CIRRHOSIS OF LIVER

INTRODUCTION

  • Chronic Degenerative disease characterised by replacement of normal liver tissue by diffuse fibrosis that disputes the structure and function of the liver.

  • cirrhosis is a late stage of scaring where scar tissue gradually replace healthy liver cells due to many condition such as hepatitis and chronic alcoholism etc.

CAUSE

  • Chronic viral hepatitis (hepatitis B, C and D)

  • Chronic alcohol abuse

  • Fat accumulating in the liver (nonalcoholic fatty liver disease)

  • Cystic fibrosis

  • Copper accumulated in the liver (Wilson's disease)

  • Poorly formed bile ducts (biliary atresia)

  • Alpha-1 antitrypsin deficiency

  • Inherited disorders of sugar metabolism (galactosemia or glycogen storage disease)

  • Destruction of the bile ducts (primary biliary cirrhosis)

  • Hardening and scarring of the bile ducts (primary sclerosing cholangitis

CLASSIFICATION

  • Micronodular cirrhosis characterised by thick , regular bands of connective tissue , by regenerating small nodules of almost same size and involvement of every lobules of the organ.

  • mostly caused by chronic alcoholism.

  • Post-necrotic cirrhosis liver reduce in size . nodules of regenerating liver cells of different sizes intersected by fibrous band of varying thickness containing proliferating bile ducts.

  • Mixed micronodular and macronodular- least common . minimal liver cell failure. and portal hypertension.

RISK FACTOR

  • alcohol consumption Excessive alcohol consumption is a risk factor for cirrhosis.

  • Obesity & overweight. Being obese increases your risk of conditions that may lead to cirrhosis, such as nonalcoholic fatty liver disease and nonalcoholic steatohepatitis.

  • Having viral hepatitis. Not everyone with chronic hepatitis will develop cirrhosis, but it's one of the world's leading causes of liver disease.

COMPLICATION

  • High blood pressure in the veins that supply the liver (portal hypertension). Cirrhosis slows the normal flow of blood through the liver, thus increasing pressure in the vein that brings blood to the liver from the intestines and spleen.

  • Swelling in the legs and abdomen. The increased pressure in the portal vein can cause fluid to accumulate in the legs (edema) and in the abdomen (ascites). Edema and ascites also may result from the inability of the liver to make enough of certain blood proteins, such as albumin.

  • Enlargement of the spleen (splenomegaly). Portal hypertension can also cause changes to and swelling of the spleen, and trapping of white blood cells and platelets. Decreased white blood cells and platelets in your blood can be the first sign of cirrhosis.

  • Bleeding. Portal hypertension can cause blood to be redirected to smaller veins. Strained by the extra pressure, these smaller veins can burst, causing serious bleeding. Portal hypertension may cause enlarged veins (varices) in the esophagus (esophageal varices) or the stomach (gastric varices) and lead to life-threatening bleeding. If the liver can't make enough clotting factors, this also can contribute to continued bleeding.

  • Infections. If you have cirrhosis, your body may have difficulty fighting infections. Ascites can lead to bacterial peritonitis, a serious infection.

  • Malnutrition. Cirrhosis may make it more difficult for your body to process nutrients, leading to weakness and weight loss.

  • Buildup of toxins in the brain (hepatic encephalopathy). A liver damaged by cirrhosis isn't able to clear toxins from the blood as well as a healthy liver can. These toxins can then build up in the brain and cause mental confusion and difficulty concentrating. With time, hepatic encephalopathy can progress to unresponsiveness or coma.

  • Jaundice. Jaundice occurs when the diseased liver doesn't remove enough bilirubin, a blood waste product, from your blood. Jaundice causes yellowing of the skin and whites of the eyes and darkening of urine.

  • Bone disease. Some people with cirrhosis lose bone strength and are at greater risk of fractures.

  • Increased risk of liver cancer. A large proportion of people who develop liver cancer have pre-existing cirrhosis.

  • Acute-on-chronic cirrhosis. Some people end up experiencing multiorgan failure. Researchers now believe this is a distinct complication in some people who have cirrhosis, but they don't fully understand its causes.

PREVENTION

  • Do not drink alcohol if you have cirrhosis. If you have liver disease, you should avoid alcohol.

  • Eat a healthy diet. Choose a plant-based diet that's full of fruits and vegetables. Select whole grains and lean sources of protein. Reduce the amount of fatty and fried foods you eat.

  • Maintain a healthy weight. An excess amount of body fat can damage your liver. Talk to your doctor about a weight-loss plan if you are obese or overweight.

  • Reduce your risk of hepatitis. Sharing needles and having unprotected sex can increase your risk of hepatitis B and C. Ask your doctor about hepatitis vaccinations

DIAGNOSIS AND INVESTIGATION

  • Laboratory tests. blood tests to check for signs of liver malfunction, such as excess bilirubin, as well as for certain enzymes that may indicate liver damage. To assess kidney function, your blood is checked for creatinine. You'll be screened for the hepatitis viruses. Based on the blood test results, your doctor may be able to diagnose the underlying cause of cirrhosis.

  • Imaging tests. Magnetic resonance elastography (MRE) may be recommended. This noninvasive advanced imaging test detects hardening or stiffening of the liver. Other imaging tests, such as MRI, CT and ultrasound, may also be done.

  • Biopsy. A tissue sample (biopsy) is not necessarily needed for diagnosis. it is use to identify the severity, extent and cause of liver damage.

HOMOEOPATHIC THERAPEUTICS

Homeopathic medicine treat the underlying cause of cirrhosis of liver such as viral infections .genetic tendency .Bad effects of alcohol and metabolic changes .

Helps to control the scarring of tissues .And if homeopathy has started at the early stage(compensated stage )  it is possible to restore the altered function of the liver .

  • Nux Vomica For Liver Cirrhosis Patients with Long-term Alcohol Abuse.

  • Phosphorus For Cirrhosis of Liver with Jaundice

  • Arsenic Album For Liver Cirrhosis with fatigue and weight loss

  • Cardus Marianus It covers a wide range of symptoms that can be relieved with its use. The first condition calling for its use is jaundice. The second is dropsical accumulation of water in abdomen. The next field is bleeding consequent to liver damage. Liver pain and sensitiveness are experienced by most patients needing Cardus Marianus.