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Cirrhosis
Cirrhosis is the result of damage to the liver cells from toxins,
metabolic problems or other causes.
As the liver cells die they are replaced by fibrous tissue. Other
liver cells regenerate in an abnormal manner, forming nodules
surrounded by the fibrous tissue. Eventually the entire liver
architecture can become abnormal, leading to decreased blood flow.
Symptoms and signs
Early symptoms include red palms, spider angiomata (red spots on the
upper body), hypertrophy of the parotid glands, and fibrosis of
tendons in the hands.
As liver throughput decreases blood will concentrate in the spleen
causing it to enlarge. From this the platelet count falls because of
splenic sequestration leading to abnormal bleeding. Blood can also
flow backwards causing gastric and esophageal varices and haemorrhoids.
If the damage is unchecked decreased
bilirubin secretion produces to
jaundice, there is immune system dysfunction, spontaneous bacterial
peritonitis and kidney dysfunction and failure (hepatorenal syndrome).
In advanced cases there can also be hepatic encephalopathy as toxic
metabolites, normally removed from the blood, reach the brain.
Common causes of cirrhosis include alcoholic liver disease, chronic
viral hepatitis (B,
C and D), chronic bile duct diseases (such as
primary biliary cirrhosis), inherited metabolic diseases (such as
haemochromatosis or Wilson disease) and parasitic infections (like
schistosomiasis).
Cirrhosis is irreversible but treatment of the causative disease will
slow or even halt the damage.
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