Cirrhosis

Cirrhosis is a severe condition characterized by extensive scarring of the liver. This serious and often life-threatening ailment can result from various liver diseases and conditions, such as chronic alcoholism and hepatitis. Each time the liver is injured—whether due to excessive alcohol consumption, infection, or other causes—it attempts to repair itself. In this process, scar tissue forms. As cirrhosis progresses, the accumulation of scar tissue hampers the liver's ability to function effectively. Advanced cirrhosis can be fatal, and the liver damage it causes is typically irreversible. However, early diagnosis and treatment of the underlying cause can limit further damage and, in rare instances, may even reverse it.

Symptoms of Cirrhosis

Cirrhosis often remains asymptomatic until significant liver damage has occurred. When symptoms do appear, they can include:

• Fatigue
• Easily bleeding or bruising
• Loss of appetite
• Nausea
• Edema (swelling in the legs, feet, or ankles)
• Weight loss
• Itchy skin
• Jaundice (yellow discoloration in the skin and eyes)
• Ascites (fluid accumulation in the abdomen)
• Spiderlike blood vessels on the skin
• Redness in the palms of the hands
• Pale fingernails
• Clubbing of the fingers
• Amenorrhea (absence of periods in women not related to menopause)
• Gynecomastia (breast enlargement in men)
• Confusion, drowsiness, or slurred speech

Causes of Cirrhosis

A variety of diseases and conditions can lead to liver damage and cirrhosis. Some common causes include:

• Chronic alcohol abuse
• Viral hepatitis (hepatitis B, C, and D)
• Nonalcoholic fatty liver disease
• Hemochromatosis (iron buildup in the body)
• Autoimmune hepatitis
• Primary biliary cholangitis (destruction of bile ducts)
• Primary sclerosing cholangitis (hardening and scarring of bile ducts)
• Wilson's disease (copper accumulation in the liver)
• Cystic fibrosis
• Alpha-1 antitrypsin deficiency
• Biliary atresia (poorly formed bile ducts)
• Inherited disorders of sugar metabolism (e.g., galactosemia, glycogen storage disease)
• Alagille syndrome (a genetic digestive disorder)
• Infections (e.g., syphilis, brucellosis)
• Certain medications (e.g., methotrexate, isoniazid)

Risk Factors for Cirrhosis

Several factors can increase the risk of developing cirrhosis:

• Excessive alcohol consumption
• Obesity
• Chronic viral hepatitis

Complications of Cirrhosis

Cirrhosis can lead to numerous severe complications, including:

• Portal hypertension (high blood pressure in the veins supplying the liver)
• Edema and ascites
• Splenomegaly (enlargement of the spleen)
• Variceal bleeding
• Infections (e.g., bacterial peritonitis)
• Malnutrition
• Hepatic encephalopathy (buildup of toxins in the brain)
• Jaundice
• Bone disease (increased risk of fractures)
• Liver cancer
• Acute-on-chronic cirrhosis (multiorgan failure)

Prevention of Cirrhosis

To lower the risk of developing cirrhosis, consider the following measures:

• Avoid alcohol if you have liver disease
• Maintain a healthy diet rich in fruits, vegetables, whole grains, and lean proteins
• Keep a healthy weight
• Reduce your risk of hepatitis by avoiding sharing needles and practicing safe sex, and consider vaccinations for hepatitis B and C

Sources

• Mayo Clinic. (2023). Cirrhosis
• National Institute of Diabetes and Digestive and Kidney Diseases. (2023). Definition & Facts for Cirrhosis
• American Liver Foundation. (2023). Cirrhosis