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Cirrhosis of the liverCirrhosis is a condition that affects the liver, characterized by the scarring of normal cell tissue. The liver is located in the upper right-hand side of the abdomen, below the ribs. A normal liver weighs about 3 lbs. and is the largest organ in the body. The liver has several important functions including:
A damaged liver cannot process drugs and toxins properly. The scar tissue also interferes with the flow of blood. Improper liver function resulting from cirrhosis causes severe complications which can be very serious. Complications to cirrhosis include:
In the U.S., alcoholism is a major cause of cirrhosis. There are several other causes of cirrhosis including:
Less common causes of cirrhosis include:
If a cause cannot be determined then the condition is called cystogenic cirrhosis. This occurs in approximately 10% of cases. SymptomsThere are few symptoms associated with cirrhosis and many of them are non-specific. These include:
DiagnosisCirrhosis is a permanent condition; therefore, the primary goal of treatment is to stop further scarring and prevent the development of complications. If an individual shows signs of cirrhosis, a physician will conduct a physical examination with a combination of blood tests in order to determine whether cirrhosis has occurred and if so, what may be the cause. During the physical examination the physician will see whether the liver is enlarged or tender. The physician is also looking for small, red, spider-like marking on the skin called telangiectasias, and signs of jaundice. The lab tests may show signs of decreased protein levels, elevated bilirubin and enzyme levels or a diminished amount of blood clotting factors, all of which would lead to diagnosing cirrhosis. Elevated iron levels would point to hemochromatosis as the cause of cirrhosis. Diminished levels of a substance called cerulplasmin would ultimately point to Wilson's disease as a possible cause of cirrhosis. Or, the presence of antibodies may suggest that autoimmune hepatitis is the cause of cirrhosis. In order to confirm the diagnosis of cirrhosis, the physician may perform a liver biopsy by inserting a needle through the skin and into the liver, removing a piece of tissue. Other procedures that may be used to diagnose cirrhosis are CAT Scan, ultrasound, radioisotope liver/spleen scan, or laparoscopy, which involves sticking a lighted viewing tube through the abdomen in order to inspect the liver. TreatmentUnfortunately, liver scarring resulting from cirrhosis is permanent. Therefore, the objective of treatment is to discontinue scarring and prevent the onset of complications such as internal bleeding or mental confusion. In general, individuals suffering from liver damage should follow a healthy diet that is not rich in fat and cholesterol. Substances that aggravate the liver such as alcohol, acetaminophen, NSAIDs and large amounts if vitamin A, should be avoided. Individuals with cirrhosis are also recommended to avoid seafood, as it could lead to liver infection. Most treatment methods focus on the cause of cirrhosis. If viral infection is the cause of cirrhosis, Interferon treatment for Hepatitis B or C may be an option, if the condition is not too advanced. Individuals with cirrhosis should be immunized for Hepatitis as well as other conditions such as influenza and pneumococcal pneumonia. If the cause of cirrhosis is due to an overload of metal in the body, such as Wilson's disease, then bloodletting or medication to increase urine excretion may be recommended. For patients with Autoimmune Hepatitis resulting in cirrhosis, medications to suppress immunity such as prednisone or azathioprine may be prescribed. Ascites and Edema may be treated with diuretics to increase urine production. Itching can be treated with medications such as cholestyramine. In cases resulting in loss of mental function, protein ingestion should be restricted and medications such as lactulose, which help bind toxins, may be prescribed. If internal bleeding occurs, resulting from ruptured veins in the esophagus, sclerosing agents may be prescribed, which will scar the veins closed. For advanced cases of vein rupture, surgery may be necessary in order to create a bypass for blood away from the liver. In cases of advanced cirrhosis, liver transplant may be an option. Liver transplantation has progressed tremendously in the recent years. New medications that prevent infection and graft rejection give transplant patients and 80% survival rate over five years. Many individuals who have undergone liver transplant surgery return to work and normal life conditions. |
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BrooklynGI.com with offices in New York City
Brooklyn Queens and Manhattan. Treating patients from New York, New Jersey and
Connecticut. is dedicated to helping patients and physicians receive accurate
and up-to-date information on the Gastrointestinal tract (GI Tract) The organs
that compose the GI tract include, Esophagus, Stomach, Small Intestine, Large
Intestine (Colon), Pancreas and the Liver and Gall Bladder (Hepato-Biliary Tree)
Dr. Scott Tenner Contact
DrTenner@BrooklynGI.com
with questions or comments.
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