Cirrhosis

Cirrhosis

Dr. Monte Selvanus Luigi Kusuma

Workstation PKU Muhammadiyah Gombong Hospital

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Definition

Cirrhosis is a condition that causes irreversible scarring of the liver. As scar tissue replaces normal tissue, blood flow through your liver is affected. This makes it increasingly difficult for your liver to carry out essential functions, such as detoxifying harmful substances, purifying your blood and manufacturing vital nutrients.

Cirrhosis rarely causes signs and symptoms in its early stages. But as liver function deteriorates, you may experience fatigue, nausea, unintended weight loss, and swelling in your legs and abdomen. In time, jaundice — a yellowing of your skin and the whites of your eyes — and intense itching can develop. You may also experience bleeding from your digestive system that could be severe.

Excessive use of alcohol and chronic infection with the hepatitis C virus are the leading causes of cirrhosis. But other factors — including damaged bile ducts, immune system problems and prolonged exposure to certain environmental toxins — can cause liver scarring, too.

Although liver damage from cirrhosis is irreversible, the disease usually progresses slowly and symptoms are often controllable. Specific treatment for cirrhosis depends on the underlying cause, but anyone with cirrhosis must avoid alcohol and other substances that harm the liver. When damage is so severe that liver function is seriously impaired, a liver transplant may be the only option.

Symptoms

You may not have signs and symptoms of cirrhosis in the early stages of the disease. But as more scar tissue replaces healthy tissue and liver function declines, you may experience some of the following:

* Lack of appetite

* Weight loss

* Nausea

* Small, red spider veins under your skin or easy bruising

* Weakness

* Fatigue

* Yellowing of your skin and eyes and dark, cola-colored urine

* Bleeding from engorged veins in your esophagus or intestines

* Loss of interest in sex

* Fluid in your abdominal cavity (ascites)

* Itching on your hands and feet and eventually on your entire body

* Swelling of your legs and feet from retained fluid (edema)

* Mental confusion, such as forgetfulness or trouble concentrating (encephalopathy)

Causes

A healthy liver performs hundreds of vital functions, including processing most of the nutrients absorbed from your intestine, removing drugs, alcohol and other harmful substances from your bloodstream, and manufacturing bile — the greenish fluid stored in your gallbladder that helps digest fats. The liver also produces cholesterol, substances to help your blood clot and certain other proteins.

Because of the complexity of the liver and its exposure to so many potentially toxic substances, it would seem especially vulnerable to disease. But the liver has an amazing capacity for regeneration — it can heal itself by replacing or repairing injured cells. In cirrhosis, however, the healing process seems to go slightly awry. In response to chronic injury, certain liver cells increase dramatically in size and number forming excess scar tissue that interferes with the liver's ability to function. And although groups of cells may continue to regenerate, the pattern of regeneration isn't normal.

What damages the liver?

Many people associate cirrhosis with alcohol abuse, and in fact, chronic alcoholism is the primary cause of cirrhosis in the United States. Alcoholic cirrhosis usually occurs after a decade or more of heavy drinking, although the amount of alcohol that can injure the liver varies from person to person. The liver is particularly vulnerable because it breaks down alcohol into highly toxic chemicals. Some of these chemicals trigger inflammation that eventually destroys liver cells. In time, web-like scars and small knots of abnormal tissue replace healthy liver tissue. In the initial stages of cirrhosis, the liver swells, but it later shrinks as larger areas of scar tissue form.