What is Cirrhosis? 

Cirrhosis is a late stage of scarring of the liver caused by many forms of liver diseases.

What are the causes of Cirrhosis?

  • Chronic alcohol abuse
  • Chronic viral hepatitis (hepatitis B, C, and D)
  • Nonalcoholic fatty liver disease
  • Hemochromatosis – iron buildup 
  • Cystic fibrosis
  • Wilson’s disease – copper buildup 
  • Poorly formed bile ducts (biliary atresia)
  • Alpha-1 antitrypsin deficiency
  • Autoimmune hepatitis
  • Primary sclerosing cholangitis
  • Medications, including methotrexate or isoniazid

What are the risk factors for Cirrhosis?

  • Excessive alcohol consumption
  • Obesity
  • Viral hepatitis 

What are the symptoms of Cirrhosis?

  • Fatigue
  • Easy bleeding or bruising
  • Loss of appetite
  • Nausea
  • Swelling in the legs, feet, or ankles
  • Weight loss
  • Itchy skin
  • Jaundice
  • Ascites
  • Spiderlike blood vessels

How to diagnose Cirrhosis?

  • History, physical and ancillary tests.
  • Blood tests
    • LFTs, CBC, hepatitis panel, INR, ANA, AMA, SMA
  • Imaging tests
    • MRI, ultrasound, CT scan, transient elastography – measures the stiffness of the liver, and liver fat.
  • Liver biopsy 

How to treat Cirrhosis?

  • Treat the underlying cause
  • Counseling on the need to avoid alcohol use. 
  • Weight loss
  • Low-sodium diet
  • Control portal hypertension with medications – vasodilators such as isosorbide mononitrate (ISMN) and beta-blockers, which include propranolol, nadolol, and timolol.

What are the complications of Cirrhosis?

  • High blood pressure in the veins that supply the liver – portal hypertension. 
  • Swelling in the legs and abdomen. The increased pressure in the portal vein can cause fluid to accumulate. Edema and ascites result from the inability of the liver to make enough albumin.
  • Splenomegaly – Decreased white blood cells and platelets is the first sign of cirrhosis. 
  • Bleeding – Portal hypertension may cause enlarged veins (varices) in the esophagus (esophageal varices) or the stomach (gastric varices) and lead to life-threatening bleeding. 
  • Infections – Ascites can lead to bacterial peritonitis.
  • Malnutrition – leads to weakness and weight loss/muscle mass wasting.
  • The buildup of toxins in the brain (hepatic encephalopathy). 
  • Increased risk of liver cancer.

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