Cirrhosis is a slowly progressing disease in which healthy liver tissue is replaced with scar tissue, thereby preventing the liver from functioning properly. This scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, drugs, hormones and naturally produced toxins.
According to the National Institutes of Health, cirrhosis is the 12th leading cause of death by disease, Fatty liver, Hepatitis C and alcohol abuse are the most common causes of cirrhosis of the liver in the U.S. Patients need to be aware of the complications of cirrhosis. The top three ones are:
- Variceal bleeding. Variceal bleeding is caused by portal hypertension. This is an increase in the pressure within the portal vein (the blood vessel that carries blood from the digestive organs to the liver). This increase in pressure is caused by resistance to blood flow through the liver as a result of cirrhosis. Increased pressure in the portal vein causes other veins in the body to enlarge (varices), such as those in the esophagus and stomach, to bypass the blockage. These varices can bleed easily, causing patients to present to hospitals either vomitting blood or dark stools. Portal hypertension also leads to extra fluid buildup in a person’s abdomen ( ascites) and( or) lower legs/feet( pedal edema). Prompt medical attention should be sought from a liver specialist for both variceal bleeding and fluid accumulation.
- Hepatic encephalopathy (confused thinking). Toxins produced in our intestines are normally detoxified by the liver, but once cirrhosis occurs, the liver cannot detoxify as well. Toxins get into the bloodstream and can cause confusion, changes in behavior, and even coma. Laxatives such as lactulose are used to speed their removal from the intestines.
- Liver cancer. There is about a 5-6% annual incidence of liver cancer in patients with cirrhosis from any cause. Usually it occurs without any symptoms at all. Liver cancer is picked up by periodic surveillance typically using ultrasound. Various modalities can be used to treat these cancers, including evaluation for liver transplantation.