CIRRHOSIS

Cirrhosis is the term used to describe a liver that has been severely scarred, and is no longer able to perform its normal functions.

CAUSES
Longstanding alcohol abuse
Chronic hepatitis (B or C )
Non-alcoholic steatohepatitis (a condition in which fat and scar tissue accumulate in the liver)
Hemochromatosis ( iron overload  in the body)
Autoimmune hepatitis (a condition in which the body’s immune system recognizes the liver as foreign)
Primary sclerosing cholangitis (a disease of the large bile ducts)
Primary biliary cirrhosis (a disease of the small bile ducts)
Wilson’s disease (a rare disease of copper metabolism)
SYMPTOMS
Fatigue
Malnutrition
Jaundice (yellowing of the skin and eyes)
Variceal bleeding ( Varices are abnormal dilated veins in any part of gastrointestinal tract)
Fluid  accumulation in the legs (edema) and abdomen (ascites)
Spontaneous bacterial peritonitis-infection in ascitic fluid
Easy bruising and bleeding ( secondary to decreased platelets and clotting factors)
Hepatic encephalopathy -confusion, delirium, and even coma
People with cirrhosis are at increased risk for developing liver cancer (hepatocellular carcinoma).
DIAGNOSIS
Laboratory tests often reveal abnormal blood chemistries, low albumin level and  platelet counts, and increased bilirubin.
Special blood tests help determine the exact cause of cirrhosis.
Imaging studies such as CT scan, ultrasound, or MRI show small shrunken liver and associated findings such as varices , ascites.
Liver biopsy is the definitive test to diagnose cirrhosis.
TREATMENT
Abstinence from alcohol and avoidance of medications that can hurt the liver are of primary importance in preventing further damage to the liver
Early diagnosis and treatment of the underlying cause of liver damage  can reverse cirrhosis.
Liver transplantation, a procedure in which the diseased liver is replaced with a new healthy liver is a major advance in treatment of Cirrhosis / End stage Liver disease

Measures to decrease complications include
beta blockers to reduce the pressure inside varices to decrease the risk of variceal bleeding
Early diagnosis and treatment of  spontaneous bacterial peritonitis
vaccinations against hepatitis A and B
pneumococcal vaccine and yearly influenza vaccine
For more information please see
www.liverfoundation.org
www.nlm.nih.gov/medlineplus/healthtopics.html
www.gastro.org/wmspage.cfm?parm1=681
www.hepnet.com
www.hepb.org