An in-depth report on the causes, diagnosis, treatment, and prevention of cirrhosis.
Get vaccinations for influenza, hepatitis A and B, and pneumococcal pneumonia (if recommended by your doctor).
Inform your doctor of all prescription and nonprescription medications, and any herbs and supplements, you take or are considering taking.
Cirrhosis is an irreversible condition. Treatment focuses on slowing the progression of liver damage and reducing the risk of further complications. Your doctor will treat any underlying medical conditions that are the cause of your cirrhosis. If liver damage progresses to liver failure, patients may be candidates for liver transplantation. Liver donations can come from either a cadaver or from a living donor. Patients with cirrhosis who have a liver transplant have very good chances for survival.
Cirrhosis is an irreversible result of various disorders that damage liver cells over time. Eventually, damage becomes so extensive that the normal structure of the liver is distorted and its function is impaired.
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Cirrhosis is a chronic liver disease that is the result of damage to liver tissue with scarring of the liver (fibrosis - nodular regeneration) causing progressive decrease in liver function, excessive fluid in the abdomen (ascites), bleeding disorders (coagulopathy), increased pressure in the blood vessels (portal hypertension), and brain function disorders (hepatic encephalopathy). Excessive alcohol use is the leading cause of cirrhosis.
Scarring. The main damage in cirrhosis is triggered by scarring (fibrosis) that occurs from injuries due to alcohol, viruses, or other assaults. The scar tissue and other changes in liver cells gradually replace healthy liver tissue and act like small dams to alter the flow of blood and bile in and out of the liver.
Altered Blood and Bile Flow. The changes in blood and bile flow have significant consequences, with both the liver and other organs responding to the altered flow:
The small blood vessels and bile ducts in the liver itself narrow (constrict ). Blood vessels in other organs, including the kidney, also narrow.
Blood flow coming from the intestine into the liver is slowed by the narrow blood vessels. It
backs up through the portal vein and seeks other routes.
Enlarged, abnormally twisted and swollen veins called varices form in the stomach and lower part of the esophagus to transport the blood diverted from the liver.
Bilirubin also builds up in the bloodstream, resulting in jaundice, a yellowish cast in the skin and eyes, as well as dark-colored urine.
Fluid buildup in the abdomen (called ascites ), and swelling in the legs (edema ) are common.
Functions of the Liver
The liver is the largest internal organ in the body. In the healthy adult, it weighs about 3 pounds. The liver is wedge-shaped, with the top part wider than the bottom. It is located right below the diaphragm and occupies the entire upper right quadrant of the abdomen.
The liver performs over 500 vital functions. Damage to the liver can impair these and many other processes. Among them are the following:
Processing Healthful Nutrients. The liver processes all of the nutrients the body requires, including proteins, glucose, vitamins, and fats.
Producing Proteins The liver is the body’s “factory” where many important proteins are made. The blood protein albumin is one example that is often underproduced in patients with cirrhosis.
Producing Bile. The liver produces bile. a green-colored fluid that helps the body absorb fats and fat-soluble vitamins. Bile contains bilirubin, a yellow-green pigment produced from the breakdown of hemoglobin, the oxygen-carrying component in red blood cells. Bile also contains bile salts, fatty acids, cholesterol, and other substances.
Bile travels from the liver to the gallbladder, where it is stored until after a meal. It is then secreted into the intestines where it helps digest fat. Because bile can also travel directly from the liver to the intestines, patients who have had their gallbladders removed can still absorb fat normally.
Eliminating Toxins. One of the liver's major functions is to render harmless potentially toxic substances, including alcohol, ammonia, drugs, and harmful by-products of digestion.
Structure of the Liver
The vital processes the liver performs rely on well-organized liver architecture.
The basic building blocks of the liver are the following structures: