The liver, the largest human organ is essential for maintaining proper body functions. He eliminate or neutralize toxins in the blood, synthesizes antibodies to infection control and eliminate microorganisms from the bloodstream. He synthesizes proteins that regulate blood circulation and produces bile, which helps in the absorption of lipids and fat-soluble vitamins. We can not survive without a functional liver. In cirrhosis, scar tissue (lymph) take the place of healthy tissue, blocking the blood flow through the body, preventing it from exercising its normal function. Cirrhosis is the 12th leading cause of death by disease, killing about 26,000 people annually. Also, the costs of patients with cirrhosis as the hospitals that treat them are high.
There are many causes of hepatic cirrhosis, but the most common is chronic alcoholism.
Alcoholic liver disease
For many people, cirrhosis of the liver is synonymous with chronic alcoholism, but in fact it is just one of the possible causes. Alcoholic cirrhosis occurs after more than 10 years of drinking. The amount of alcohol that can damage the liver varies from person to person. In women, it takes a consumer at least 2-3 drinks per day, while men at least 3-4 per day. It seems that alcohol affects the liver by blocking the protein metabolisms, lipid and carbohydrate.
Along with chronic alcoholism, chronic hepatitis C is a major cause of chronic liver disease and liver cirrhosis. Infection with this virus causes inflammation in the liver tesultul and a variable degree of destruction that time (several decades), can lead to cirrhosis.
Chronic hepatitis B and D
Chronic hepatitis B, as well as chronic hepatitis C causes inflammation and degree of destruction that can lead to cirrhosis while. Chronic hepatitis D is a viral infection that can occur only in patients already infected with B.
These diseases are caused by the immune system that attacks the liver, causing inflammation, destructions and eventually cirrhosis.
These include alpha 1-antitrypsin deficiency, hemochromatosis, galactosemia, Wilson’s disease, glycogen production diseases. They interfere with liver function to produce, process and store enzymes, proteins, metals or other substances that the body needs to function normally.
In this case, the lipids are stored in the liver and can result in lumps and consequently cirrhosis. This disease appears to be associated with diabetes, protein malnutrition, obesity, coronary artery disease and treatment with corticosteroids.
In the event that the ducts that carry bile from the liver into the duodenum, are blocked, bile in the liver reflueaza destroying liver tissue. In children, the most common cause of biliary obstruction is biliary atresia, a disease in which the bile ducts are absent congenitally or destroyed. In adults, the most common cause is primary biliary cirrhosis, a disease in which the bile ducts become inflamed, blocked, and scarred. Secondary biliary cirrhosis can occur after bile ducts were damaged or inadvertently resected during surgery gall.
Drugs, toxins, and infections
Severe reactions medicamentatele prescribed prolonged exposure to environmental toxins, schistosomiasis and liver congestion repeated stops card (excessive inflow of blood) can all lead to cirrhosis.
Many patients with cirrhosis have no symptoms in the early stages of the disease. However, as the necrotic tissue (scar) replaces the normal liver function becomes inefficient and experience the following symptoms:
- Inappetence (loss of appetite)
- Abdominal pain
- Angiomas (vascular spider star shape that develops on the skin).
As the disease progresses, complications may occur. In some cases, it may be the first signs of the disease.
Loss of liver function affects the body in various ways. The most common complications are presented below.
Edema and ascites
When the liver loses its function of albumin synthesis occurs in the legs, fluid retention (edema) and abdomen (ascites).
Ecchymosis (bruising) and bleeding
When loss occurs on or off the synthesis of proteins regleza bloodstream, patients will invinetii and will bleed easily. The hands may be stained reddish, which is called palmar erythema.
Jaundice, yellowing of skin and eyes (ie whites), occurs when the function is impaired absorption of bilirubin.
Metabolites bilirubin deposited in the skin, causes severe pruritus (itching).
If cirrhosis prevents bile from reaching the gallbladder can develop gallstones (stones) bile.
Hepatic encephalopathy (toxins in the bloodstream and brain)
Liver function is impaired elimination of toxins that accumulate in the blood and eventually the brain. The result is impaired mental function, leading to personality disorders, coma and even death. The first signs of accumulation of toxins in the brain include neglect of personal appearance, unresponsiveness, forgetfulness, trouble concentrating, or trouble sleeping.
Cirrhosis of liver function affects the elimination of drugs in the bloodstream. Because of this, the drugs for a longer period than expected and it accumulates in the body. However, lead to a greater sensitivity to medications of patients with cirrhosis and their side effects.
Normally, blood from the intestines and spleen reaches the liver through the portal vein. Cirrhosis prevents the normal circuit (due to scar tissue and tissue destruction), which leads to increased pressure in the portal vein. This is called portal hypertension.
When portal hypertension occurs, venous blood coming from the intestines and spleen, reflueaza the veins in the esophagus or stomach. These veins dilate because they are overloaded, resulting in varicose veins. Varicose veins, which have thin walls contain a blood pressure greatly increased, so that they can break very easily. The result is an upper gastrointestinal bleeding (esophageal or stomach) which is a medical emergency.
Insulin resistance and diabetes mellitus type II
Cirrhosis cause insulin resistance. This hormone produced by the pancreas, enables blood tissues use glucose as an energy source. When insulin resistance occurs, adipose tissue, muscle and liver can not properly use insulin. Although pancreas tissue trying to meet the needs of insulin, it may be insufficient and type II diabetes occurs as glucose builds up in the blood.
Hepatocellular carcinoma is a type of liver cancer commonly caused by cirrhosis. The mortality rate is high.
Disorders in other organs
Cirrhosis can cause immune system dysfunction, leading to increased susceptibility to infection. Retained fluid in the abdomen (ascites) may become infected with bacteria normally present in the intestines. It can cause impotence, kidney failure and osteoporosis.
Of the liver cirrhosis is not reversible, but treatment can slow or halt disease progression and improve complications. Treatment depends on the cause of cirrhosis and type of complication. For example, in the case of alcoholic cirrhosis, treatment is to ban the consumption of alcoholic beverages of any kind. Treatment for cirrhosis posthepatitis consists of various drugs used to treat hepatitis, such as interferon for viral hepatitis and corticosteroids for autoimmune hepatitis. Cirrhosis caused by Wilson’s disease (copper accumulation in the body) is treated with drugs chelation (removal) of copper. These are just a few examples.
In all cases, regardless of the cause of cirrhosis, a healthy diet and abstinence from alcohol are essential because the body needs all the nutrients that she can get, and alcohol does nothing to accelerate liver destruction. Light physical activity is also important.
Treatment addresses and complications. For example, for ascites and edema recommend a low-salt diet or diuretics. Antibiotics are used in infections and a lot of drugs are available for pruritus (unfortunately not very effective). Protein intake triggers the accumulation of toxins in the blood and brain, so a low protein diet is very useful. It may also prescribe laxatives (eg Lactulose) that absorb toxins and remove them from the intestines.
Treatment of portal hypertension consists of antihypertensive medications such as beta blockers (eg, propranolol). If variceal bleeding, it injects an agent can coagluant or variceal ligation or banding (put a ring that would not allow blood to flow).
When complications can not be kept under control and stop liver function, liver transplantation is the only solution. Replace diseased liver with a healthy one from a donor. Approximately 80-90% of patients with liver trasplant survive. Survival rates have increased in recent years due to drugs such as cyclosporine and tacrolimus, which suppress the immune system and prevents damage and destruction of the transplanted liver.