Cirrhosis is a chronic disease of the liver, characterized by destruction and replacement of liver health tissues with scars or fibrosis. Liver is an important organ that play a vital role in detoxification and in the elimination process. In liver cirrhosis, there is constant damage to the liver tissues from illness or other causes, occuring over a long period of time.  When this happens, it reaches a time when the liver cannot be able to function fully due to scarring or damage.  Without  prompt medical intervention to try and slow down the disease progression process, liver cirrhosis can eventually lead to other serious complications.

Causes of Liver Cirrhosis

There are four main different types of liver cirrhosis, classified according to the possible causes;

Alcoholic Cirrhosis

Alcoholic cirrhosis also known as Laennec's cirrhosis - The scared tissues are found around the portal areas. Alcoholic cirrhosis is the most common type of liver cirrhosis, frequently resulting from chronic alcoholism. Other causes of Laennec's cirrhosis include; portal hypertension and malnutrition.

Post Necrotic Cirrhosis

In post necrotic cirrhosis there is present of broad bands of scar within the liver tissues.  Causes of post necrotic cirrhosis include; hepatitis viral infections and hepatotoxic drugs.

Biliary Cirrhosis

In biliary cirrhosis the scaring occurs in the liver, around or near the biliary ducts. The most common cause fo biliary cirrhosis is chronic biliary obstruction (biliary atresia) or biliary infection (cholangitis).

Right-Sided Congestive Heart Failure (RSCHF)

The condition in which the right side of the heart loses its ability to pump blood to other parts of the body. When this happens, the liver also becomes congested due to blood pooling in the portal vein  (liver is connected to the heart through a vein called the portal vein). This leads to swelling of the liver cells (hepatocytes) and eventually, the liver tissues may get scarred or damaged.

Other causes of liver cirrhosis include;

Symptoms of Liver Cirrhosis

The signs and symptoms experienced by an individual suffering from liver cirrhosis, depends on the stage of the disease progression. In the early stages, no symptoms are present and the disease may only be discovered during a routine physical examination.

 

Early Signs and symptoms of Liver Cirrhosis (Compensated Cirrhosis) may include;

Late Signs and Symptoms of Liver Cirrhosis (Uncompensated Cirrhosis) may include;

Possible complications associated with liver cirrhosis include;

 

Cirrhosis Diagnostic Tests

Tests used to diagnose liver cirrhosis include;

Liver Cirrhosis Treatment and Management

The kind of treatment given is determined by the presenting signs and symptoms, what is causing the liver damage and the extent of the disease progression by the time of diagnosis.  Liver cirrhosis is not reversible but the progression of the disease can be halted and by treating the resulting symptoms.

For example. If the cause of liver cirrhosis is alcohol, patient is advised to stop taking alcohol. Vitamin supplements and nutritional support may be given for vitamin deficiencies and to improve over all nutritional status of the patient. If the cause of liver cirrhosis is hepatitis, anti-viral medications may be given.  If the presenting sign and symptom is ascites, a potassium-sparing diuretic may be prescribed. Patient may also be advised to limit fluid intake, sodium intake and to increase protein in the diet. 

How to Manage Some of the Complications Caused by Liver Cirrhosis

Dilated collaterals may be managed by preventing rupturing and by inserting a tube known as sengstaken blakemore that is used to apply direct pressure on the esophageal varices to control bleeding.

Hepatic encephalopathy -  Medication to decrease the level of ammonia in the blood  (lactulose to help in excretion and neomycin to decrease the production of ammonia) and a low protein diet may be ordered.

Infection - Antibiotics for bacterial infections. Limiting visitors and proper hand washing is necessary to prevent spread of infection.

Skin pruritus

Proper skin care and collodial oatmeal bath may help to ease itchness.

Liver Cirrhosis Prevention

• Stop drinking alcohol and if you really have to drink, drink moderately.
• Maintain a health weight by regular exercises.
• Get vaccinated against hepatitis viruses.
• Do not share your personal belongings like a razor and syringes with anyone to avoid getting infected with hepatitis B and C viruses.
• Always practice safe sex if you have multiple partners.
• Avoid using over the counter drugs or medications that may have a negative effect on the liver.
• Eat a healthy diet with less fat.
• Seek medical help if you are concerned about your health or if you suspect you are at a risk of acquiring liver cirrhosis.