Liver Cirrhosis: How can be Prevented ?


What are the causes of inflammation that causes liver cirrhosis?

  • Excessive alcohol consumption: the incidence of cirrhosis in a country is directly related to the consumption of alcohol, per capita. In Spain, approximately half of cirrhosis cases is due to alcohol.
  • Chronic viral hepatitis: in chronic viral hepatitis both viruses are involved in the hepatitis B and hepatitis C . Cirrhosis caused by hepatitis B virus is common in Africa and Asia. The importance of virus C is big in Europe and in the U.S., and is still rising. In Spain, 40% of adults with liver cirrhosis are infected with hepatitis C, alcohol abuse increases the aggressiveness of HCV on the liver.
  • Primary biliary cirrhosis: The Primary biliary cirrhosis is a rare disease that affects mostly women. Do not abuse alcohol. In these patients is the body which, for obscure reasons, triggers an attack on his own liver.
  • Autoimmune chronic active hepatitis: disease even rarer than the previous one, in which the action taken against the body’s own liver is triggered by the immune system.
  • Drugs and chemicals: Although there are many drugs and chemicals that can damage the liver, cirrhosis few ever produce. However, some specific drugs should be administered under supervision, because they damage the liver.
  • Metabolic and Hereditary diseases are different, uncommon, which leads to the accumulation of toxins in the liver. The most common is hemochromatosis , in which iron is the toxic accumulated in excess in the liver.

What are the symptoms of cirrhosis?

His presence and intensity depend on the degree of injury sustained by the liver. In the early stages of the disease symptoms may be absent, in which case the disease is discovered as a result of a study prompted by another process.

As the disease progresses, there may be fatigue, weakness, loss of appetite, nausea and weight loss.

In the later stages of the disease, the liver has trouble developing all its functions and may present a variable combination of the following symptoms:

In the final stages of the disease, serious complications can occur as gastrointestinal bleeding with vomiting of blood, which may be due to rupture of dilated veins in the lower esophagus (esophageal varices), or come from a stomach ulcer . This fact can be very serious and requires hospital treatment.

One function of the liver is to remove toxic substances from the blood. In cirrhosis, the blood can not pass through the liver due to the disruption of its structure, and dicahs toxic substances can reach the brain resulting in a condition of your function is called hepatic encephalopathy, and that manifests itself in confusion, behavioral disorders , sleepiness and finally, coma. This complication is also serious and requires hospital treatment.

  • Jaundice: is a yellowing of the skin and sclera (the “white” of the eyes), due to the inability of the liver to remove from the blood a substance called bilirubin.
  • Nail disorders: the shape and appearance of the nails can be changed, you can increase its curvature (watch glass nails) or show a whitish opaque, rather than pink.
  • Skin changes: about a quarter of patients develop skin darkening.
  • Fluid retention: is a common disorder at some point along the course of the disease. Although the liver is not directly involved in the elimination of fluids in the body, helps decisively in its distribution, and proper excretion through the kidneys. When its function is impaired, fluid may accumulate in the legs (edema) or abdomen (ascites).
  • Alterations of blood vessels: the most common disorder are spider nevi or spider veins, which consist of a central red dot, ie a glass that emerges perpendicularly under the skin (“body”) and small vessels departing radial form (the “legs”). It is also common flushed face and palms.
  • Fragility of skin and mucous membranes: the nosebleeds are common and the cardinals and skin erosions due to blood vessel abnormalities and impaired coagulation, because they decrease the hepatic synthesis of proteins involved in the same.
  • Breast enlargement in men: this sign is called gynecomastia, and is due to the diseased liver does not destroy the female sex hormones produced by the male body. For the same reason decreases the size of the testicles.

Who do you give the greatest risks?

The risk is proportional to the consumption of alcohol. The more a person drinks, the more likely you are to develop cirrhosis. Women seem to be more susceptible than men. Therefore, it is advisable to reduce the consumption of alcohol to drink 28 units per week in men and 21 in women. A drink is a unit normal consumption of any alcoholic beverage: 250 ml of beer (the “cane” has 200 ml), a glass of wine 150 ml, or a glass of liqueur 40 ml.

  • People with chronic and progressive by hepatitis B or hepatitis C.
  • Patients with primary biliary cirrhosis (which is only a true cirrhosis in later stages of their evolution), or autoimmune chronic active hepatitis.
  • People with metabolic or hereditary.

How can I prevent cirrhosis?

  • Reducing alcohol consumption (see above)
  • Looking for help to stop drinking in the case of alcoholics.
  • Taking precautions against hepatitis, and in case of getting it, treating it properly
  • Avoiding contact with toxic chemicals in the workplace

How is cirrhosis diagnosed?

If in the course of a medical examination suspicions arise of liver cirrhosis, blood tests may be strengthened. Although an imaging ultrasound liver (ultrasound liver) can confirm, it is sometimes necessary to perform a liver biopsy to obtain samples of liver tissue. The biopsy also provides information on the cause of cirrhosis.

Good advice

If excessive drinking and alcohol dependence are the cause of your liver disease should you stop drinking immediately and completely. Once the alcohol has damaged the liver, liver cells are vulnerable to even small amounts of alcohol.

Seek help from friends and family, and one of the organizations that specialize in helping people who have problems with alcohol. Your doctor can help.

Activity

Try to lead an active life. This can be difficult because of tiredness and feeling weak, but it compensates persevere. If you develop swelling of the legs may be convenient to keep them elevated while resting.

Feeding

  • Make a well balanced diet, rich in protein (always check with your doctor).
  • Do not add salt to food. If your doctor says you can use small amounts of salt for cooking. Please note that most canned convenience foods or contain a lot of salt.
  • In more advanced stages of their disease, and always on the advice of your doctor, it may be desirable to reduce the consumption of protein (primarily meat and fish).
  • It may take vitamin and mineral supplements.

Complications

  • Impotence in men, due to the combined effect of alcohol and cirrhosis itself.
  • Severe internal bleeding from ruptured varicose veins in the esophagus or stomach. It is a serious complication that requires hospital treatment.
  • Liver cancer. developed in some patients with advanced cirrhosis. The risk is greater in patients with hemochromatosis or chronic infection by hepatitis viruses B or C.
  • Infection of the fluid in the abdomen (ascites), which causes peritonitis and secondarily generalized infection (sepsis) for entry of germs or toxins in the blood.

Perspectives

You can stop the progressive destruction of the liver by eliminating the cause. This reinforces the advice to leave the alcohol. It offers treatment for chronic infection with hepatitis viruses B and C. Iron overload can be corrected by performing periodic bloodletting (including a pint of blood a week!). Autoimmune chronic active hepatitis may be treated with steroids (glucocorticoids).

Even if the injury is not curable the symptoms can be alleviated and controlled. If treatment is started early, it is possible that the patient can lead a near normal life. However, if not eliminated cause scar tissue formation and destruction of hepatic structure will grow and eventually lead to hepatic failure and death.

How is liver cirrhosis?

At present there is no cure for liver cirrhosis established, although you should always try to eliminate the cause. Therefore, we must emphasize try and alleviate the complications of the disease.

You have the following treatment options:

  • Drugs that increase urine production (diuretics) to treat fluid retention in the legs (edema) or abdomen (ascites)
  • Vitamin and mineral supplements
  • Calorie supplements (usually sugary drinks) to maintain good nutrition
  • Laxatives (usually a lactulose-based syrup) to prevent constipation and reduce the risk of toxic products generated in the intestine from entering the body and reach the brain, after avoiding passage through the liver. This is the mechanism of hepatic encephalopathy, characterized by drowsiness, confusion, and eventually coma.
  • Some patients who have bleeding from ruptured varices in the lower esophagus can continue treatment with a drug called propranolol, which reduces the pressure within the veins and thus the chances of bleeding again.
  • Finally, you might consider the indication for liver transplantation in patients with terminal cirrhosis. The treatment itself can be curative, but only suitable for a minority of patients who meet very specific criteria.

Dr. Carl J. Brandt , International Medical Director & Co-NetDoctor; Dr. Ove Schaffalitzky of Muckadell , specialist in internal medicine, Dr. Alan Ogilvie , a specialist in Gastroenterology