Cirrhosis of the Liver

What is Liver Cirrhosis?

The liver is the largest solid organ in our body. It performs many important functions, such as:

• Synthesizing blood proteins that help with clotting, oxygen transport, and supporting the immune system.
• Storing excess nutrients and returning them to circulation when needed.
• Producing bile, a substance necessary for digestion.
• Participating in the storage of sugars (glucose) in the form of glycogen.
• Cleaning and eliminating harmful substances from the body, including drugs and alcohol.

Cirrhosis is a slowly progressive disease in which healthy liver tissue is replaced by scar tissue. The scar tissue slows the liver’s ability to process nutrients, hormones, medications, and natural toxins. It also reduces the production of proteins and other substances made by the liver. Ultimately, cirrhosis destroys the liver and prevents it from functioning properly.

What Causes Liver Cirrhosis?

The most common causes of cirrhosis are chronic viral infections of the liver (types B and C hepatitis), fatty liver associated with obesity and diabetes, and alcohol abuse. Additionally, anything that damages the liver can cause cirrhosis, including hereditary conditions such as:

• Cystic fibrosis
• Glycogen storage diseases, where the body cannot process glycogen (a form of sugar converted to glucose and serves as an energy source)
• Alpha-1 antitrypsin deficiency (absence of a specific enzyme in the liver)
• Diseases causing abnormal liver function, such as hemochromatosis (a condition where excessive iron is absorbed and deposited in the liver and other organs) and Wilson’s disease (abnormal copper storage in the liver).
• Obstruction of the bile duct, which carries bile from the liver to the intestine to aid in fat digestion.
• Recurrent episodes of heart failure causing congestion in the liver.

Although less common, other causes of cirrhosis include reactions to prescribed medications, prolonged exposure to environmental toxins, or infections by parasites.

Will People Who Drink Excessive Alcohol Develop Liver Cirrhosis?

Most people who drink large amounts of alcohol damage their liver in some way, but not everyone will develop cirrhosis. Generally, about 30% of people who consume 250 to 500 ml of spirits or other alcoholic drinks daily for 15 years or more will develop cirrhosis. Women who are heavy drinkers are at a higher risk than men. People with hepatitis B or C are more likely to suffer liver damage from alcohol.

What are the Symptoms of Liver Cirrhosis?

Symptoms of cirrhosis depend on the stage of the disease. In the early stages, there may be no symptoms. As the disease progresses, symptoms may include:

• Loss of appetite
• Fatigue
• Weight loss or sudden weight gain
• Bruising
• Yellowing of the skin or eyes (jaundice)
• Itching skin
• Fluid retention (edema) and swelling in the ankles, legs, and abdomen
• Brown or orange-colored urine
• Pale stools
• Confusion, disorientation, personality changes
• Blood in the stool
• Fever

An early sign of cirrhosis is fluid retention and salt retention. This may start as a swollen ankle or foot but can progress to significant fluid retention in the abdomen (ascites). By reducing salt intake and using the right combination of diuretics, fluid retention can be managed for a period. In more severe cases, the doctor may need to remove the fluid from the abdomen with a procedure.

Fluid in the abdominal cavity can become infected (a condition called peritonitis), which requires prompt diagnosis and treatment with antibiotics. Some people with severe fluid retention that do not respond to treatment may require a liver transplant.

Complications Associated with Liver Cirrhosis:

• Variceal bleeding: Varices are enlarged veins, usually in the esophagus and stomach. Variceal bleeding is caused by portal hypertension, which is an increase in pressure in the portal vein (the large vessel that carries blood from the digestive organs to the liver). This increase in pressure is caused by obstruction of blood flow through the liver due to cirrhosis. The varices become fragile and can easily bleed, leading to severe bleeding and ascites.
• Other severe complications of cirrhosis: Many other problems can arise as a result of cirrhosis, including:
• Άλλες σοβαρές επιπλοκές της κίρρωσης. Πολλά άλλα προβλήματα μπορεί να προκύψουν ως αποτέλεσμα της κίρρωσης, μεταξύ των οποίων:
  • Kidney failure
  • Reduced oxygen in the blood
  • Diabetes
  • Blood disorders
  • Increased risk of infections
  • Increased risk of bleeding and minor hemorrhages
  • Gynecomastia in men
  • Early menopause
  • Loss of muscle mass

Most of these complications can be managed with medication. Once treatment for these complications becomes ineffective, the next step is considered to be a liver transplant. Nearly all complications can be treated with a transplant.

However, in many cases, careful management can reduce the harmful effects of cirrhosis and may delay or even prevent the need for a transplant.

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