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Of all pathologies of the liver, liver cirrhosis is one of the most dangerous. A potentially life-threatening disease, it progresses through stages with the liver suffering increasing damage and eventually losing all or most of its functioning. The final stage of liver cirrhosis is inevitably fatal if not treated. A common cause of cirrhosis is severe alcohol abuse; however, the disease occurs in non-alcoholic forms as well, associated with obesity and diabetes, among other things.

Symptoms


In its early stages, cirrhosis of the liver is often asymptomatic. When early symptoms do occur, they usually include one or more of the following: fatigue, swelling of the upper abdomen, jaundice, dry mouth and thirst, and discoloring of patches of skin.


Diagnosis


Aside from these symptoms, which may or may not be present, cirrhosis may first be indicated by a blood test revealing elevated liver enzymes. The same blood test result, however, often accompanies much less serious liver conditions such as fatty liver (which may also be an early sign of cirrhosis). Scanning with medical imaging technology such as ultrasound or MRI may reveal growth of abnormal tissues or liver inflammation. The presence of these indicators calls for a biopsy to determine the specific nature of the problem, particularly when a known risk factor for cirrhosis, such as alcohol abuse or obesity, is present.


Continued below....

Causes and Risk Factors


Cirrhosis of the liver can arise from a number of different causes. One common cause of cirrhosis is severe alcohol abuse over a number of years. (As with most liver diseases, a distinction is made between alcoholic and non-alcoholic cirrhosis; while the progression of the disease is identical regardless of cause, the treatment is different.)

Besides alcohol abuse, cirrhosis can arise as a complication of fatty liver disease or another liver disorder such as hepatitis, with chronic infectious hepatitis being particularly likely to produce cirrhosis as a complication. Obesity is a major risk factor for developing the disease. So is type II diabetes. Liver cirrhosis can also arise more rarely from autoimmune disorders, various hereditary factors, and cystic fibrosis.

The most significant risk factors for developing cirrhosis of the liver are alcohol abuse, obesity, and type II diabetes.

Statistics


Cirrhosis and other severe liver disease was the 10th leading cause of death in men and the 12th in women in the United States as of 2001; more recent statistics are expected to be worse, given the increase in non-alcoholic liver disease. The 10-year mortality expectation of patients diagnosed with cirrhosis is between 34 and 66 percent; the wide range is due to higher expectation of death in later stages of the disease and also a worse prognosis with alcoholic than with non-alcoholic cirrhosis. Liver disease kills an estimated 27,000 people each year in the U.S.

Stages


Cirrhosis progresses in stages. Four stages are recognized by doctors. In stage one, the disease may be asymptomatic or have mild symptoms such as those noted above. Tests reveal the presence of swelling and abnormal growth of tissues. In the second stage, the abnormal growth hardens and becomes fibrous and rigid. This condition is called fibrosis, which is a liver disease in itself and can occur without a diagnosis of cirrhosis as well as being a description of cirrhosis in its second stage.

In third-stage cirrhosis, the fibrotic tissue has spread through the liver and begun to merge into inflamed regions of the liver. At this stage, hepatic function begins to be seriously impaired and more serious overt symptoms may manifest as a result of impairment of the body's ability to digest fats. The primary problem with that is an impaired ability to make use of fatty acids and fat-soluble vitamins, which are necessary nutrients.

Stage four cirrhosis is characterized by severe impairment of liver function. The prognosis is terminal. A liver transplant must be performed if the patient is to survive.

Treatment


Treatment of cirrhosis, except in the fourth stage, involves attempting to stop the progression of the disease by removing the cause of the illness. It's important for that reason that the cause be correctly identified.

Liver damage resulting from cirrhosis is irreversible, but may be arrested by correcting the cause of the condition. If the cirrhosis is alcoholic in origin, the treatment is to eliminate alcohol abuse. If it is non-alcoholic, the treatment may involve gradual weight loss, treatment for infections, or management of other diseases such as diabetes, depending on the specific circumstances. While the damage to the liver cannot be repaired, if the progression of the disease is stopped early enough to retain adequate hepatic function, it's possible for the patient to live a normal life.

Cirrhosis of the liver does not exist in isolation. All of the causes of the disease have other negative consequences for health as well. The lifestyle changes necessary to treat cirrhosis therefore often result in significant improvement in overall health.


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