What is cirrhosis?
Cirrhosis of the liver – a multifactorial progressive liver disease characterized by a significant decrease in the number of hepatocytes of the liver cells, increasing fibrosis (replacement of connective tissue), alteration of the normal structure of the liver and the subsequent development of liver failure and portal hypertension. Because destruction of liver cells by various damaging factors normal liver tissue is replaced with the formation of fibrous components and reconstruction of the entire structure of the liver. Distortion of the structure of the liver leads to disruption of its functions.
In economically developed countries, cirrhosis among the six major causes of death in patients 35 to 60 years, accounting for 14-30 per 100 thousand population. From cirrhosis of the liver in the world annually kills about 300,000 people, and for the past 10 years, the incidence has increased by 12%. Asymptomatic cirrhosis occurs in 12% of patients suffering from chronic alcoholism.
More common in men: male to female ratio is 3:1 on average. The disease can occur in all age groups, but most often after 40 years.
The causes of cirrhosis
– Viral hepatitis (B, C, delta, G). Most viruses tsirrozogenny C and delta, and hepatitis C virus are called “tender murderer,” that is k it leads to cirrhosis of the liver in 97% of cases, with long-term illness does not have any clinical symptoms;
– Autoimmune hepatitis (when the body perceives its own cells as foreign)
– Abuse of alcohol, the disease develops in 10-15 years from the start of use (60 grams / day for men, 20 g / day for women)
– Metabolic disorders (hemochromatosis, Wilson’s disease Konovalov, lack of alpha-1-antitrypsin, etc.)
– Chemical toxins and drugs;
– Hepatotoxic drugs;
– Biliary tract disease – obstruction (blockage) of the intrahepatic and extrahepatic bile ducts. Cirrhosis develops in 3-18 months after the breach of the bile duct patency;
– Long venous congestion of the liver (constrictive pericarditis, venooklyuzionnaya disease, congestive heart failure).
Unfortunately, quite often, the cause of cirrhosis is impossible to identify, in case it is called cryptogenic cirrhosis (i.e. of unknown cause).
Manifestations characteristic of cirrhosis of the liver
Signs of cirrhosis can not depend on what the cause of it has caused, but determined by the stage of the disease.
In the initial stage of cirrhosis (International Classification is a class A) does not have complications of the disease.
It was at this time is very important to remove the cause of the disease, which will save the remaining healthy liver tissue and lead a normal life. The fact that the liver has a very great potential of regeneration (recovery), and healthy cells can work for themselves and their fellow victims.
Increase in the volume of the stomach, the appearance of changes in the consciousness and behavior, bleeding gums, nosebleeds say about the complications of the disease (International Classification are classes B and C).
Presenting complaints patients with cirrhosis of the liver: nasal, gastrointestinal, gums, hemorrhoids, as well as bruising, frequent bacterial infections (respiratory tract, etc.), decreased sex drive, men – often gynecomastia (breast enlargement).
Along with the increase or decrease in the size of the liver is characterized by its seal, concomitant splenomegaly (enlarged spleen), signs of portal hypertension, jaundice. Uncommon dull or aching pain in the liver area, aggravated after errors in diet and physical activity; dyspeptic symptoms (nausea, vomiting, diarrhea), skin itching due to delay separation and accumulation of bile acids in the tissues.
On examination, the patient revealed typical of cirrhosis “hepatic signs”: vascular telangiectasia (“asterisk”, “spiders”) on the skin of the upper half body, palmar erythema redness of the palms (“liver palms”), “lacquer language” crimson “hepatic language”.
Complications of cirrhosis of the liver
Hepatic encephalopathy – a reversible brain damage, toxic products that are not neutralized by the liver as a result of her injuries.
For hepatic encephalopathy is characterized by various disturbances of consciousness, intelligence, behavior, and neuromuscular disorders.
Hepatic encephalopathy is hidden (invisible to the patient and others), then it may only reveal a doctor during special tests.
Extreme degree of hepatic encephalopathy – a coma (unconsciousness), it is based on acute or chronic liver failure.
Bleeding from the gastrointestinal tract as a result of portal hypertension
In cirrhosis of the liver breaks down the blood flow coming from the lower half of the body through the liver, so the blood is “circuitous” path through the vessels of the abdominal wall, the veins of the esophagus, hemorrhoidal veins (veins of the rectum). With the progression of cirrhosis of the liver at some point comes decompensation and start bleeding from varicose veins. Each patient with cirrhosis should know that gastrointestinal bleeding manifested by vomiting, which looks like “coffee grounds” and a chair that looks like a “raspberry jelly”; appears or increases sharply weakness until he lost consciousness. Perhaps bleeding from hemorrhoidal veins of the rectum.
Also, the characteristic symptom is a “Medusa’s head” – over-filling veins of abdominal wall.
Infectious complications of cirrhosis of the liver
Patients with cirrhosis of the liver more susceptible to bacterial and viral infections than healthy individuals. Most such patients are respiratory tract infections and urinary tract. Sometimes it happens that the body temperature can rise without a specific reason. This is due to their high intestinal absorbability “bad” (toxic) microorganisms. This condition is called endotoxemia.
The elimination or limitation of reason leading to cirrhosis of the liver (reduced alcohol consumption, vaccination against Hepatitis B), early detection and treatment of chronic hepatitis and fatty liver.
What can your doctor?
Cirrhosis of the liver – not a fatal disease, it is necessary and possible to effectively treat.
The observation and treatment of patients with cirrhosis of the liver should be performed only in specialized hospitals.
If possible, remove the cause of the disease, such as alcoholic cirrhosis of the liver eliminate alcohol in viral cirrhosis, antiviral treatment is prescribed.
Selection of the optimal treatment regimen for a particular patient can make a doctor.
In case of failure of conservative (medical) treatment, the patients included in the waiting list for a liver transplant.
What can you do?
The success in the treatment of patients with cirrhosis of the liver can be achieved only in the case of strict implementation of physician advice.