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Cirrhosis

Description:
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions, such as hepatitis and chronic alcoholism.

Each time your liver is injured — whether by disease, excessive alcohol consumption or another cause — it tries to repair itself. In the process, scar tissue forms. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function (decompensated cirrhosis). Advanced cirrhosis is life-threatening.

The liver damage done by cirrhosis generally can’t be undone. But if liver cirrhosis is diagnosed early and the cause is treated, further damage can be limited and, rarely, reversed.

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Symptoms:
You may not have any symptoms at first. But as time goes on, and the damage to your liver gets worse, you may notice things like:

*Fatigue and weakness
*Lack of appetite and weight loss
*Nausea
*Jaundice (when your skin and eyes turn yellow)
*Intense itching
*Spider web-like blood vessels in your skin
*Redness in the palms of your hands or whitening of your nails
*Vomiting blood
*Fluid retention (swelling in legs, abdominal distension)
*Severe muscle cramps
*Brownish urine
*Fever
*Enlarged spleen
*Bone disease, causing bones to break more easily

Keep in mind that you may not get all these symptoms, and some of these problems are also signs of other conditions.

Causes:

A wide range of diseases and conditions can damage the liver and lead to cirrhosis.

Some of the causes include:

*Chronic alcohol abuse
*Chronic viral hepatitis (hepatitis B, C and D)
*Fat accumulating in the liver (nonalcoholic fatty liver disease)
*Iron buildup in the body (hemochromatosis)
*Cystic fibrosis
*Copper accumulated in the liver (Wilson's disease)
*Poorly formed bile ducts (biliary atresia)
*Alpha-1 antitrypsin deficiency
*Inherited disorders of sugar metabolism (galactosemia or glycogen storage disease)
*Genetic digestive disorder (Alagille syndrome)
*Liver disease caused by your body's immune system (autoimmune hepatitis)
*Destruction of the bile ducts (primary biliary cirrhosis)
*Hardening and scarring of the bile ducts (primary sclerosing cholangitis
*Infection, such as syphilis or brucellosis
*Medications, including methotrexate or isoniazid

Diagnosis:
Your doctor will ask about your symptoms. He or she will also ask if you have a history of health conditions that make you more likely to develop cirrhosis.

Your doctor will ask about your use of alcohol and over-the-counter and prescription medicines.

Physical exam:
Your doctor will examine your body, use a stethoscope to listen to sounds in your abdomen, and tap or press on specific areas of your abdomen. He or she will check to see if your liver is larger than it should be. Your doctor will also check for tenderness or pain in your abdomen.

Different tests:
*Blood tests
Your doctor may recommend the following blood tests

*liver tests NIH external link that can show abnormal liver enzyme levels, which may be a sign of liver damage. Your doctor may suspect cirrhosis if you have
*increased levels of the liver enzymes alanine transaminase (ALT), aspartate transaminase (AST), and alkaline phosphatase (ALP)
*increased levels of bilirubin
*decreased levels of blood proteins
*complete blood count NIH external link, which can show signs of infection and anemia that may be caused by internal bleeding
*tests for viral infections to see if you have hepatitis B or hepatitis C
*blood tests for autoimmune liver conditions, which include the antinuclear antibody (ANA), anti-smooth muscle antibody (SMA), and anti-mitochondrial antibody (AMA) tests

Based on the blood test results, your doctor may be able diagnose certain causes of cirrhosis.

Your doctor can use blood tests to tell how serious your cirrhosis is.

Imaging tests:
Imaging tests can show the size, shape, texture, and stiffness of your liver. Measuring the stiffness of the liver can show scarring. Your doctor can use stiffness measures to see if the scarring is getting better or worse. Imaging tests can also show how much fat is in the liver. Your doctor may use one or more of the following imaging tests

*magnetic resonance imaging (MRI) NIH external link
*ultrasound NIH external link
*x-rays such as computerized tomography (CT) scans
*transient elastography, a special ultrasound that measures the stiffness of your liver and can measure liver fat

Liver biopsy:
Your doctor may perform a liver biopsy to see how much scarring in is your liver. A liver biopsy can diagnose cirrhosis when the results of other tests are uncertain. The biopsy may show the cause of cirrhosis. Sometimes your doctor may find that something other than cirrhosis has caused your liver to become damaged or enlarged. Your doctor can also diagnose liver cancer external link based on liver biopsy results.

Treatment:
Treatment of cirrhosis involves managing symptoms and preventing further damage to the liver, since the existing scarring cannot be repaired or reversed. The specific cause for the cirrhosis will be addressed. Treatment varies depending on the cause.

Doctors most often treat the causes of cirrhosis with medicines. Your doctor will recommend that you stop activities such as drinking alcohol and taking certain medicines that may have caused cirrhosis or may make cirrhosis worse. If you have alcoholic liver disease, your doctor will recommend that you completely stop drinking alcohol.

Liver transplant surgery:
In advanced cases of cirrhosis, when the liver stops working properly, a liver transplant may be the only treatment option. A liver transplant is a procedure to replace your liver with a healthy liver from a deceased donor or with part of a liver from a living donor. Cirrhosis is one of the most common reasons for a liver transplant. Candidates for liver transplant have extensive testing to determine whether they are healthy enough to have a good outcome following surgery.

Historically, those with alcoholic cirrhosis have not been liver transplant candidates because of the risk that they will return to harmful drinking after transplant. Recent studies, however, suggest that carefully selected people with severe alcoholic cirrhosis have post-transplant survival rates similar to those of liver transplant recipients with other types of liver disease.

For transplant to be an option if you have alcoholic cirrhosis, you would need to:

Find a program that works with people who have alcoholic cirrhosis.
Meet the requirements of the program. These would include lifelong commitment to alcohol abstinence as well as other requirements of the specific transplant center.

(Liver transplant dramatically improves the prognosis of liver cirrhosis. If the disease is detected at its earlier stage, cirrhosis life expectancy is about 15 to 20 years. Life expectancy decreases to about 6 to 10 years, when cirrhosis is detected during the second stage. But these patients have enough time and can opt for liver transplant.)

Lifestyle and home remedies:
If you have cirrhosis, be careful to limit additional liver damage:

*Don’t drink alcohol. Whether your cirrhosis was caused by chronic alcohol use or another disease, don’t drink alcohol. Drinking alcohol may cause further liver damage.

*Eat a low-sodium diet. Excess salt can cause your body to retain fluids, worsening swelling in your abdomen and legs. Use herbs for seasoning your food, rather than salt. Choose prepared foods that are low in sodium.

*Eat a healthy diet. People with cirrhosis can experience malnutrition. Combat this with a healthy diet that includes a variety of fruits and vegetables. Choose lean protein, such as legumes, poultry or fish. Don’t eat raw seafood.

*Protect yourself from infections. Cirrhosis makes it more difficult for you to fight off infections. Protect yourself by avoiding people who are sick and washing your hands frequently. Get vaccinated for hepatitis A and B, influenza, and pneumonia.

*Use over-the-counter medicines carefully. Cirrhosis makes it more difficult for your liver to process medicines. For this reason, ask your provider before taking any medicines, including nonprescription ones. Don’t take aspirin and ibuprofen (Advil, Motrin IB, others). If you have liver damage, your provider may recommend that you not take acetaminophen (Tylenol, others) or take it in low doses for pain relief.

Regular Yoga and meditation under the guideline of an expart is very helpful.

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Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
https://www.mayoclinic.org/diseases-conditions/cirrhosis/symptoms-causes/syc-20351487
https://www.webmd.com/digestive-disorders/understanding-cirrhosis-basic-information
https://www.healthline.com/health/cirrhosis#causes

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