Liver cirrhosis is defined as a progressive destruction of the liver cells, manifested by changes in its architecture and in its vessels as well as the appearance of nodules. This degeneration is usually caused by an excess use of alcohol - involved in 80% of cirrhosis cases -, but it can also be secondary to drug intoxication or hepatitis (liver disease). In general, after heavy drinking, one goess through the stage of alcoholic liver disease before developing cirrhosis.
In the early stages, cirrhosis is asymptomatic. A doctor will just be able to detect a slight increase in liver size. But it is only later, after several years, that cirrhosis can be truly revealed. It is then manifests itself through the impairment of liver cells, with lower functional capacity and signs of portal hypertension as well as an increased pressure in the vessels:
- Loss of appetite and weight loss,
- severe fatigue,
- abdominal pain, malaise and vomiting,
- yellow coloring of the skin, or jaundice,
- cutaneous signs, angiomas (dilation of blood vessels under the skin in a star shape), clubbing (curveing of the fingertips), and red palms,
- an increase in the size of the spleen, called splenomegaly,
- accumulation of fluid, called ascites, in the abdominal cavity,
- genital disorders (for women menstrual issues, and for men, impotence)
- Digestive bleeding.
A series of medical tests can help confirm the existence of liver cirrhosis:
- clotting problems, with a decrease of prothrombin,
- increased levels of
o alkaline phosphatase,
- a decrease in the amount of albumin (blood protein levels).
An abdominal ultrasound can identify any changes in the liver, but a liver biopsy - taking a small part of the liver to analyze - will confirm the diagnosis and help decide on the cause.
Other tests should be performed to evaluate the complications of cirrhosis: an endoscopy to identify esophageal varices that may rupture and cause bleeding.
It is essential to address the cause of cirrhosis (usually alcohol). The treatment is generally comprised of various drugs:
- diuretics (to remove excess fluid)
- beta-blockers, to control hypertension and to prevent varices
Draining punctures are also used to prevent the accumulation of ascites. Vaccination against hepatitis A and B is recommended. In the case of dangerous esophageal varices, ligation is possible. Close monitoring is necessary as a follow-up. The main risk is the development of a hepatocellular carcinoma.
Prevention of cirrhosis consists of avoiding excessive alcohol consumption. After a diagnosis is made, prevention of complications and monitoring are essential to prevent their worsening.