Cirrhosis refers to formation of regenerative nodules in liver parenchyma, which hampers the function of human liver.
The cirrhosis of liver is considered one of the deadliest diseases worldwide. Since the alcohol consumption is increased to a great level it is not surprising to encounter cases of cirrhosis across the world. Peer pressure and lifestyle changes even contribute to the development of cirrhosis.
Alcohol is considered most common cause of cirrhosis in western countries. No age group is spared. Initially the person presents with hepatic dysfunction and jaundice. With continuous consumption of alcohol or what is known as binge drinking person is bound to suffer from cirrhosis of liver. There are various stages through, which a liver passes to attain the decompensate stage. The initial stage is development of nodules and in this stage there is a clear cut demarcation between hepatocytes. After this stage comes a state of fibrosis where there is distortion of hepatocytes.
With continuous consumption of alcohol there is a stimulation of Kuppfer cells which in turn stimulate stellate cells or Ito cells which are mainly responsible for fibrosis. On receiving stimulation stellate cells gets converted to myofibroblast and starting laying down fibrous tissues. Thus liver appears is full of fibrosis.
How Serious Is The Cirrhosis Of Liver?
Cirrhosis needs to be managed in initial phase of development. It is a serious disease as if it progresses to decompensate state then there are chances of development of various complications, which includes the following-
Portal Hypertension- Due to cirrhosis of liver there is increased resistance to flow of blood through the sinusoids and thus there is increase in portal pressure. When the portal wedge pressure is increased to more than 12 mm Hg then it is considered as portal hypertension.
Ascites- the other severe complication of cirrhosis of liver is ascites. Ascites is due to splanchnic vasodilatation and increase in portal pressure due to which there is movement of fluid from portal vein to peritoneal cavity. Patient of ascites is advised for paracentesis. At times culture of fluid is done to rule out any bacterial infection else chances of peritonitis may develop. That is why, timely management is key to get rid of ascites.
Oesophageal Variceal Bleeding- When portal pressure is increased chances of bleeding may occur. Patient presents with hematemesis and it is considered as a medical emergency as chance of shock are high in such patients. The variceal blessings is present with mild bleeding sclerotherapy can be done. The drug of choice in such condition is octreotide.
Coagulation Disorders- in severe cirrhosis there may occur deficiency of coagulation factors and thus there may be excessive bleeding. Patients are usually treated with vitamin K supplements to overcome bleeding disorders.
Hepatic Encephalopathy- This is a state of confusion which arises due to accumulation of ammonia in the brain. When there is cirrhosis of liver the neurotoxin present in gut directly reaches brain without detoxification. In such condition there are personality disorders. So before the onset of encephalopathy patient needs to be treated. Encephalopathy is considered a serious problem because there are chances that patient may go into coma of it persists for long. Lactulose is given in such patients.
Jaundice– When there is disturbance of liver function then there is problem in conjugation of bilirubin and thus this leads to decreased in bilirubin metabolism which finally causes jaundice in later stage. Thus cirrhosis comes with so many problems.
Immunity is decreased in patient of cirrhosis as complement protein which mainly occurs in liver is not taken place. So, with so many problems one can easily understand how important is liver to a human body and how severe is cirrhosis of liver.
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