liver cirrhosis

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1. What causes liver cirrhosis?

causes

• Chronic Alcoholism.
• Viral infections caused by chronic viral hepatitis (types B, C and D).
• Metabolic diseases such as alpha-1-antitrypsin deficiency, galactosemia and glycogen storage disorders.

Causes (continued)

• Inherited diseases such as Wilson's disease and hemochromatosis.
• Fatty liver caused by obesity.
• Repeated episodes of heart failure with liver congestion and bile duct obstruction.

2. Symptoms

symptoms

• Tiredness/laziness
• Low platelets
• Loss of appetite
• Nausea
• Bruising
• Stomach pains
• Diarrhea

3. Diagnosis

Physical Examinations

Physical examinations indicate

• Pale skin
• Yellow eyes
• Reddened palms
• Hand tremors
• An enlarged liver or spleen
• Small testicles
• Excess breast tissue (in men)
• Decreased alertness.

Laboratory Tests

• Liver function: Blood test is done in order to detect the presence of excess bilirubin and certain enzymes such as Alanine aminotransferase (ALT), Aspartate aminotransferase (AST) and Alkaline phosphatase.

• Kidney function: Your blood is tested in order to check the presence of creatinine (creatinine is a breakdown product of creatinine phosphate in muscle and is usually produced at a fairly constant rate by the body.)

• Tests for hepatitis B and C: Your blood is tested to detect the presence of hepatitis virus. (HBV AND HAV).

• Clotting: International normalized ratio (INR) is done to check your blood’s ability to clot (prothrombin).

Imaging and other Tests

• Magnetic resonance elastography (MRE): the non-invasive test that detects the stiffening or hardening of the liver.

• Other imaging techniques: MRI (Magnetic resonance imaging), CT scan (Computed tomography) and Ultrasound can image the liver.

• Biopsy: it is a method of taking sample of a tissue of your liver in order to identify the severity, extent and cause of the liver damage.

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4. Treatment

lifestyle changes

• Stop and quit alcohol.
• Talk to your doctor about all the medicines you take because medicines such as acetaminophen (for example Tylenol), aspirin, ibuprofen (for example, Advil or Motrin), and naproxen (Aleve) can increase the risk of liver damage and bleeding.

lifestyle changes (continued)

• Get immunized for hepatitis A, b, influenza and pneumococcus.
• Begin following a low sodium diet if have ascites.

Treatment for complications

EXCESS FLUID IN THE BODY:

• Low sodium diet to prevent ascites.
• More severe fluid buildup may require procedures to drain the fluid or other interventions to relieve pressure.

At times, a small tube — a transjugular intrahepatic portosystemic shunt (TIPS) — is placed in the vein within the liver to reduce blood pressure in your liver and slow the rate of fluid accumulation.

PORTAL HYPERTENSION:

• Certain blood pressure medications may control increased pressure in the veins that supply the liver (portal hypertension) and prevent severe bleeding.

infections

• You may receive antibiotics or other treatments for infections. Your doctor also is likely to recommend vaccinations for influenza, pneumonia and hepatitis.

5. Prognosis

Portal Hypertension

• The nodules and the scar tissue compress the veins within the liver.
• This causes high blood pressure within the liver.

This can cause the blood to back up in the intestines and other organs in the abdomen, causing bleeding into the intestines and fluid accumulation throughout the body.

Gastrointestinal Bleeding

• Portal Hypertension causing backup of blood flow in the veins of stomach and esophagus.
• Veins can become enlarged or even tear and bleed.

Fluid retention

• Portal Hypertension forces the fluid out of the blood vessels in the liver.
• The fluid floods the abdomen.

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hepatic encephalopathy

• Toxins in the bloodstream build up because the liver can't get rid of them
• This can cause sleepiness and confusion.

Greater risk of being infected

• The liver can not form the proteins needed to fight off infections.

other results

• Kidney failure
• Reduced oxygen in the blood
• Diabetes
• Changes in blood counts
• Excessive bleeding and bruising
• Breast enlargement in men
• Loss of muscle mass

Decompensated vs compensated

• Compensated cirrhosis, when there is no gastrointestinal bleeding or fluid retention in the abdomen.
• Decompensated cirrhosis, there is is gastrointestinal bleeding and fluid retention in the abdomen.

6. Current Research

Block the protein that leads to the overproduction of scar tissue.

block the protein

• Not only stop the progression of scarring but also reverse some of the cell damage.
• HSC is activated when a protein called RSK is activated.
• HSC activation results in large amounts of collegen

Using a blood test to tell the amount of liver damage.

The tracking blood test

• A blood test that can measure the amount of damage the liver has been through.
• Reduces the amount of resources needed for diagnosis.
• No biopsy needed.
• The progress of the patient can be tracked.

Diagnosing with breath samples.

Diagnosis with breath samples

• 'A specific exhaled volatile profile can predict the presence of compensated cirrhosis among CLD patients with a higher accuracy than serological markers and can aid in reducing liver biopsies.'
• Can only be used for patients with any chronic liver diseases.
• Gas chromatography mass spectrometry is used.

lifestyle effects on liver cirrhosis

• Drinking 2 additional cups of coffee can reduce the risk of developing live cirrhosis by 44%

Citations:
https://www.sciencedaily.com/releases/2016/04/160409091737.htm
http://www.nature.com/articles/srep19903
http://www.albanydailystar.com/health/per-year-millions-death-by-cirrhosis-...
https://www.sciencedaily.com/releases/2007/12/071226225538.htm
http://www.emedicinehealth.com/cirrhosis/page2_em.htm
http://www.webmd.com/digestive-disorders/cirrhosis-liver?page=3
http://rmhealthy.com/10-signs-liver-damage/10/
http://www.m.webmd.com/a-to-z-guides/cirrhosis-liver

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