Cirrhosis is a chronic disease during which develops fibrous transformation of the liver. Impaired are also blood vessels with which is the liver well vascularized. The liver is one of the largest organs of our body. In an adult man is weight of the liver around 1.5 kg. Position of the liver is on the right side under the diaphragm and is divided into the right and left lobe. Under normal circumstances the liver have a smooth surface and dark red color. The liver is the metabolic centre of whole body where metabolic processes take place. If there is a serious disease of this organ, its functions are impaired which has a major impact on the proper functioning of whole organism.
Causation of liver cirrhosis
Liver cirrhosis is a long-running process that is scattered throughout the whole liver tissue. Its result is a complete impairment of the original anatomy, both the very tissue of this organ and its vascularization. The incidence of this disease is unfortunately not rare and the number of patients continues to rise. In the development of liver cirrhosis contributes two main causes viral infection of the liver and long-term excessive consumption of alcohol.
Hepatitis and alcohol
Acute hepatitis B leads in about 3%, and acute hepatitis C in about 5-15% to liver cirrhosis. Alcoholism is on the constant rise and causes up to 50% of all liver cirrhoses. For a man is considered dangerous dose of 60 g of pure alcohol per day, for women over 20 grams per day. In other words, the man should not exceed a dose of 2 liters of beer, 0.7 liters or 0.2 liters of spirits. The maximum dose of alcohol for women is about three times lower 0.5 liters of beer, 0.2 liters of wine or 0.05 liters of spirits.
The cause of cirrhosis may be also problems in other organs, such as chronic heart venous insufficiency or biliary stricture. In liver tissue comes to necrosis of cells which is so extended that the recovery of cells is no longer possible and they are replaced by fibrous tissue. The remaining islets of healthy cells form so-called nodes. According to their size is liver cirrhosis divided into macronodular (post-necrotic cirrhosis), micronodular (Laennec's cirrhosis or portal cirrhosis) and mixed.
Manifestations and complications of liver cirrhosis
Symptoms of cirrhosis of liver at an early stage are usually not expressed. If so, it is already the disease in developed stage. Liver surface changes from smooth to rough, and liver is enlarged and firm to palpation. Depending on the type of symptoms cirrhosis can be distinguished to compensated and decompensated.
- In compensated liver cirrhosis patients complain of indigestion, changes in bowel movements and feeling of fullness after meals. In women are common menstrual disorders. The physician usually reveals enlargement of the liver, the gradual enlargement of spleen, typical are also swellings around ankles especially in the evening. Changes can be also detected by the blood test. However to most significant changes in the liver comes especially in the stage of decompensation.
- Decompensated liver cirrhosis is a condition when the functions of liver are significantly impaired. Typical are disturbances of metabolic processes or developed symptoms caused by increased pressure in the bloodstream of portal vein that brings blood to the liver from other parts of digestive tract. Obvious is jaundice, blood clotting disorders, significant swelling of the legs and abdomen, so-called ascites. There is a risk of bleeding from veins of lower esophagus which are connected with joints just to portal vein. The impairment of brain functions is also not unique. The patient complains primarily about insuperable fatigue, loss of appetite, weight loss, enlargement of the abdomen, previously mentioned swelling or joint pain.
- Among the complications of liver cirrhosis are mainly bleeding into the esophagus which was mentioned above and other consequences of increased pressure in portal vein, increased susceptibility to infection or disease of the gastrointestinal tract. The most serious complication of liver cirrhosis is a malign tumor of liver cells, hepatocellular carcinoma professionally.
Diagnosis of liver cirrhosis
In addition to a careful history and self-examination is for proper diagnosis essential imaging of the liver by ultrasound and blood tests. By use of ultrasound (ultrasonography) can be very well described the change of liver, spleen enlargement and also detected possible ascites. Blood test helps to detect the elevated so-called liver function tests, furthermore we find anemia, or blood clotting disorders. If the cause of this condition is not certain, so-called biopsy is often used which aim is removal of liver tissue so it can be then examined in detail.
Treatment and prognosis of liver cirrhosis
Although cirrhosis is irreversible liver disease, it is essential to start treatment early because it can slow down or almost stop the progression of disease and significantly prolong survival. During the treatment we monitor nutritional status and if necessary we adjust the amount of each constituent in the diet. Of course there should be an absolute ban on alcohol, regardless of the cause of cirrhosis. To increase the resistance of liver cells is used medication called hepatoprotectives. In later stages of the disease is considered transplantation of the liver. Cirrhosis significantly shortens life of affected individual. However, the cause of death of these people are usually associated complications than actual hepatic malfunction.