Cirrhosis of the Liver
What is cirrhosis of the liver?
The liver is the largest solid organ in the body. It performs many important functions, including:
- Making blood proteins that aid in clotting, transporting oxygen, and helping the immune system.
- Storing excess nutrients and returning some of the nutrients to the bloodstream.
- Manufacturing bile, a substance needed to help digest food.
- Helping the body store sugar (glucose) in the form of glycogen.
- Ridding the body of harmful substances in the bloodstream, including drugs and alcohol.
- Breaking down saturated fat and producing cholesterol.
Cirrhosis is a slowly developing disease in which healthy liver tissue is replaced with scar tissue. The scar tissue blocks the flow of blood through the liver and slows the liver’s ability to process nutrients, hormones, drugs and natural toxins (poisons). It also reduces the production of proteins and other substances made by the liver. Cirrhosis eventually keeps the liver from working properly.
What causes cirrhosis?
The most common causes of cirrhosis are chronic (long-term) viral infections of the liver (hepatitis types B and C), fatty liver associated with obesity and diabetes, and alcohol abuse. In addition, anything that damages the liver can cause cirrhosis, including the following inherited diseases:
- Cystic fibrosis;
- Glycogen storage diseases, in which the body is unable to process glycogen (a form of sugar that is converted to glucose and serves as a source of energy for the body);
- Alpha-1 antitrypsin deficiency (an absence of a specific enzyme in the liver);
- Diseases caused by abnormal liver function, such as hemochromatosis (a condition in which excessive iron is absorbed and deposited into the liver and other organs), and Wilson's disease (the abnormal storage of copper in the liver);
- Autoimmune diseases of the liver (chronic conditions in which the body’s own immune system attacks the liver or bile duct cells), including: autoimmune hepatitis; primary biliary cholangitis and primary sclerosing cholangitis; and overlap syndromes;
- Blockage of the bile duct. The bile duct carries bile that is formed in the liver to the intestines, where it helps in the digestion of fats.
- Repeated bouts of heart failure, with fluid backing up into the liver and causing congestion (clogging).
Although less likely, other causes of cirrhosis include reactions to prescription drugs, lengthy exposure to environmental toxins, or infections by parasites.
What are the symptoms of cirrhosis?
The symptoms of cirrhosis depend on the stage of the illness. In the beginning stages, there may not be any symptoms. As the disease gets worse, symptoms may include:
- Loss of appetite
- Lack of energy (fatigue)
- Weight loss or sudden weight gain
- Yellowing of skin or the whites of eyes (jaundice)
- Itchy skin
- Fluid retention (edema) and swelling in the ankles, legs and abdomen
- A brownish or orange color to the urine
- Light-colored stools
- Confusion, disorientation, personality changes
- Blood in the stool
An early sign of cirrhosis is retaining (holding onto) fluid and salt. This may start as a swollen ankle or leg, but can move on to significant fluid retention in the abdomen (ascites). By reducing salt in the diet, and using the right combination of diuretics (water pills), fluid retention can be lessened for some time. In more severe cases, a doctor may need to drain fluid from the abdomen.
Fluid in the abdomen can become infected (a condition called peritonitis), which requires quick diagnosis and treatment with antibiotics. Some people with severe fluid retention that does not improve with treatment may need a liver transplant.