The liver is responsible for neutralizing the blood of toxins, germs and bacteria as well as producing immune agent to control infections. Bile, critical to the absorption of fats and fat-soluble vitamins is made by the liver. Cirrhosis is a condition where the liver is affected by irreversible scar tissue leading to its damage and consequent failure. Blood flow to the liver is then affected. Symptoms of cirrhosis range from exhaustion and fatigue to weight loss and abdominal pain. A person suffering from liver cirrhosis may experience abdominal pain and loss of appetite. There are noticeable red spider veins under the skin and the skin and eyes may turn yellow. There is decreased interest in sex and edema (swelling on hands and legs) might be noticed. A person suffering from cirrhosis and damaged liver may notice an increased tendency to bruise and bleed easily. Intense itching is felt on account of the bile products being deposited in the skin. Gallstones may develop as a result of inadequate bile reaching the gallbladder. There might be a buildup of toxins in the brain bringing about bouts of unresponsiveness and forgetfulness. Cirrhosis can bring on Portal hypertension - a condition where there is reduced flow of blood to the portal vein and increased pressure within it. Cirrhosis can eventually lead to liver cancer caused by carcinoma. Impotence, kidney dysfunction and osteoporosis are other likely complications of liver disease.
Cirrhosis of the liver is usually caused by chronic alcoholism or hepatitis C. Other possible factors leading to cirrhosis are problems in the immune system and damaged bile ducts.
Chronic Alcoholism - One of the common causes for cirrhosis is alcoholism. But this condition occurs only after at least 10 years or more of heavy drinking. Alcohol affects the liver's ability to metabolize proteins, fats and carbohydrates.
Chronic hepatitis - Hepatitis C virus can lead to severe inflammation and damage of the liver, thereby causing cirrhosis. Hepatitis B is one of the most common causes of liver inflammation in many of the developing nations.
Blocked bile ducts - In such a condition, the bile is unable to travel out of the liver and instead ends up damaging liver tissue. This can be a congenital defect in some infants.
Cirrhosis of the liver can cause many other abnormalities. It can leads to elevated levels of triglycerides, cholesterol and sugar. Diabetes mellitus is a common fallout. There might be a fall in platelet count and GI bleeding. In severe cases of cirrhosis, there can be an immune system dysfunction or even brain swelling and later coma. The liver of an affected person will feel be larger and harder to touch. A liver scan or ultrasound can help detection of cirrhosis. A liver biopsy is sometimes resorted to. Damage to the liver due to cirrhosis cannot be reversed but further complications can be reduced with the right treatment. Cirrhosis caused by excess alcohol consumption needs lifestyle changes such as avoiding alcohol and following a nutritious diet. Low-sodium diet can help drain excess fluid-buildup within the body. Chronic viral hepatitis B and C are treated with prednisone and azathioprine. Any bacterial infection is treated with appropriate antibiotics. Liver transplantation surgery is done on cases where the liver is not capable of functioning. With the help of modern drugs such as cyclosporine and tacrolimus, the success of liver transplantation surgery has risen manyfold.
Primary Biliary Cirrhosis
Primary biliary cirrhosis (PBC) is a condition caused by inflammation of the small bile ducts in the liver, leading to cirrhosis. Inflammation later spreads and destroys liver cells. This leads to scarring and toxicity arising out of trapped bile. This condition is not caused by alcohol or drug. It is an autoimmune disorder that is more likely to affect women than men.
Primary biliary cirrhosis advances over the years and often the patient may not experience any symptoms and may not look ill at all. Persons suffering from PBC tend to feel severe fatigue. There may be severe itching on the skin. Hyperpigmentation may be noticed on the skin of a person suffering from PBC. There may be thyroid problems and joint pains. Dry Eye syndrome is also noticed. Another symptom of Primary biliary cirrhosis is enlarged abdomen. The patient may notice easy bruising and bleeding. Pain is felt in the abdomen and liver areas. Renal stones and gallstones may develop. As the condition worsens, there may be softening of the bones making them susceptible to fractures. Jaundice is often noticed in patients suffering from Primary biliary cirrhosis. It also results in digestive problems and infection of the urinary tract.
An alkaline phosphatase activity test can help diagnose PBC. Liver function tests and other diagnostic tests such as serum cholesterol and lipoproteins are also conducted. A liver biopsy can aid the physician in understanding the severity and extent of liver damage. Any thyroid malfunction is corrected with thyroid hormone. Corticosteroids are prescribed to patients suffering from Primary biliary cirrhosis. Cholestyramine may be effective in reducing the itching. Liver transplantation is the final alternative when there are signs of liver failure such as GI bleeding, jaundice and accumulation of fluid in the abdomen.
Hepatoma is primary liver cancer which occurs in the liver itself and did not spread from another area of the body to the liver. Often associated with cirrhosis of liver and hepatitis B infections, malignant hepatoma is common among alcoholics. It is found in people above 40 years of age and more noticed among men than women.
While the exact cause of malignant hepatoma is not known, there are several risk factors that contributes to the cause of hepatoma. These include being above 40 years of age, male sex, history of cirrhosis and exposure to hepatitis viruses B, C, D and G. Symptoms of malignant hepatoma may be the same as other liver diseases, including pain and swelling in the abdominal area, loss of weight, appetite, jaundice, fatigue and fever. Crucial pain extending to the back and shoulder is another symptom, when the cancer progresses. A collection of fluid known as ascites in the abdomen occurs in some patients, while some show signs of bleeding in the digestive tract.
The procedure for diagnosis is for the medical practitioner to go through the medical history of the patient first and physically examine the patient's abdomen for lumps if any. The liver could be swollen, hard and sore. Certain diagnostic parameters inclusive of blood tests are conducted to determine and evaluate the liver condition and function. An ultrasound and CT scan are undertaken to detect possible tumors in the liver. If necessary, a sample of liver tissue is sent for a biopsy to confirm if the hepatoma is malignant. Sometimes, a doctor looks for chest x-ray to understand if the liver tumor is primary or has spread to the lungs as well.
Hepatomas are neither contagious nor hereditary. They could be cured, if detected in the early stages. But unfortunately, most hepatomas are detected late making the rate of survival very low. In most advanced stages, malignant hepatoma cannot be cured although treated to relieve pain. Surgery is recommended if cancer is contained in one lobe of the liver and the patient is healthy enough without afflictions of cirrhosis, jaundice or ascited. Sometimes, chemotherapy or radiation therapy is undertaken to destroy the cancer cells in order to slow the disease spread. Although chemotherapy is not very successful but is tried in patients whose tumor is too large or advanced to be surgically resected. Liver transplant is adopted in patients who suffer acute liver damage with too large a portion of the tumor in the liver.
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Bibliography / Reference
Collection of Pages - Last revised Date: May 26, 2019