Cirrohsis (liver Disease)
When liver tissue is damaged by infection, toxin or ailment, it leads to a scarring called Cirrhosis. Cirrhosis is not reversible and is dangerous and it cannot be treated. Diseases of the liver can be instigated by hepatitis, some inherited diseases and alcoholism and in most of the cases, no indications exist for these diseases. Fatty liver refers to liver cells enlarged with fat globules and water and is produced due to too much drinking; this ultimately leads to liver disease, cirrhosis and that of liver failure. (Healthy Steps for Healthy Men) Persistent severe liver diseases lead to scarring of the liver and liver dysfunction. This frequently has many complexities, inclusive of buildup of fluid in the abdomen, bleeding ailments, enhanced pressure in the blood vessels, and perplexity or a variation in the level of awareness. (Cirrhosis: (www.healthcentral.com)
About 40 to 50% of those people with alcoholic obsession who drink the largest quantity of the alcohol for the longest time have cirrhosis in their liver. As livers of women are smaller, they have a larger vulnerability to this condition. Genetic factors also have an influence. Cirrhosis can be caused also due to the surplus deposits of the mineral copper in the liver, which is known as Wilson’s disease. Further Hemochromatosis, which refers to surplus iron sediments in the liver, can also bring about Cirrhosis. Alpha-anti-trypsin deficiency, which occurs when an enzyme holds back the protein trypsin also lead to cirrhosis and respiratory disease. Enzyme deficiencies caused by Cystic fibrosis can lead to cirrhosis. Yet another cause of Cirrhosis is Glycogen storage disease, a rather uncommon hereditary condition. (Cirrhosis: (www.gutdoc.org)
Both genetic and lifestyle factors can cause alcoholic cirrhosis. About 50% of the cases of cirrhosis belong to this condition. Liver’s capacity can be overworked by chemical and drug overload leading to scarring. A possible cause is any illness that injures the liver like viral hepatitis B and C. And chronic active hepatitis and autoimmune hepatitis. A secondary condition to a very old bile duct obstruction and jaundice is an autoimmune condition described as biliary cirrhosis or cirrhosis. A condition called Sarcoidosis that looks like tuberculosis can cause cirrhosis. This is presently considered an autoimmune disease. One more cause is heart failure causing blood to pool in the liver and this overcrowding can cause cirrhosis. (Cirrhosis: (www.gutdoc.org)
Signs and Symptoms:
Following are the symptoms for cirrhosis: Fluid in the stomach leading to enlargement of the abdomen, weakness, vomiting, nausea, swellings in the legs, pain on the liver and loss of weight. The other symptoms are GI bleeding from varices like abnormally enlarged veins or as a result of restricted circulation, which develops around the part of the esophagus, around the navel or umbilicus, or in the part of the anus. (Cirrhosis: (www.gutdoc.org)
Continuous contact with toxic agents such as continuing ethanol abuse, severe viral infection, ailments of metabolism and autoimmune disease can all lead to chronic cirrhosis. Huge injury from toxins, infection, or ischemia that has caused in severe hepatocyte necrosis can lead to cirrhosis. The etiology in most cases is not decided and is described as cryptogenic. Lately, through work by Alison et al., the function of marrow stem cells in the cycle of hepatocyte regeneration has been recognized. Both gross morphologic and pathophysiologic variations in hepatic circulation, due to regeneration and scarring, add to morbidity in terms of lower metabolic function and increase of portal venous pressures, with consequent risk for fatal variceal hemorrhage. Hepatocellular carcinoma — HCCA is a common and typically fatal complication. Cholangiocarcinoma is developed in patients with cirrhosis due to primary sclerosing cholangitis and is always fatal. From 1994 onwards, cirrhosis and chronic liver disease comprise the 10th most widespread cause of death in the United States. (Cirrhosis: (www.emedicine.com)
Worldwide, the WHO estimates that cirrhosis is accountable for 1.1% of all deaths. Greater prevalence of HCCA usually occurs in Asia, South Africa, and some regions of the Middle East. No specific vulnerability is supposed to exist based upon race, but instead on the widespread environmental factors, which are inclusive of epidemiologic factors and exposure to environmental toxins like aflatoxin. From 1980-1989, death rates in the United States indicate a 50% increased rate for African-Americans rather than for Caucasians. Based on etiologic differences, male-to-female ratio is 1.5-3:1. Primary biliary cirrhosis accounting for only 1.5% of deaths from cirrhosis is mostly found in females and ethanol-related cirrhosis is greatly found in males. Age-specific death rates in the United States tend to be greatest in the older age groups, topping at 49 per 100,000 males aged from 65-74 years and at 26.7 per 100,000 women of the age group from 75-84 years. (Cirrhosis: (www.emedicine.com)
Diagnosis and Imaging Modalities:
Ultrasound, computed tomography, magnetic resonance imaging, and angiography are suggested as imaging modalities for the diagnosis of liver cirrhosis. In cases of patients doubtful for diffuse liver disease, ultrasound of the liver is being used as a screening-imaging tool and it is useful in for follow-up examinations. In order to make the presence of liver disease to be clear, computed tomography is usually carried out and it is detected by ultrasound. Against this background, extrahepatic situation and precise assessment of the vascular structures of the liver are necessary. Making use of contrast-enhanced MR imaging along with liver specific contrast media, the diagnosis of diffuse liver disease and categorization of morphologic variations is being enhanced. Complete assessment of cirrhosis is possible with combined magnetic resonance imaging. (Hammersting; Schwarz; Schmitt; Faust; Dietrich; Zeuzem; Vogl, p. 852)
With this, a superior detection rate and categorization of regenerating nodules can be attained in comparison to imaging modalities like ultrasound and computed tomography. Using un-enhanced and liver-specific-contrast-enhanced sequence protocols, MR imaging can be carried out as a single technique to assess the liver parenchyma. Also, MR cholangiography is used to confirm the bile duct system, and MR angiography is used to identify the vascular situation. This technique is the best protocol for diagnostic imaging in patients who are suffering from liver cirrhosis and the method of choice to arrive at the final diagnosis. (Hammersting; Schwarz; Schmitt; Faust; Dietrich; Zeuzem; Vogl, p. 852)
Treatment for cirrhosis is aimed at averting additional liver damage and at managing the complications of cirrhosis. The following are the treatment methods to be adopted. Alcohol and wrong medications are to be ended. Upper endoscopy with banding or sclerosis is to be used for treating bleeding varices. Surplus abdominal fluid is treated with the help of diuretics, fluid and salt restriction, and removal of fluid. Vitamin K or blood products are used for treating Coagulopathy. Encephalopathy is treated with the help of the medication lactulose and sometimes antibiotics are used and patients should keep away from a diet, which is high in protein. Antibiotics are used to treat infections and finally, a liver transplant should be thought about if cirrhosis advances and becomes grave. (Cirrhosis Treatment)
To conclude cirrhosis is a liver disease or liver damage. The most prominent cause for this disease is excessive drinking. Unfortunately, no symptoms exist for cirrhosis in its early stage. Cirrhosis cannot be fully cured. It can only be managed or further growth of cirrhosis can be averted by treatments. Hence, it is important to prevent cirrhosis.
Diagrams of the Liver:
a) Digestive system organs:
Retrieved from Digestive System Organs) b) Liver cirrhosis, CT scan
Retrieved from Liver cirrhosis, CT scan)
Cirrhosis. Retrieved October 7, 2005, from the World Wide Web http://www.gutdoc.org/Cirrohis.htm
Cirrhosis. Retrieved October 7, 2005, from the World Wide Web http://www.healthcentral.com/ency/408/000255.html
Cirrhosis Treatment. Retrieved October 7, 2005, from the World Wide Web http://health.allrefer.com/health/cirrhosis-treatment.html
Digestive System Organs. Retrieved October 7, 2005, from the World Wide Web http://www.healthcentral.com/ency/408/ImagePages/8710.html
Hammersting, R.M; Schwarz, W.V; Schmitt, E; Faust, D; Dietrich, C; Zeuzem, S; Vogl, T.J. 2001. Diagnostic imaging in liver cirrhosis. Radiologe. Vol: 41; No: 10; pp: 852-67. Retrieved October 7, 2005, from the World Wide Web: http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11715576&dopt=Abstract
Healthy Steps for Healthy Men. Retrieved October 7, 2005, from the World Wide Web: http://www.uaex.edu/healthy_steps/mens_health/healthy_steps_healthy_men.htm
Liver cirrhosis, CT scan. Retrieved October 7, 2005, from the World Wide Web: http://www.healthcentral.com/ency/408/ImagePages/1176.html
Taylor, Carroline. R. Cirrhosis. 2004. Retrieved October 7, 2005, from the World Wide Web http://www.emedicine.com/radio/topic175.htm
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