What is Liver Fibrosis: Stages, Causes, Symptoms, Treatment, Diagnosis

The formation of connective tissues due to accumulation of matrix proteins in any organ of the body is called fibrosis. Fibrosis can be reparative or reactive in nature. When excessive tissues are formed in the liver, it is known as Liver Fibrosis. Fibrosis develops when the liver is repeatedly or continuously damaged. As a result of the damage, scar tissues are formed in replacement of the liver cells. However, unlike the normal liver cells, the scar tissues fail to perform many important functions of the liver. Over time, this process can result in cirrhosis of the liver, in which the functional units of the liver become disrupted in such a manner that blood flow through the liver is blocked.

Liver Fibrosis is divided as 0 to 4 stages:

• Stage 0: No fibrosis
• Stage 1 of Liver Fibrosis: Creation of scar tissues and hence enlargement of the portal areas.
• Stage 2 Liver Fibrosis: Indicates the moderate fibrosis and extends out of the portal areas.
• Stage 3 Liver Fibrosis: Indicates severe fibrosis and linking up the portal areas with central areas of the liver.
• Stage 4 Liver Fibrosis: Severe scarring of the tissues which leads to Liver cirrhosis or absolute blockage.

The major problem with the disease is that in early stages of liver fibrosis, there are no noticeable symptoms and liver mostly functions absolutely normally helping to lead a usual and active life. However, as the disease progresses the blood flow in liver is restricted. Once the fibrosis reaches the stage of cirrhosis, the symptoms include hypertension, variceal bleeding, ascites, and portosystemic encephalopathy among other symptoms.

The advanced stages of liver fibrosis results into pain in the abdomen, fluid in abdomen, water retention, yellow skin and eyes, bruising, dark urine, enlarged veins around belly button, itching, mental confusion, muscle weakness, shortness of breath, swelling etc. Also, the fibrosis causes the liver to become harder in nature and as it progresses to cirrhosis the hardness becomes more acute.

The main cause of liver fibrosis is formation of scar tissue; the scar tissues are formed as a result of continuous damage of the liver. The body produces cellular protein in reaction to initial damage. However, continuous injury leads to over production of the extra cellular protein or the scar tissue which results into fibrosis.

When the functional liver cells are injured, the immune system goes on to repair the damage. During such process of fibrosis, the injured cells produce substances to be released into the liver causing the buildup of more scar tissues.

The significant causes of liver fibrosis being:

• Chronic infection with hepatitis C or hepatitis B virus (HCV or HBV)
• Heavy alcohol consumption
• Consumption of toxins.

Liver fibrosis is diagnosed in various ways including blood tests and imaging tests in the initial stages, however, doctors may suggest abdominal ultrasound, abdominal CT, elastography, magnetic resonance elastography, or liver biopsy to diagnose the same.

Biopsy of liver is the most prescribed way to be sure of the condition as it gives a detailed view of the level of damage in the liver.

The treatment depends on the cause of the fibrosis and it can be treated as follows:

• Low Sodium/Low Fat Diet: To adapt to a routine diet with low sodium and low fat.
• Restrain from Alcoholic Drinks: Not drinking alcohol if people have alcoholic liver disease.
• Weight Loss and Controlling Blood Sugar to Treat Liver Fibrosis: Patients with non-alcoholic fatty liver are prescribed to reduce weight and control level of blood sugar.
• Regular exercise and Rest.

• Antiviral Drugs to Treat Liver Fibrosis: These antiviral drugs are used to reduce the virus if people have chronic viral hepatitis.
• Medicinal Drugs to Treat Liver Fibrosis: Drugs to remove heavy metals are prescribed if patients have excessive iron hemochromatosis or Wilson disease.
• Restricting Specific Drugs to Treat Liver Fibrosis: Stop using a drug that is the cause of damage of the liver.
• Besides, removal of the blockage in the bile ducts may also be necessary.

Liver fibrosis in the early stages can be cured if the underlying cause of the disease can be eliminated. Earlier, the advanced stages of the disease was considered terminal, but in the recent times it is considered largely curable through cellular recovery. Hence, it’s very important to diagnose liver fibrosis at the right time and failure to do so may lead to cirrhosis, liver failure, and liver cancer as well. Options to adopt the healthy lifestyle changes, medication, and cholesterol and diabetes management can lead to minimization of the risk of overall liver damage.