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Cirrhosis

What is Cirrhosis?
Cirrhosis refers to severe scarring of the liver. It occurs as a complication of many liver diseases. Repeated liver damage with inflammation over time results in scar tissue forming which replaces the normal liver tissue.

What conditions can cause Cirrhosis?
The causes of cirrhosis can include:

> Viral hepatitis – hepatitis B,
> hepatitis C
> Excessive & regular alcohol
> Fatty liver disease
> Autoimmune hepatitis
> Drugs
> Diseases that damage the bile ducts – primary biliary cirrhosis, primary sclerosing cholangitis
> Inherited diseases – e.g. Wilson’s disease (copper overload), haemochromatosis (iron overload), alpha 1 antitrypsin deficiency, cystic fibrosis
> “Cryptogenic” – in a minority of cases the cause of cirrhosis is unknown

What are the symptoms of Cirrhosis?
Cirrhosis can cause a number of symptoms including lethargy, loss of appetite and abdominal discomfort. In more severe cases, it can lead to itching, jaundice and swelling of the abdomen/legs.

How is Cirrhosis diagnosed?
The diagnosis of cirrhosis is made based on a combination of medical history, physical examination, blood tests and imaging findings. A liver biopsy can definitively diagnose cirrhosis. Recently, a test called “Fibroscan” has become available at some centres, and allows for a non-invasive assessment of liver scarring. However, Fibroscan does not provide any information on the cause of cirrhosis.

What are the complications of Cirrhosis?
A number of complications can occur as the degree of cirrhosis and liver function worsens

> Ascites and Edema – build up of fluid with swelling of the abdomen and legs
> Jaundice and itching – due to the inability of the liver to metabolise a substance called bilirubin, which in turn can deposit in the skin and whites of the eyes
> Oesophageal varices – this refers to the development of enlarged veins in the lower portion of the food pipe or oesophagus. Bleeding of these “varices” is a medical emergency
> Encephalopathy – mental disturbances and confusion which occur due to the inability of the liver to filter toxins.
> Bruising and bleeding – due to the inability of the liver to make sufficient proteins involved in blood clotting.
> Liver cancer – cancer that originates in the liver is known as hepatocellular carcinoma
> Bone disease – increased susceptibility to bone fractures
> Infection – cirrhosis can also impair the immune system, and increase the likelihood of infections.

What is the treatment for Cirrhosis?
The aim of treating cirrhosis is to prevent it from getting worse. It was previously believed that cirrhosis was irreversible, although research has now indicated that a degree of improvement in liver scarring is possible. The strategies of treating cirrhosis include:

Treating the cause: e.g. abstinence from alcohol, treatment of viral hepatitis etc
Screening and treatment of the complications
A liver transplant may be necessary in some cases

Your GastroNorth doctor can provide you with more specific information on the management of cirrhosis.

More Information?
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