due to a variety of chronic liver diseases. The liver tries to repair itself in response to damage. While doing so, scar tissue is formed. If the causative injury continues, cirrhosis progresses, more scarring occurs and liver fails to function adequately (decompensated cirrhosis). Liver damage due to cirrhosis, though irreversible,can be further limited if diagnosed early.
Symptoms
- Cirrhosis often has no signs or symptoms until liver damage is extensive.
- Fatigue, weakness, nausea, loss of appetite
- Jaundice
- Swelling in the legs, feet or ankles (edema)
- Fluid accumulation in the abdomen (ascites)
- Easily bleeding or bruising
- Changes in mental state (Confusion, drowsiness and slurred speech- (hepatic encephalopathy)
- Hematemesis- blood vomiting
- Spiderlike blood vessels on skin
- Redness in the palms of the hands
- Menstrual disturbances in women
- Breast enlargement (gynecomastia) or testicular atrophy in men
Causes
- Long time consumption of alcohol
- Chronic viral hepatitis (hepatitis B, C and D)
- Fatty liver (Fat accumulating in the liver)
- Autoimmune hepatitis (body attacking its own cells)
- Iron buildup in the body (hemochromatosis)
- Copper accumulated in the liver (Wilson’s disease)
- Genetic disorders: cystic fibrosis, Alagille syndrome
- Bile duct atresia, destruction, stone and tumor
- Vascular diseases: Budd-Chiari syndrome, cardiac fibrosis
- Inherited disorders of glucose metabolism
- Alpha 1 anti-trypsin deficiency
- Medications such as methotrexate or isoniazid
Complications
- High blood pressure in the veins that supply the liver (portal hypertension)
- Swelling in the legs and abdomen (edema and ascites)
- Enlargement of the spleen (splenomegaly)
- Blood vomiting
- Infections
- Malnutrition
- Buildup of toxins in the brain (hepatic encephalopathy)
- Bone disease
- Increased risk of liver cancer
Multi-organ damage (heart, kidney, lungs etc.)
MON – WED
8AM – 7PM
THU
8AM – 5PM
FRI
8AM – 5PM
SAT – SUN
Closed
DIAGNOSIS:
DIAGNOSIS: Though cirrhosis is a histological diagnosis, a combination of clinical, laboratory abd imaging features can help to confirm a diagnosis of cirrhosis.
BLOOD TESTS:
- Liver function test – which evaluates normal functioning of liver. It includes the enzymes/proteins it synthesizes like alanine transaminase (ALT), aspartate aminotransferase (AST), alkaline phosphatase (ALP) and albumin; the bilirubin-(direct and indirect) which it excretes and the coagulation factors it produces indicated by coagulation studies like prothrombin time.
- Complete Blood Count (CBC)- measures the levels of red blood cells, white blood cells, and platelets
- Serologic testing for specific liver disease: Hepatitis A, B and C markers, serum iron studies (for hemochromatosis), serum ceruloplasmin (for Wilson disease), antibodies (for autoimmune hepatitis)
- Kidney function tests: Urea and creatinine, electrolytes.
- Tumor markers
IMAGING:
- Fibroscan-detects hardening or stiffening of the liver.
- Abdominal Ultrasonography
- MRI scan
- CT Scan
Liver biopsy-gold standard.
Treatment
Treatment for cirrhosis depends on the cause and extent of liver damage. The goals of treatment are to slow the progression of cirrhosis and to prevent or treat symptoms and complications.
- To stop alcohol consumption
- Antiviral medications
- Dietary changes
- Steroids for autoimmune cause
- Toxins and harmful drugs must be avoided.
- Excess fluid removal from the body with medicines (diuretics and albumin infusions) and/or drainage procedures.
- Medicines like beta blockers to reduce blood pressure in portal veins
- Esophageal variceal banding/glue injection for bleeding varices
- A small tube — a transjugular intrahepatic portosystemic shunt — placed in the vein to reduce blood pressure in liver.
- Antibiotics to treat infections
- Hemodialysis
- Periodic follow up to look for progression of cirrhosis and development of complications.
Liver transplantation:
A liver transplant is a procedure to replace patient’s liver with a healthy liver from a deceased donor or with part of a liver from a living donor.
Dysphagia
Diagnostic Indications & Treatment
- Symptoms
- Causes
- Complications
- Treatment
- Cirrhosis often has no signs or symptoms until liver damage is extensive.
- Fatigue, weakness, nausea, loss of appetite
- Jaundice
- Swelling in the legs, feet or ankles (edema)
- Fluid accumulation in the abdomen (ascites)
- Easily bleeding or bruising
- Changes in mental state (Confusion, drowsiness and slurred speech- (hepatic encephalopathy)
- Hematemesis- blood vomiting
- Spiderlike blood vessels on skin
- Redness in the palms of the hands
- Menstrual disturbances in women
- Breast enlargement (gynecomastia) or testicular atrophy in men
- Long time consumption of alcohol
- Chronic viral hepatitis (hepatitis B, C and D)
- Fatty liver (Fat accumulating in the liver)
- Autoimmune hepatitis (body attacking its own cells)
- Iron buildup in the body (hemochromatosis)
- Copper accumulated in the liver (Wilson’s disease)
- Genetic disorders: cystic fibrosis, Alagille syndrome
- Bile duct atresia, destruction, stone and tumor
- Vascular diseases: Budd-Chiari syndrome, cardiac fibrosis
- Inherited disorders of glucose metabolism
- Alpha 1 anti-trypsin deficiency
- Medications such as methotrexate or isoniazid
- High blood pressure in the veins that supply the liver (portal hypertension)
- Swelling in the legs and abdomen (edema and ascites)
- Enlargement of the spleen (splenomegaly)
- Blood vomiting
- Infections
- Malnutrition
- Buildup of toxins in the brain (hepatic encephalopathy)
- Bone disease
- Increased risk of liver cancer
Multi-organ damage (heart, kidney, lungs etc.)
Treatment for cirrhosis depends on the cause and extent of liver damage. The goals of treatment are to slow the progression of cirrhosis and to prevent or treat symptoms and complications.
- To stop alcohol consumption
- Antiviral medications
- Dietary changes
- Steroids for autoimmune cause
- Toxins and harmful drugs must be avoided.
- Excess fluid removal from the body with medicines (diuretics and albumin infusions) and/or drainage procedures.
- Medicines like beta blockers to reduce blood pressure in portal veins
- Esophageal variceal banding/glue injection for bleeding varices
- A small tube — a transjugular intrahepatic portosystemic shunt — placed in the vein to reduce blood pressure in liver.
- Antibiotics to treat infections
- Hemodialysis
- Periodic follow up to look for progression of cirrhosis and development of complications.
Liver transplantation:
A liver transplant is a procedure to replace patient’s liver with a healthy liver from a deceased donor or with part of a liver from a living donor.
A TIPPS Procedure was done at Kolhapur which gave patient immediate relief. This kind of procedure is done for the first time ever in this region.
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