Abstract
Cirrhosis is a disease resulting from advanced liver disease and is characterized by the development of fibrosis and regenerative nodules. It causes the loss of liver function and leads to poor quality of life. Complications such as ascites, edema and hepatic encephalopathy may result from the disease. Damages from cirrhosis are usually irreversible. However, treatment can be used to prevent it from causing more harm and may be used to manage the complications that come with it. A liver transplant is required if the disease is in its advanced stages.
Introduction
The liver is one of the most important organs of the body due to its functions. It is responsible for detoxification, synthesis of proteins and production of digestive enzymes (Anthea, Hopkins, McLaughlin, Johnson, Warner, LaHart, & Wright, 1993). The organ also plays an important role in the production of hormones and the storage of some nutrients. The decomposition of red blood cells may not be possible without the help of the liver. In its major role of metabolism, the liver aids in the production of bile. This chemical emulsifies lipids and is useful during digestion. However, the liver is also prone to many diseases. Some of the diseases and infections include cirrhosis, cancer, hepatitis, alcohol and drug damage. Children have diseases unique to them and they include alagille syndrome and biliary atresia.
Cirrhosis is a result of injury and damage caused by some diseases. When this occurs, the liver tissue will display scarring (fibrosis) and have regenerative nodules. These are mainly the lumps that result from attempts of the liver to repair the damage caused by the disease. These changes in the liver have adverse effects on the functions of the liver. The scarring effect also causes changes in the liver’s structure and may prevent the efficient flow of blood in the organ. The changes may also affect the processes of nutrient, protein and hormone production. The process of detoxification is also affected.
This disease is one of the leading causes of death in the U.S. in hospitalized patients (Singla, Hart, Li, Tseng, & Shah, 2011). Patients with the disease are most vulnerable during the first year. No medical treatment is currently available for the disease. However, liver transplants may be done to save a victim and this has been determined to be the only definitive cure. For patients experiencing complications, effective care could be ensured as they await transplantation. Such complications may include hepatorenal syndrome, ascites and variceal hemorrhage.
Causes of the disease
Cirrhosis may be caused by several factors. In some instances, more than one factor may be present in the same individual and contribute to cirrhosis. More than 50% of all cases globally are caused by Hepatitis B or C. Another major cause of the disease is alcohol consumption since it contributes to about 20% of all incidences (Perz, Armstrong, Farrington, Hutin, & Bell, 2006). Alcohol liver disease (ALD) occurs as a result of heavy drinking over prolonged periods (years). Drinking alcohol may cause harm to the organ since it interferes with the usual processes. These processes include protein, fat and carbohydrate metabolism. The active ingredient is acetaldehyde, which forms from alcohol. This substance is reactive. Alcohol also causes the accumulation of products in the liver.
Obesity is also a major contributing factor. In particular, non-alcoholic steatohepatitis (NASH) is a result of accumulated fat deposits in the liver and it eventually causes scarring. Another similar disease is non-alcoholic fatty liver disease (NAFLD). These diseases are similar to alcoholic liver disease in various respects. However, they only occur to persons who drink little or no alcohol. Non-alcoholic fatty liver disease does not cause inflammation or damage. For this reason, it does not produce any symptoms. Non-alcoholic steatohepatitis, on the other hand, causes inflammation and destruction.
Another cause of the disease is chronic hepatitis C. This disease significantly damages the organ. Several years of inflammation and damage may lead to cirrhosis. A significant proportion of patients with hepatitis C may develop cirrhosis (Longo, 2012). When cirrhosis develops from hepatitis C, the most common intervention required is a liver transplant. The same case applies to cirrhosis developing from alcohol liver disease. Chronic hepatitis B is another cause of cirrhosis. Similar to hepatitis C, hepatitis B may affect the liver causing inflammation and injury. Over time, it may develop into cirrhosis.
Primary biliary cirrhosis is another cause. At times, the symptoms may be absent. However, the patient may complain of such issues as fatigue and pruritus. Primary sclerosing cholangitis (PSC) may also lead to cirrhosis. This condition may be caused by metabolic bone disease. Cirrhosis may also arise from autoimmune hepatitis, which occurs due to damage to the immune system. When this occurs, the liver may be damaged and inflamed.
Cirrhosis may also be inherited if a family history of the disease exists. In this case, it is referred to as hereditary hemochromatosis. Wilson’s disease may also contribute to cirrhosis. This is mainly due to the fact that it causes an increase in hepatic copper content in the liver. A similar disease is Indian childhood cirrhosis (Tanner, 1998). Other causes may include hepatotoxic drugs or toxins, galactosemia and cardiac cirrhosis.
Approaches to detect cirrhosis
Cirrhosis can be detected by the examination of some of the signs and symptoms. Some signs may present themselves directly due to the inability of the organ to perform its functions. This may lead to hypogonadism, gynecomastia, spider angiomata, ascites, jaundice, fetor hepaticus, enlarged liver and palmar erythema. Other symptoms may present themselves as a result of increased resistance to blood flow and high pressure. They include an enlarged spleen, esophageal varices and caput medusa. The best way to diagnose cirrhosis is through the use of a liver biopsy. However, it is not necessary if all other tests including the laboratory tests suggest the presence of the disease. The main reason is that liver biopsy may present a significant risk to the individual. In addition to this, cirrhosis disease itself places the individual at risk of complications caused by the procedure.
Approaches to treat cirrhosis
Reversing the damage caused to the liver due to cirrhosis is impossible. However, treatment could help in reducing complications and stopping further damage (Iredale, 2003). Lifestyle changes may also greatly help in the management of the disease. For example, individuals with alcoholic cirrhosis could stop drinking alcohol. Adopting a healthy diet is also a major treatment measure. Foods taken should include those that have low sodium concentrations. These foods are important for patients with edema or ascites. Such foods include those that are easy to digest. Proteins from this category include white meat and legumes.
Patients should also take vaccinations for hepatitis A and B so as to prevent the occurrence of these diseases. This is mainly because the occurrence of such diseases may result in significant sickness or death. Medicines should also be given to reduce the symptoms of cirrhosis. Such patients should be discouraged from eating raw seafood. They should also seek advice from their doctors before taking any medication. Such symptoms include itching, edema and ascites. Since cirrhosis can cause some alterations in the individual’s mental function, treatment may be necessary. In this case, diet and drug therapies may be employed. For example, reducing the consumption of red meat may help in reducing the toxins formed during digestion. Laxatives may also be used to absorb the toxic substances and speedily remove the substances from the digestive tract. Liver transplantation is the most effective intervention.
Conclusion
The liver is the body’s largest organ. It plays a vital role in the support of life. Its functions are diverse and they include detoxification and protein synthesis, among others. The liver is prone to many diseases including cirrhosis. This disease occurs as a result of advanced liver disease. It causes scarring and the presence of lumps. The symptoms include those that directly result from failure of the liver’s functions. Other symptoms present themselves as a result of portal hypertension (Kim, Choi, Baik, 2010). Cirrhosis is caused by several factors including alcoholic liver disease, non-alcoholic steatohepatitis, hepatitis B and hepatitis C. However, it is important to note that cirrhosis can be managed effectively in order to ensure that patients with the disease live healthy lives for many years.
References
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Kim, M., Choi, H., & Baik, S. (2010). Portal Hypertensive Gastropathy: Correlation with Portal Hypertension and Prognosis in Cirrhosis. Digestive Diseases and Sciences, 55(12), 3561-3567.
Longo, D. (2012). Harrison’s principles of internal medicine. New York: McGraw-Hill.
Perz, J., Armstrong, G., Farrington, A., Hutin, J., & Bell, B. (2006). The contributions of hepatitis B virus and hepatitis C virus infections to cirrhosis and primary liver cancer worldwide. Journal of Hepatology, 45(4), 529-538.
Singla, A., Hart, J., Li, Y., Tseng, J., & Shah, S. (2011). Hospitalization for complications of cirrhosis: Does volume matter? Journal Gastrointestinal Surgery, 15(1), 330-335.
Tanner, M. (1998). Role of copper in Indian childhood cirrhosis. The American journal of clinical nutrition, 67(5), 1074-1081.