What is Decompensated Cirrhosis?
When talking about Decompensated Cirrhosis one needs to understand what exactly is cirrhosis. Cirrhosis is a medical condition in which the liver which is an extremely important organ of the body gets scarred due to formation of scar tissue. This takes place gradually over years and the most common cause of it is alcohol abuse. When the entire liver gets scarred, it shrinks and starts to malfunction resulting in serious complications. The damage done to liver at this stage is permanent and is not reversible. There are four stages of cirrhosis of which the fourth stage is the deadliest and practically incurable. This fourth stage of cirrhosis is called as Decompensated Cirrhosis. Once a patient is diagnosed with cirrhosis and is not treated appropriately with medications and lifestyle changes and strict dietary modifications then the liver quickly starts to decompensate causing permanent damage to the liver with the only option for treatment being left is liver transplantation.
What are the Symptoms of Decompensated Cirrhosis?
The symptoms which may point towards progression from cirrhosis to a Decompensated Cirrhosis are:
Bleeding Varices: This is one of the potentially many life threatening symptom of a Decompensated Cirrhosis. As a result of a severely damaged liver, the large blood vessels also known as varices in the esophagus become enlarged and as the disease condition worsens with time these enlarged varices rupture and start to bleed. Because of this, the patient suffering from decompensated cirrhosis may start vomiting blood or may have black tarry stools. This is an emergent condition and needs treatment right away so that appropriate measures are taken to stop the bleeding. The bleeding is normally stopped by using beta-blockers and if they are ineffective a banding procedure is carried out in which the enlarged varices are banded to stop the bleeding.
Ascites- As a Symptom of Decompensated Cirrhosis: As the damage to the liver worsens due to cirrhosis and the patient slips towards a Decompensated Cirrhosis, the pressure in the veins of the liver increases multi-fold. This results in another life threatening condition known as Ascites. In this condition, there is a fluid buildup in the abdomen leading to enlargement of the abdomen resulting in decreased appetite as there is little to no room for food in the stomach. There may be fluid buildup in the legs as well causing swelling of the legs which may cause difficulty with ambulation. Due to this, respirations also become difficult, especially with sleeping. Apart from all this, Ascites becomes a basic cause for infection which is by far the most life threatening if not identified and treated on time. Usually, diuretics are prescribed for Ascites to get rid of the excess fluid accumulated in the body but in extreme cases aspiration of the fluid may be needed to treat Ascites.
Hepatic Encephalopathy: This condition is yet another symptom which tends to occur when a patient with cirrhosis advances to a Decompensated Cirrhosis. Since the liver in such patients with decompensated cirrhosis is extremely damaged and practically nonfunctioning, it fails to eliminate toxins from the body like ammonia which may then enter the brain and cause what is called as Hepatic Encephalopathy causing confusion, decreased fine motor skills, frequent mood changes, altered sleep patterns, decreased concentration abilities, and in some cases may even cause coma. A patient with encephalopathy will have a tough time dealing with activities like driving, writing, calculations, and performing other activities of daily living. The physician normally recommend lactulose for treatment of encephalopathy as it increases the frequency of bowel movements and thus helps in clearing up ammonia from the body.
Severe Jaundice: Since the liver does not functioning appropriately in patients with decompensated cirrhosis there is a significant rise in the bilirubin levels giving the body a yellowish tinge. If not treated, this is potentially a life threatening condition.
Treatment for Decompensated Cirrhosis
Once a patient has been diagnosed with Decompensated Cirrhosis then liver transplant is the only available treatment. While the patient is awaiting a transplant there are certain things that can be done for the patient with the main aim being to make the patient comfortable. This is done by trying the decompensated cirrhosis patients to be kept as asymptomatic as possible and prevent complications. Efforts are also made to improve quality of life as patients with Decompensated Cirrhosis have a rather poor quality of life. Complications like internal bleeding, ascites, and jaundice need to be treated aggressively by medications, lifestyle changes and dietary modifications.
What is the Prognosis & Life Expectancy of Decompensated Cirrhosis?
Overall prognosis is quite grim for people suffering from decompensated cirrhosis with life expectancy being a maximum of three years and a minimum of one year but this depends on the overall age and health of the patient, any other concurrent illness, comorbidities, prevention of complications, response to the treatments provided and how severe the symptoms are due to Decompensated Cirrhosis.