Cirrhosis of the liver is a chronic disease that affects the entire liver. In this case, there is an increase in the specific weight of the connective tissue of the liver with the growth of scar nodes, the destruction of liver cells, its blood supply and lobular structure.
With timely diagnosis and elimination of the cause of the disease, it is possible to achieve a complete stop in the development of the disease. Aggressive forms of cirrhosis can progress despite the elimination of the cause of the disease.
The most common causes of the disease are long-term alcohol abuse, as well as viral diseases (hepatitis caused by virus B, C and D). In addition, cirrhosis of the liver can be caused by chronic infections, stagnation of bile, autoimmune processes, chronic obstruction of the outflow of blood from the hepatic veins, metabolic disorders and accumulation of trace elements such as iron and copper, deficiency of a specific protein (Alpha-1 antitrypsin) or poisoning, including drugs. Even fatty destruction of the liver with excess weight and unbalanced nutrition can lead to cirrhosis of the liver.
When alcohol is abused, a complete rejection of its use is shown. Vaccinations are available against viral hepatitis A and B. Unfortunately, there is no vaccine against hepatitis C. Here, strict adherence to hygiene rules is recommended when in contact with blood and other body fluids, semen, etc. In the case of other, very rare causes of liver cirrhosis, the only type of effective prevention is the timely detection of the disease. When the cause of the disease is identified, specific treatment can be started to protect against cirrhosis of the liver.
Feeling of fatigue, decreased performance and exercise tolerance, fatigue, in advanced stages, jaundice, changes in skin elasticity, trembling of the hands, clouding of consciousness, decreased body hair, in men, enlargement of the mammary glands. Alarming symptoms are the appearance of dropsy of the abdomen with an increase in its size and increased bleeding caused by disorders of the blood coagulation system.
Detailed laboratory diagnostics, investigating the process of destruction of liver cells and impaired liver function in protein metabolism and blood clotting, also shows changes in the cellular structure of blood and bile metabolism. Determination of the tumor marker Alpha-Fetoprotein contributes to the timely detection of the development of malignant neoplasms of the liver (sensitivity 70%).
A thorough ultrasound examination helps to determine the structure and size of the liver, hepatic vessels and nearby organs. Since cirrhosis of the liver causes the development of esophageal varices, regular gastroscopy is necessary to determine the degree of development of varicose veins and the severity of their bleeding.
An examination with the highest degree of diagnostic sensitivity is a liver puncture, which is quite simple and is carried out under ultrasound control using a thin needle. Complications after a liver puncture are extremely rare.
Specific treatment is possible when determining the disorder or cause leading to cirrhosis of the liver. In addition, it is necessary to completely abandon the use of alcohol, eat a balanced diet, establish a sparing rhythm of life, and also avoid medications, the side effect of which is a negative effect on the liver.
In some cases, depending on the cause of cirrhosis, liver transplantation is indicated.
An increase in pressure in the liver portal vein system with the formation of collateral circulation (bridge veins) leads to the development of varicose veins of the esophagus, as well as organs of the upper abdomen, such as the spleen, gastric fornix, umbilical vein, or hemorrhoids of the anus. An increase in pressure in the portal vein system of the liver leads to the appearance of dropsy of the abdomen. It is necessary to pay attention to the increased susceptibility to infections of the abdominal cavity, the risk of bleeding from varicose veins of the esophagus and the fornix of the stomach in case of blood clotting disorders, with progressive insufficiency of liver function, neurological and psychiatric symptoms are observed with deterioration in coordination of movements (handwriting), impaired renal function with the development of the syndrome kidney failure.
Changes in bone marrow tissue are also possible due to a decrease in the number of platelets (platelets), often accompanied by an increase in the spleen. Ultimately, liver cancer may occur (70% patients with liver cancer have cirrhosis).
Head of the Clinic of Gastroenterology and Internal Diseases
Head of the Gastroenterology Clinic
Руководитель клиники гастроэнтерологии и гепатологии, университетская клиника Эссена