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Treatment of Lung Cancer Therapy for Healthy

The treatment of lung cancer, also known as lung cancer treatments and therapy can result in surgical removal of the tumor, chemotherapy or radiotherapy, and combinations of these treatments. The decision on which treatments are appropriate for a given individual should take into account the location and extent of the tumor and the patient’s general health.

As with other types of cancer treatment can be provided that the allegations curative (removal or eradication of cancer) or palliative (measures that are not able to cure cancer, but may reduce pain and suffering). More than one type of treatment may be prescribed. In such cases, therapy is added to enhance the effects of primary therapy is known as adjuvant therapy. An example of adjuvant treatment with chemotherapy or radiation therapy after surgery to remove a tumor, to be sure who killed the tumor cells.

Lung Cancer Surgery

Surgical removal of the tumor is usually performed for limited stage (stage I or, sometimes, phase II) and NSCLC (non-small-cell lung cancer) is the treatment against cancer that has not spread beyond the lung. Approximately 10% -35% of lung cancers can be surgically removed, but the withdrawal does not always translate into a cure, because the tumors have already spread in May and may occur at a later date. Among those who are isolated, slow-growing cancer of the lung removed, 25% to 40% are still alive five years after diagnosis. Surgery may not be possible if the cancer is near the trachea or if you have other serious diseases (like heart or lung disease) that limit their ability to tolerate surgery. The operation was performed less often because SCLC tumors are less likely to be located in an area that can be eliminated.

The surgical lung cancer procedure chosen depends on the size and location of the tumor. Surgeons must open the chest wall and may perform a lung wedge resection (removal of part of one lobe), lobectomy (removal of one lobe) or pneumonectomy (removal of an entire lung). Sometimes lymph nodes in the region of the lungs are removed (lymphadenectomy). Surgery for lung cancer is a major surgery requiring general anesthesia, hospitalization and follow-up care for weeks or months. After surgery, patients may experience difficulty breathing, shortness of breath, pain and weakness. The risks of surgery are complications due to hemorrhage, infection and complications from general anesthesia.

Lung Cancer Radiation

Therapy radiation may be used as a treatment for both NSCLC (non-small-cell lung cancer) and SCLC (small cell lung cancer). Radiation therapy of lung cancer uses high-energy X-rays or other radiation to kill cancer cells from dividing. Radiotherapy may be administered in curative treatment, palliative treatment (using low doses of radiation that have curative regimes), or as adjuvant therapy in combination with surgery or chemotherapy. The radiation is delivered either externally, using a machine that aims radiation at cancer, or internally by placing radioactive material in sealed containers in the area of the body where the tumor is located. Brachytherapy is a term used to describe the use of a small pellet of radioactive material placed directly in cancer or in the air near the cancer. This is usually done through a bronchoscope.

Radiotherapy lung cancer may be given if a person refuses surgery if the tumor has spread to areas such as the lymph nodes or trachea, making surgical removal impossible, or if a person has other conditions that make too sick to go through major surgery. Radiation therapy is usually only reduce the tumor or the limits of its growth when given alone, however, in 10% -15% of people that leads to a long-term remission and palliation of cancer. Combining radiation therapy with chemotherapy may increase survival when given chemotherapy. External radiation therapy, in general, can be performed on an outpatient basis, while internal radiotherapy requires a short hospital stay. A person who has a serious lung disease, in addition to lung cancer may not be able to receive radiotherapy in the lungs. A type of external radiation called “Gamma Knife” is sometimes used to treat brain metastases only. In this procedure, the multiple radiation beams are focused on the tumor for a few minutes to several hours, while the head is held in place by a rigid structure.

For external beam radiation, a process called simulation is necessary before treatment. Using CT, computers and precise measurements, simulation maps the exact location where the radiation is delivered, called the treatment field or port. This process usually takes 30 minutes to two hours. The external radiation therapy in general, it takes four or five days a week for several weeks.

Radiation therapy does not increase risk of major surgery, but can have unpleasant side effects such as fatigue and lack of energy. A small number of white blood cells (making a person more vulnerable to infection) and low levels of platelets in the blood (blood clotting more difficult) can also occur with radiotherapy. If the digestive organs are in the area exposed to radiation, patients may experience nausea, vomiting or diarrhea. Radiotherapy May irritate the skin in that area, but the irritation usually improves with time after treatment.

Lung Cancer Chemotherapy

Both non-small-cell lung cancer (NSCLC) and CPM can be treated with chemotherapy. Chemotherapy refers to the administration of drugs that inhibit the growth of cancerous cells by killing them or preventing them from dividing. Chemotherapy can be administered alone as adjuvant therapy to surgery or in combination with radiotherapy. If a number of chemotherapy drugs have been developed, the drugs of the class of drugs known as platinum have been most effective in the treatment of lung cancer.

Chemotherapy is the treatment of choice for most CPM, because these tumors are very common in the body when diagnosed. Only half of those with SCLC survive for four months without chemotherapy. With chemotherapy, their survival time increased from four to five times. Chemotherapy alone is not particularly effective in the treatment of non-small-cell lung cancer (NSCLC), but when have metastatic NSCLC, it may prolong survival in many cases.

Chemotherapy may be given in pill form as intravenous infusion, or a combination of both. Chemotherapy treatments are usually given on an outpatient basis. A combination of drugs is given in a series of treatments, called cycles for a period of weeks or months, with breaks between cycles. Unfortunately, chemotherapy drugs also kill normal dividing cells in the body, causing unpleasant side effects. Damage to blood cells may cause increased susceptibility to infections and difficulties related to blood coagulation (bleeding or bruising easily). Other side effects include loss, fatigue, weight gain, hair loss, nausea, vomiting, diarrhea and mouth sores. Side effects of chemotherapy depend on the dose and combination of drugs used and can vary from person to person. Drugs have been developed that can treat or prevent many side effects of chemotherapy. Side effects usually disappear during the recovery phase of treatment or after its completion.

Prophylactic cranial irradiation

Small cell lung cancer (SCLC) often spreads to the brain. Sometimes people with SCLC, which responds well to treatment, are treated with radiation to treat quickly spread to the head brain (called micrometastases) is not yet detectable with CT or MRI and no symptoms yet. Brain radiation therapy can cause problems with short-term memory, fatigue, nausea and other side effects.

Treatment of recurrence

Lung cancer that has returned after treatment with surgery, chemotherapy and / or radiation therapy is called recurrent or relapsed. If recurrent cancer is confined to a site in the lungs, can be treated by surgery. Relapsed tumors do not usually respond to chemotherapy drugs administered previously. As platinum-based drugs are generally used in the initial chemotherapy of lung cancer, these drugs are not useful in most cases of recurrence. A type of chemotherapy called second-line chemotherapy is used to treat recurrent cancer previously treated with chemotherapy, and a series of second-line chemotherapy have proven effective in prolonging survival. People with lung cancer are quite recurrent to tolerate the treatment are also good candidates for experimental therapies (see below), including clinical trials.

Targeted therapy

An alternative to standard chemotherapy is the drug erlotinib (Tarceva), which can be used in patients with ( NSCLC non-small-cell lung cancer ) who no longer respond to chemotherapy. Specific call is a drug, a drug that specifically target cancer cells, causing less damage to normal cells. Erlotinib targets a receptor protein called epidermal growth factor (EGFR), which helps cells to divide. This protein is found in abnormally high levels on the surface of certain types of cancer cells, including many cases of non-small cell cancer of lung cells. Erlotinib is taken orally as tablets.

Among other efforts targeted therapy known as the fight against drugs that block angiogenesis, the development of new blood vessels in cancer. Without blood vessels that carry oxygenated blood adequate cancer cells to die. Anti-angiogenic drug bevacizumab (Avastin) has recently been found to prolong survival in lung cancer in advanced stage when added to standard chemotherapy. Bevacizumab is administered intravenously every two to three weeks. However, since this medication may cause bleeding, is not suitable for use in patients who are coughing up blood, if lung cancer has spread to the brain, or those receiving anticoagulant therapy (diluent blood “) drugs. Avastin is also used in cases of squamous cell cancer, because it causes bleeding of this type of lung cancer.

Photodynamic therapy (PDT)

Therapy newer used for different types and stages of lung cancer (and some other cancers) is photodynamic therapy. In photodynamic therapy, an agent of photosynthesis (as a porphyrin, a naturally occurring substance in the body) is injected into the bloodstream of a couple of hours before surgery. Meanwhile, the deposition agent itself selectively in rapidly growing cells like cancer cells. Then follows a procedure in which the physician applies a certain wavelength of light through a handheld wand directly to the site of the cancer and surrounding tissues. Light energy activates the photosensitizing agent, causing the production of a toxin that kills tumor cells. PDT has the advantage to precisely target the cancer site, is less invasive than surgery and can be repeated on the same site if necessary. The disadvantages of PDT is that it is only useful in the treatment of cancers that can be achieved with a light source and is not suitable for the treatment of cancer spread. The investigation is ongoing to determine the effectiveness of photodynamic therapy in lung cancer.

Radio Frequency Ablation (RFA)

Radiofrequency ablation is studied as an alternative to surgery, especially in cases of lung cancer early. In this new type of treatment involves inserting a needle through skin cancer, usually under the direction of TC. Radiofrequency (electrical) energy is transmitted to the tip of the needle where it produces heat in the tissues, killing the cancerous tissue and the closure of small blood vessels that cancer feed. RFA is usually not painful and has been approved by the Food and Drug Administration of the United States to treat certain types of cancers including lung cancer. Studies have shown that this treatment may prolong survival similar to surgery, when used to treat early stage lung cancer, but without the risks of major surgery and prolonged recovery time associated with major surgical procedures .

The experimental treatments

As no treatment is currently available that is very effective in treating lung cancer, patients can offer a range of treatments that are still being tested, which means that doctors have not yet sufficiently d ‘information to decide if these treatments must be accepted forms of treatment for lung cancer. New drugs or new combinations of drugs are tested in the so-called clinical trials, which are studies that evaluate the effectiveness of new drugs, compared with treatments that are already widely used. Experimental treatment known as immunotherapy, are being considered that involve the use of vaccine-related therapies or other therapies that seek to use the body’s immune system to fight cancer cells.

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Lung Cancer Diagnosis Guide

What is the diagnosis of lung cancer ? Lung cancer doctors use a variety of diagnostic procedures and lung cancer tests to diagnose lung cancer. Some of lung cancer diagnosis (diagnóstico de cáncer de pulmón, La diagnosi di cancro al polmone, lungenkrebs diagnose, diagnóstico de cáncer de pulmón) are :

Physical and history examination

The history and physical examination may reveal the presence of symptoms and signs that, with suspected lung cancer. In addition, to inquire into the causes and risk factors for cancer such as smoking, doctors can detect signs of respiratory distress, airway obstruction or lung infection. Cyanosis, a bluish color of the skin and mucous membranes due to lack of oxygen in the blood, suggesting compromise of lung function. In addition, changes in the tissues of the nail, known as clubs, can also indicate lung disease.

Chest X-ray

Using Chest X-Ray is the most common first diagnostic step, when new lung cancer symptoms are present. Chest X-ray procedure often includes a view from the back of the front of the chest as well as the view from the outside. Like any X-ray procedure, chest X-rays expose patients below the minimum amount of radiation. In the chest X-rays can detect suspicious areas in the lungs, but can not determine if these areas are cancerous. In particular, calcified nodules in the lungs or benign tumors called hamartomas can be identified by chest radiography and simulate a lung cancer.

CT-Scan (computed tomography scan, or computed tomography)

Computed Tomography Scan, better know as CT-Scan can be performed in the chest, abdomen and / or to study the brains of primary and metastatic tumors. The CT scan may be ordered when a chest X-rays showed no abnormalities or does not provide sufficient information or the location of the tumor. CT X-ray procedures is to combine several images using a computer to produce cross-section view of the body. Photos taken large donut-shaped X-ray machine at various angles around the body. One advantage of CT is more sensitive than standard chest x-ray ray in detecting lung nodules. Sometimes intravenous contrast agent is given before the procedure helps to identify the bodies and their positions. CT exposes the patient to a minimal amount of radiation. The most common side effect is an adverse reaction to contrast material intravenously, which can be given before the procedure. There may be a result of itching, a rash, which usually disappear fairly quickly. Severe anaphylactic reactions (life-threatening allergic reactions with shortness of breath), in contrast to the material are rare. Abdominal CT scan can detect liver metastases or adrenal glands, and computed tomography of the head may be required to identify the presence and extent of metastatic brain cancer.

A technique called low-dose spiral CT (computed tomography or spiral)

CT Spiral, or computed tomography spiral is sometimes used for screening of lung cancer. This procedure requires a special type of scanner and shown to be an effective tool to identify lung cancer in smokers and former smokers. However, there has not been demonstrated that the use of this method actually saves lives and reduces the risk of death from lung cancer. Increased sensitivity of this method is actually one of the sources of its weaknesses, as it is easy nodules require further evaluation will be considered in approximately 20% of people with this technique. Nodules identified low-dose spiral transformer test, 90% not cancerous, but require up to two years of expensive and often difficult monitoring and verification. Trials conducted in order to determine more precisely the utility of spiral CT screening for lung cancer.

Magnetic resonance imaging (MRI)

Using MRI may be appropriate if the precise details on the whereabouts of the tumor is not necessary. Appliances Magnetic Resonance Imaging (MRI) uses magnetism, radio waves and a computer to produce images of body structures. Like CT, the patient is in bed furniture, which is inserted into the MRI. There are no known side effects of MRI, and no exposure. And the resolution of the image produced by MRI in detail and can detect small changes in the structure within the body. Persons with pacemakers, metal implants, artificial heart valves and other structures surgically implanted can not be scanned with MRI because of the risk that the magnet may move the metal parts of these structures.

Positron Emission Tomography (PET)

PET, or positron emission tomography is a specialized imaging technique that uses radioactive drugs short-term three-dimensional color images of these substances in the tissues in the body. Although CT and MRI to examine the anatomical structures and measure the metabolic activity of PET and functioning of tissues. PET can determine if the tumor tissue is actively growing and can help determine the type of tumor cells determined. In PET, the patient receives an average cut of radioactive drugs and about the amount of radiation in two chest X-ray. Drug discharges particles called positrons from wherever they are accepted and used in the body. As the positrons encounter electrons in the body, the reaction of gamma ray production occurs. The scanner records these gamma rays and map the area where radioactive drugs. For example, the combination of glucose (a common source of energy in the body) with radioactive materials will be displayed quickly when glucose is used, for example, the growing tumor.

Thoracentesis

Why thoracentesis can diagnose lung cancer? Sometimes lung cancer involving the lining of the lung tissue (pleura) and lead to accumulation of fluid in the space between the lungs and thorax (called pleural effusion). The desire of the fluid sample with a fine needle (thoracentesis) can detect cancer cells and to establish the diagnosis. As the needle biopsy, a small risk of pneumothorax associated with this procedure.

Bronchoscopy
Examination of bronchoscopy of the airways (Airways viewing through a thin fiber optic probe is inserted through the nose or mouth), can identify areas of tumor, which may be sampling ( biopsy) for diagnosis by the pathologist. A tumor in the central regions of mild or arising in connection with the large airways is available for sampling using this technique. Bronchoscopy can be performed with the fiber, rigid or flexible-optic bronchoscope and can be done in the office that day bronchoscopy suite, operating room or living room. The procedure can be uncomfortable and requires sedation or anesthesia. Although bronchoscopy is relatively secure, it must be done by lung specialists (pulmonologist or surgeon) with experience in this procedure. When the tumor is visualized and adequately sampled, accurate diagnosis of cancer, as a rule, is possible. Some patients may cough up blood, dark brown for a day or two after the procedure. The most serious complications, but rarely include more bleeding, reduced blood oxygen, and cardiac arrhythmia, and complications of sedation and anesthesia.

Sputum cytology

What is the sputum cytology? The lung-cancer diagnosis always requires confirmation of malignant cells pathologist, even when symptoms and X-ray studies with suspected lung cancer. The easiest way to establish the diagnosis of sputum examination under a microscope. If the tumor is located in the center and into the respiratory tract, this procedure is known as the examination of sputum cytology, may allow visualization of the tumor cells for diagnosis. This is the biggest risk diagnostic procedure for free and cheap material, but its value is limited because tumor cells can not always be present in sputum, even if cancer is present. Also, sometimes benign cells undergo changes in response to inflammation or trauma, which makes them look like cancer cells.

The Bone Scan

The bone scan is used to create images of bones on a film or computer screen. Doctors may order a bone scan to determine the lung cancer metastasis to bone. In the analysis of bones, a small amount of radioactive material is injected into the blood and accumulates in bones, especially in abnormal areas, such as those involved in the metastatic tumors. Radioactive material detected by the scanner and the image of the bones is recorded on special film for permanent display.

The needle biopsies

Fine needle aspiration (FNA) through the skin, most commonly performed with X-ray images for guidance, can be useful in extracting the cells for diagnosis of tumors of the lymph in the lungs. Needle biopsy is particularly useful for peripheral lung tumor in the lungs and is not accessible for sampling by bronchoscopy. A small amount of local anesthetic for the installation of a thin needle through the chest wall in the anomalous region in the lungs. The cells were sucked into the syringe and examined under the microscope of the tumor cells. This procedure is usually necessary when the tissue in the affected area is an adequate sample, but in some cases, the district or outside the field can easily be confused with the sample. Small risk (3% -5%) of air leaks in the lungs (called pneumothorax, which can be easily treated) accompanies the procedure.

The major surgical procedures

If none of these methods provides methods of diagnosis, surgery should be used to obtain tumor tissue for diagnosis. These may include mediastinoscopy (examination of the chest cavity between the lungs through a tube inserted into a surgical biopsy of tumor masses or lymph nodes that may contain metastases) or thoracotomy (surgical opening of the chest wall to remove or biopsy). At thoracotomy, is a rare opportunity to completely remove the lung, and both mediastinoscopy and thoracotomy entails risks of major surgical procedures (for complications such as bleeding, infection, and risks associated with anesthesia and drugs). These procedures are performed in the operating room and the patient should be hospitalized.

Blood tests

Although regular blood tests alone can not diagnose lung cancer can be identified biochemical and metabolic disorders in the body that accompany cancer. For example, elevated levels of calcium or alkaline phosphatase enzyme may accompany cancer, which is a bone metastasis. In addition, elevated levels of certain enzymes normally present in liver cells, including alanine aminotransferase (ALT or SGPT) and aspartate aminotransferase (AST or SGOT), signal liver damage, possibly due to the presence of metastases.

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Hepatic Cirrhosis Complication Symptoms and Signs Part 2

Previously, we have discussed about signs and symptoms of hepatic cirrhosis complications such as edema and ascites, spontaneous bacterial peritonitis (SBP), and Bleeding esophageal varices in Part 1. Now we will discuss the continuation of hepatic cirrhosis complication symptoms and signs such as hepatic encephalopathy, hepatorenal syndrome, hepatopulmonaire syndrome, hypersplenism and hepatocellular carcinoma (liver cancer) details as below.

Hepatic Encephalopathy

Some of the proteins in food that escapes digestion and absorption is used by bacteria normally present in the intestine. While the utilization of protein for their own purposes, bacteria that cause substances emitted in the intestine. These substances can be absorbed by the body. Some of these substances, eg ammonia, can have toxic effects on the brain. Normally, these toxic substances are transported from the intestine into the portal vein to the liver where they are eliminated from the blood and detoxification.

As mentioned above, when cirrhosis is present, liver cells can not function normally, either because they are damaged or because they have lost their normal relationship with the blood. In addition, some blood in the portal vein bypasses the liver through other veins. The result of these anomalies is that toxic substances can be removed by the liver cells, and instead, toxic substances accumulate in the blood.

When toxic substances accumulate sufficiently in the blood, brain function is disrupted, a condition called hepatic encephalopathy. Sleeping during the day instead of night (reversal of normal sleep pattern) is one of the first symptoms of hepatic encephalopathy. Other symptoms include irritability, inability to concentrate or perform calculations, memory loss, confusion, depression, or levels of consciousness. Ultimately, severe hepatic encephalopathy leading to coma and death.

Toxic chemicals also cause the brain of patients with cirrhosis very sensitive to drugs that are normally filtered and detoxified by the liver. The dose of many drugs that are normally liver detoxification should be reduced to avoid toxic accumulation in cirrhosis, particularly sedatives and drugs used to promote sleep. Alternatively, medications may be used which need not be decontaminated or disposed of the body by the liver, for example, drugs that are eliminated by the kidneys.

Hepatorenal Syndrome

Patients with cirrhosis can develop an intensification of hepatorenal syndrome. This syndrome is a serious complication in which kidney function is reduced. This is a malfunction in the kidneys, i.e. no physical damage to the kidneys. In contrast, the reduction function is due to changes in how blood flows through the kidneys themselves. Hepatorenal syndrome is defined as the progressive inability of the kidneys to clear substances from the blood and produce adequate amounts of urine, but some other important functions of the kidneys, such as salt retention are maintained. If liver function or a healthy liver is transplanted into a patient with hepatorenal syndrome, the kidneys usually start working normally. This suggests that reduced renal function is the result of accumulation of toxic substances in the blood when the liver fails. There are two types of hepatorenal syndrome. An error occurs gradually in recent months. The other is quickly over a week or two.

Hepatopulmonaire Syndrome

More rarely, some patients with advanced cirrhosis may develop hépatopulmonaire syndrome. These patients may have difficulty breathing because of certain hormones released in advanced cirrhosis causes the lungs to function abnormally. The fundamental problem in the lungs is not enough blood flows through tiny blood vessels in the lungs that are in contact with the alveoli (air sacs) of the lungs. The lung blood is diverted around the alveoli and can not collect enough oxygen in the alveoli. Consequently, the patient has trouble breathing, especially with exertion.

Hypersplenism

The spleen normally acts as a filter to remove more red blood cells, white cells and platelets (small particles that are important for blood clotting.). The blood that flows in the rate reaches the blood in the veins of the intestine. With increasing pressure in the portal vein in cirrhosis, which blocks blood flow further and further into the spleen. Blood “backs and accumulates in the spleen, the spleen and swell in size, a condition known as splenomegaly. Sometimes, the spleen is so swollen that causes abdominal pain.

As the spleen, cells from the blood leaks and more and more until the number of platelets in the blood are reduced. Hypersplenism is the term used to describe this condition, and is associated with a low number of red blood cells (anemia), low white blood cell count (leukopenia), and / or a low platelet count (thrombocytopenia). Anemia can cause weakness, infections can cause leukopenia, thrombocytopenia and may inhibit blood clotting and cause prolonged bleeding.

Hepatocellular Carcinoma ( liver cancer )

Cirrhosis due to a cause increases the risk of primary liver cancer (hepatocellular carcinoma). Principal means that the tumor originates in the liver. A secondary liver cancer is one that comes from other parts of the body and spread (metastasize) to the liver.

The most common symptoms and signs of primary liver cancer are abdominal pain and swelling, enlarged liver, weight loss, fever. In addition, cancers of the liver can produce and release a number of substances, including those that cause an increase in red blood cells (polycythemia), blood sugar (hypoglycemia) and high calcium levels (hypercalcemia).

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Signs and Symptoms of Hepatic Cirrhosis Complications

Patients with cirrhosis may have little or no liver disease symptoms and liver disease. Some cirrhosis symptoms may be nonspecific, i.e. not suggest that the liver is the cause. Among the most common symptoms and signs of cirrhosis, it’s include : itching, fatigue, loss of appetite, weakness, jaundice (yellowing of the skin) due to accumulation of bilirubin in the blood, and easy bruising of the decreased production of blood coagulation by the diseased liver.

Some cirrhosis patients also develop signs and symptoms of cirrhosis complications. The complications of cirrhosis such as edema and ascites, Spontaneous bacterial peritonitis (SBP), Bleeding esophageal varices described here, and Hepatic encephalopathy, Hepatorenal syndrome, Hepatopulmonaire Syndrome, Hypersplenism and Liver cancer (hepatocellular carcinoma) will be explained in part 2.

Edema and ascites

As liver cirrhosis is severe, the signals are sent to the kidneys retain salt and water in the body. The excess salt and water is first stored in the tissue under the skin of the ankles and legs due to gravity standing or sitting. This fluid buildup is called swelling or edema marks. (Fovea refers to the fact that the pressure of a finger firmly against the ankle or leg with edema causes bleeding in the skin that persists for some time after pressure release. In fact, any pressure, as the elastic of a sock, can be enough to cause pitting.) Swelling is often worse at the end of the day, after standing or sitting and may lower overnight due to the loss the effects of gravity on the position supine. As cirrhosis worsens and more salt and water is conserved, the fluid can also accumulate in the abdominal cavity between the abdominal wall and abdominal organs. This accumulation of fluid (called ascites) causes abdominal bloating, abdominal discomfort, and weight gain.

Spontaneous bacterial peritonitis (SBP)

Of fluid in the abdominal cavity (ascites) is the ideal place for bacteria to grow. Normally, the abdominal cavity contains a very small amount of liquid that is able to resist infection well, and bacteria that enter the abdomen (usually the intestine) are killed or find their place in the door and the liver vein, which killed. In cirrhosis, fluid accumulates in the abdomen can not normally resist infection. In addition, more bacteria find their way from the intestine into the ascites. Therefore, the infection within the abdomen and ascites, known as spontaneous bacterial peritonitis or SBP, is likely to happen. SBP is a potentially fatal complication. Some patients with PAS have no symptoms, while others may have fever, chills, abdominal pain, diarrhea, and worsening ascites.

Bleeding esophageal varices

In cirrhosis of the liver, scar tissue blocks the flow of blood to the heart of the intestines and increases the pressure in the portal vein (portal hypertension). When the pressure in the portal vein is large enough, which causes blood flow to the liver through the veins with less pressure to reach the heart. The most common veins through which blood passes through the liver are the veins along the lower esophagus and upper stomach.

Because of increased blood flow and thereby increasing the pressure, the veins of the lower esophagus, upper stomach and the expansion and then called esophageal and gastric varices, portal pressure, varicose veins more and more likely that a patient is bleeding from varices in the esophagus or stomach.

Bleeding varices are often severe and, without immediate treatment can be fatal. Symptoms of bleeding varices are vomiting blood (vomiting can be red blood mixed with clots or “coffee” in appearance, the latter due to the effect of acid in the blood), passage of stool that is black and tarry stools, due to changes in the blood that passes through the intestine mane () and dizziness or fainting hypotension (caused by a fall in blood pressure, especially when standing in the supine position).

It may also be bleeding from varices that form in other parts of the intestine, for example, the colon, but this is rare. For unknown reasons, patients hospitalized with active bleeding from esophageal varices are at high risk for spontaneous bacterial peritonitis.

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