CIRRHOSIS OF THE LIVER

The Impact of Alcohol on Health

Chronic abusers of alcohol are at risk of permanently damaging their health. An organ that receives a great deal of punishment from this type of overindulgence is the liver. The body does its best to repair this damage, but if the abuse continues then it is no longer able to do this. When the liver has damaged beyond repair it is known as cirrhosis. This is a serious condition, and the individual will not survive long if they continue to abuse alcohol. It is not possible to reverse the damage of cirrhosis, but it can be managed so long as the individual remains abstinent. Most heavy drinkers are in denial about the risks of developing alcoholic liver disease. It is estimated that about 90% of them will experience at least the early stages of this condition. Cirrhosis is a real risk for anyone who abuses alcohol.

Vital Functions of the Liver

The liver is responsible for over 500 different functions in the body. It would not be possible for humans to survive without this important organ. It is made up of four lobes and has a reddish brown colour. It can be found on the left side of the abdominal cavity. The liver is the largest organ in the body and normally weighs about three pounds. The functions of the liver include:

  • Removing toxins from the bloodstream
  • Excreting waste products from the body
  • Stores excess glucose
  • Converting glucose to glycogen
  • Maintaining appropriate levels of glucose in the bloodstream
  • Manufacturing proteins
  • Manufacturing cholesterol (it creates about 80% of cholesterol needed by the body)
  • Manufacturing bile
  • Regulating various hormones
  • Digesting fat
  • Clotting blood
  • Producing urea

Cirrhosis of the Liver Explained

Cirrhosis refers to scarring of the liver that most often occurs because of alcohol abuse or a viral infection known as hepatitis C. It is also possible to develop the condition due to a number of other diseases such as hepatitis B or cystic fibrosis. Cirrhosis develops because of previous episodes of inflammation caused by these conditions. It leaves behind scar tissue and this replaces healthy cells. This means that the liver is no longer able to function as it should. The evidence of this becomes apparent as the body struggles to cope. The scarring also means that blood can no longer flow efficiently through the organ. This leads to an increase in blood pressure that causes problems elsewhere in the body. Once cirrhosis has developed the liver is no longer able to replace damaged cells.

Symptoms of Liver Cirrhosis

The symptoms of liver cirrhosis include:

  • Nausea and vomiting
  • Abdominal discomfort
  • Vomiting up blood
  • Blood vessels appearing under the skin in a spider-web shape
  • Clay-coloured or pale faeces
  • Blood in the faeces
  • Nosebleeds
  • Itching
  • Breast enlargement
  • Palms of hands taking a reddish colour
  • Bleeding gums
  • Loss of appetite
  • Loss of interest in sex
  • Shrunken testicles
  • Weight loss
  • Fatigue and weakness
  • Edema, a build-up of fluids in the lower limbs
  • Jaundice, a yellowing of the skin and whites of the eye

Complications Associated with Cirrhosis

These are some of the complications that can be triggered from scaring in the liver:

  • Ascites refers to a collection of fluid the peritoneal cavity in the abdomen. The interference with the smooth flow of blood through the organ leads to increased sinusoidal pressure. This is believed to encourage fluid to accumulate in the abdomen. Ascites can be uncomfortable. It is also dangerous because it can interfere with breathing and there is the risk of developing an infection. Ascites usually indicates a poor prognosis for the individual. About 50% of people who develop this build-up of fluids will be dead within a couple of years.
  • Esophageal varices is also caused by the poor movement of blood through the liver. The back pressure of this causes veins to become distended in the esophagus. These distended veins are referred to as varices. If the pressure is really high the varices can burst and begin allowing blood to flow into the esophagus. This is a medical emergency, because there can be a critical loss of blood. The fluid may also enter the lungs and suffocate the individual.
  • Hepatic encephalopathy occurs because the body is no longer able to break down toxins, and they just accumulate. The individual will become increasingly confused and may eventually fall into a coma. This differs from another form of encephalopathy that alcoholics may experience caused by Wernicke-Korsakoff Syndrome.
  • The problems in the liver can lead to kidney failure through a process known as hepatorenal syndrome.
  • Type II Diabetes results from increased insulin resistance. This takes place because the liver is no longer able to use insulin properly.
  • Those individuals who have developed cirrhosis have an increased risk of developing liver cancer.

Alcoholic Liver Disease

Heavy drinkers can develop a condition known as alcoholic liver disease. The progression of this condition can be broken down into stages. If the individual manages to quit alcohol before it progresses to cirrhosis then they can expect a full recovery. These are the stages of alcoholic liver disease:

  • The first stage is referred to as fatty liver. This occurs due to the abnormal retention of lipids in the organ because of a process known as steatosis. It is not unusual for the liver to hold onto to lipids in this way, but if it goes above 10% of the weight of the liver it is referred to as fatty liver. This abnormally high retention of lipids can occur if people have been drinking alcohol excessively. If the individual reduces their intake of alcohol the liver will return to normal.
  • If people continue to abuse alcohol it can lead to hepatitis. The individual has been drinking so much alcohol that the liver has become inflamed. This inflammation is dangerous because it can leave behind scarring. So long as the scarring is not excessive the liver will be able to repair itself, but this cannot happen while the individual continues to abuse alcohol.
  • If the individual continues to abuse alcohol they will eventually develop cirrhosis of the liver. There is now so much scarring that the organ is unable to function properly. The situation has deteriorated so much that the liver can no longer repair itself.

Treatment of Liver Cirrhosis

It is not possible to reverse liver cirrhosis. The aim of any treatment will be to manage the condition and to prevent any further scaring. It is vital that people with alcoholic liver disease give up drinking immediately. In some cases organ transplantation might be considered but only if the individual has stopped drinking. The individual may need to limit their salt intake, and they will usually be encouraged to eat a balanced diet. People with cirrhosis need to be careful when taking any type of medication.

Prognosis for Liver Cirrhosis

The prognosis for cirrhosis can be determined using a measurement tool called the Child-Pugh score. Factors such as INR level and presence of ascites are taken into account to determine life expectancy. Those with the lowest score (5-6) have the highest chance of long-term survival. The result of this assessment is never exact, but it can provide a useful guide.

Living with Cirrhosis in Recovery

It is possible for people with liver cirrhosis to build a good life in recovery. They may live with the condition for decades if it is managed properly. The most important thing is that nothing more happens that would cause further scarring. This means that the individual will need to commit themselves fully to their recovery. Relapse is highly likely to mean death. There is also the possibility of a liver transplant if things deteriorate.