liver health

Liver Cirrhosis

Generality

Liver cirrhosis is a chronic and degenerative disease of the liver.

It occurs when the organ responds to a lesion or a morbid process by destroying its cells and replacing them with cicatricial interconnections, among which nodules of regenerating cells develop; consequently, the liver gradually loses architecture and functions, with negative repercussions on the entire organism.

According to current knowledge, cirrhosis cannot be cured. For this reason, medical therapy is limited to slowing its evolution, identifying the cause that caused it and then trying to eliminate it or control it through specific drugs, surgical interventions and behavioral measures.

Causes

Anything that causes chronic liver damage can cause cirrhosis; among the main causes of this disease we find viral hepatitis (B, C and D) and autoimmune diseases, alcohol abuse (which in industrialized countries represents the most common cause of cirrhosis) or certain drugs, some metabolic diseases (steatosis non-alcoholic hepatic disease, glycogen storage disease, haemochromatosis, Wilson's disease), occlusion of the bile ducts (for stones, inflammatory processes or tumors) and circulatory stasis in the liver (which characterizes chronic heart failure).

One speaks instead of cryptogenic cirrhosis when the cause of origin is not determinable.

Potential Causes of Fibrosis and Liver Cirrhosis

  1. Chronic viral hepatitis (HBV and HCV)
  2. Toxic (eg alcohol or drugs)
  3. Hepatopathies with autoimmune genesis (autoimmune hepatitis)
  4. Metabolic diseases (Hemochromatosis, Wilson's disease)
  5. Parasitic diseases (eg Schistosomiasis)
  6. Non-alcoholic steatohepatitis
  7. Vascular alterations (congenital or acquired)
  8. Biliary tract diseases (primary sclerosing cholangitis)

Because of the aforementioned pathological situations, the liver is found in a chronic inflammatory state, which leads to the release of certain substances (called cytokines); in turn these substances favor the proliferation of fibrous tissue ( liver fibrosis ) and - in the most advanced stages - lead to the development of regeneration nodules typical of cirrhosis.

Symptoms and Complications

To learn more: Liver Cirrhosis Symptoms

Because of the central role that the liver plays in regulating the body's metabolism, and for the anatomopathological changes associated with the disease, cirrhosis causes dramatic consequences for the patient; these include:

  • portal hypertension (the nodules oppose the normal hepatic circulation, whereby the blood can return to the portal vein * increasing the pressure; thus, intra and extrahepatic collateral circles are formed, through which the blood is poured directly into the outflow channels without entering in contact with the hepatic parenchyma, the portal hypertension therefore reduces the blood flow to the liver cells that are still functioning, causing the appearance in the circulation of toxins normally inactivated by the organ and the decrease of the substances synthesized by it);
  • jaundice (yellow coloring of the skin due to accumulation of bile pigments in the blood);
  • splenomegaly (enlarged spleen);
  • varices (esophageal and hemorrhoidal);
  • edema, ascites (accumulation of extracellular fluid in the abdominal cavity, particularly noticeable in patients with decompensated cirrhosis) and water retention, muscular and testicular atrophy, gynecomastia, hepatic encephalopathy, hair loss and bruising and hemorrhage (all conditions caused by the decrease in liver function - with reduced synthesis of albumin, coagulation factors and proteins - associated with the decrease in detoxifying and metabolic capacity in general).

Liver cirrhosis - Video: Causes, Symptoms, Cures

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Cirrhosis and Liver Cancer

Cirrhosis is also one of the main risk factors for hepatocellular carcinoma (see liver cancer).

Fortunately, in principle the liver damage is established with a slow progression, through stages that can however follow each other more quickly in certain situations (for example for the possible overlapping of more aggravating factors).

Care

To learn more: Drugs for the treatment of cirrhosis

The absolute prohibition of drinking alcohol (as a general rule and in particular in the presence of alcoholic cirrhosis), the restriction in the use of certain drugs, therapy with specific anti-inflammatories (in the presence of chronic hepatitis), surgical removal of the obstruction ( in the case of secondary biliary cirrhosis) and the pharmacological treatment of heart failure, they can stop the progression of the disease, which otherwise evolves inexorably until the patient's death.

Diet

To learn more: Diet and Cirrhosis

The adoption of particular dietary measures - variable according to the stage of cirrhosis - is extremely important; there is a tendency to limit, for example, the intake of sodium (particularly if ascites are present), poorly tolerated foods (fries and other difficult to digest) and coarse (which can traumatize esophageal varices), often using dietary supplements ( for example lactulose, fiber, probiotics and prebiotics - to control constipation and improve intestinal bacterial flora - and, in the presence of advanced cirrhosis, branched amino acids in association with a hypoproteic diet).

Prevention

Despite the impossibility of treating it, the disease is susceptible to effective prevention; many cases of cirrhosis are in fact linked to alcohol abuse (especially in industrialized nations) and to viral hepatitis (most common in underdeveloped countries).

For the prevention of liver cirrhosis it is therefore very important:

  • moderation or abstention from alcohol consumption;
  • vaccination against viral hepatitis (vaccines are available for hepatitis A, B, D and E), the use of condoms in case of occasional intercourse and abstention from consumption of contaminated water or food when going to countries developing.

Cirrhosis - Drugs for the treatment of cirrhosis "