Cirrhosis

Overview

Cirrhosis is the twelfth leading cause of death in the United States, according to the National Institute of Diabetes and Digestive and Kidney Diseases. Because of chronic damage to the liver, scar tissue slowly replaces normal functioning liver tissue, progressively diminishing blood flow through the liver. As the normal liver tissue is lost, nutrients, hormones, drugs, and poisons are not processed effectively by the liver. In addition, protein production and other substances produced by the liver are inhibited.

Causes

The most common cause of cirrhosis is alcohol abuse. Other causes include:

  • Hepatitis and other viruses
  • Use of certain drugs
  • Chemical exposure
  • Bile duct obstruction
  • Autoimmune diseases
  • Obstruction of outflow of blood from the liver (for example, Budd-Chiari syndrome)
  • Heart and blood vessel disturbances
  • Alpha1-antitrypsin deficiency
  • High blood galactose levels
  • High blood tyrosine levels at birth
  • Glycogen storage disease
  • Cystic fibrosis
  • Diabetes
  • Malnutrition
  • Hereditary accumulation of too much copper (Wilson disease) or iron (hemochromatosis)

Symptoms

Signs and symptoms of cirrhosis vary, depending on severity of the condition. Mild cirrhosis may not cause any symptoms at all. The following are the most common symptoms of cirrhosis. However, each individual may experience symptoms differently.

 Symptoms may include:

  • Abnormal nerve function
  • Ascites (fluid buildup in the abdominal cavity)
  • Breast enlargement in men
  • Vomiting blood
  • Curling of fingers (Dupuytren's contracture of the palms)
  • Gallstones
  • Hair loss
  • Itching
  • Jaundice (yellowing of the skin and eyes)
  • Kidney failure
  • Liver encephalopathy
  • Muscle loss
  • Poor appetite
  • Portal hypertension
  • Redness of palms
  • Salivary gland enlargement in cheeks
  • Shrinking of testes
  • Spider-like veins in the skin
  • Weakness
  • Weight loss

Diagnosis

In addition to a complete medical history and physical examination, diagnostic procedures for cirrhosis may include:

  • Laboratory tests
  • Liver function tests - A series of special blood tests that can determine if the liver is functioning properly.
  • Liver biopsy - A procedure in which tissue samples from the liver are removed (with a needle or during surgery) for examination under a microscope.
  • Cholangiography - X-ray examination of the bile ducts using an intravenous (IV) dye (contrast).
  • Computed tomography scan (CT or CAT scan) - A diagnostic imaging procedure using a combination of X-rays and computer technology to produce horizontal, or axial, images (often called slices) of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.
  • Ultrasound - A diagnostic imaging technique, which uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs. Ultrasounds are used to view internal organs of the abdomen such as the liver, spleen, and kidneys and to assess blood flow through various vessels.

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