Posts Tagged ‘hepatic cirrhosis’

The Most Frequent Cirrhosis Causes

There are some causes of cirrhosis, such as alcohol, non-alcoholic fatty liver disease (NAFLD), cryptogenic cirrhosis, chronic viral hepatitis, Inherited disorders, primary biliary cirrhosis, primary sclerosing cholangitis, autoimmune hepatitis, biliary atresia, and cardiac chronic heart failure as cirrhosis causes problems.

• Alcohol cause hepatic cirrhosis

Alcohol is a very common cause of cirrhosis, especially in the western world. The development of cirrhosis depends on the amount and regularity of alcohol consumption. Chronic high levels of alcohol consumption for liver cell damage. Thirty percent of people drinking daily for at least eight to sixteen ounces of hard liquor or the equivalent of fifteen or more years will develop cirrhosis. Alcohol causes a range of diseases of the liver to be simple and uncomplicated fatty liver (steatosis), to more severe fatty liver with inflammation (nonalcoholic steatohepatitis or hepatitis), cirrhosis.

• Non-alcoholic Fatty Liver Disease (NAFLD)

NAFLD, better known as Non-Alcoholic Fatty Liver Disease refers to a broad spectrum of liver diseases such as alcoholic liver disease, ranging from simple steatosis to non-alcoholic steato-hepatitis (NASH) to cirrhosis. All stages of NAFLD have in common the accumulation of fat in liver cells. The term is used because NAFLD nonalcoholic occurs in people who do not consume excessive amounts of alcohol, however, in many respects, the microscopic image of non-alcoholic fatty liver is similar to what can be seen in liver disease caused by excessive alcohol consumption. Is NAFLD associated with a condition called insulin resistance, which in turn is associated with metabolic syndrome and type 2 diabetes mellitus. Obesity is a major cause of insulin resistance, metabolic syndrome, type 2 diabetes. NAFLD is the most common liver disease in the United States and is responsible for 24% of all liver diseases. In fact, the number of livers that are transplanted from non-alcoholic fatty liver, cirrhosis is related to the increase. The public health administrators that the current epidemic of obesity dramatically increases the development of nonalcoholic fatty liver and cirrhosis in the population.

• Cryptogenic cirrhosis (cirrhosis due to unidentified causes)

Cirrhosis due to unidentified causes, better known as Cryptogenic-Cirrhosis is a common reason for liver transplantation. It’s called cryptogenic cirrhosis because for years doctors have been unable to explain why a proportion of patients with cirrhosis developed. Doctors now believe that cryptogenic cirrhosis due to NASH (nonalcoholic steatohepatitis) caused by long-standing obesity, type 2 diabetes and insulin resistance. The fat in the liver of patients with NASH is estimated to disappear with the onset of cirrhosis, and this makes it difficult for physicians to establish the link between NASH and cryptogenic cirrhosis long. An important clue leading to NASH cryptogenic cirrhosis is the discovery of a large number of Nash in the new liver of patients undergoing liver transplantation in cryptogenic cirrhosis. Finally, a French study suggests that patients with NASH have a similar risk of developing cirrhosis patients with long-term infection with hepatitis C. (See below). However, it is expected that progression to cirrhosis from NASH to be slow and the diagnosis of cirrhosis is usually performed in patients in the sixties.

• Chronic Viral Hepatitis

Viral hepatitis chronic is a condition where chronic hepatitis B or chronic hepatitis C affects the liver for years. Most patients with viral hepatitis develop chronic hepatitis and cirrhosis. For example, most patients infected with hepatitis A recover completely within a few weeks without developing chronic infection. However, some patients infected with hepatitis B and most patients infected with hepatitis C develop chronic hepatitis, which in turn leads to progressive liver disease leading to cirrhosis and sometimes liver cancer.

• Inherited (genetic) disorders

Inherited genetic disorders that cause the accumulation of toxic substances in the liver, leading to tissue damage and cirrhosis. Examples include the abnormal accumulation of iron (hemochromatosis) or copper (Wilson’s disease). In hemochromatosis, patients inherit a tendency to absorb too much iron from food. Over time, iron accumulation in various organs in the body causes cirrhosis, arthritis, heart muscle damage leading to heart failure, and testicular dysfunction causing loss of sexual appetite. Treatment aims to prevent organ damage from the removal of iron in the body by bleeding (blood removal). In Wilson’s disease, is an inherited abnormality in one of the proteins that control copper in the body. Over time, copper accumulates in the liver, eyes and brain. Cirrhosis, tremor, psychiatric disorders and other neurological disorders occur if the condition is not treated quickly. Treatment with oral medication that increases the amount of copper from the body in urine.

• Primary biliary cirrhosis (PBC)

PBC, better known as Primary Biliary Cirrhosis is a liver disease caused by abnormal immune system that is predominantly female. Abnormal immunity in PBC causes chronic inflammation and destruction of small bile ducts in the liver. The bile ducts are the passages in the liver, bile travels to the intestine. Bile is a liquid produced by the liver that contains substances necessary for digestion and absorption of fat in the intestine, and other compounds that are waste products such as bilirubin, a pigment. (Bilirubin is produced by the breakdown of hemoglobin in red blood cells.). Along with the gallbladder, bile ducts form the biliary tract. In the PBC, the destruction of small bile duct blocks the normal flow of bile into the intestine. As the inflammation continues to destroy more of the bile ducts, also extends to destroy liver cells nearby. That the destruction of hepatocytes of products, the scar tissue (fibrosis) forms and propagates in the areas of destruction. The combined effects of ongoing inflammation, scarring, and the toxic effects of waste accumulation leads to cirrhosis.

• Primary sclerosing cholangitis (PSC)

PSC, better known as Primary Sclerosing Cholangitis is a rare disease that occurs frequently in patients with ulcerative colitis. In the PSC, the large bile ducts outside the liver become inflamed, narrowed and blocked. Outflow obstruction of the bile duct in biliary tract infections and jaundice, and eventually causes cirrhosis. In some patients, bile duct injury (usually after surgery) can also cause obstruction and cirrhosis of the liver.

• Autoimmune hepatitis

Autoimmune hepatitis is a liver disease caused by abnormal immune system that occurs most often in women. The abnormal immune activity in autoimmune hepatitis resulting in inflammation and progressive destruction of liver cells (hepatocytes), which eventually leads to cirrhosis.

• Babies can be born without bile ducts (biliary atresia)

Biliary atresia, also known as infant can be born without bile ducts and eventually develop cirrhosis. Other babies are born without enzyme vital for control of sugar that leads to the accumulation of sugars and cirrhosis. On rare occasions, the absence of a specific enzyme can cause cirrhosis and scarring of the lungs (alpha-1 antitrypsin deficiency).

• Other less common causes of cirrhosis include unusual reactions to certain drugs and exposure to toxins, and chronic heart failure (cardiac cirrhosis)

In some parts of the world (especially North Africa), infection of the liver parasites (schistosomiasis) is the most common cause of liver disease and cirrhosis.

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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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Hepatic Cirrhosis Problems for Patients

Do you know that liver is an important organ in the body? It serves many critical functions, which both produce substances the body needs, for example, coagulation of proteins needed for blood to clot, and removing toxic substances that may be harmful to the the body for example, drugs. The liver also plays an important role in regulating the supply to the body of glucose (sugar) and lipids (fats), your body uses as fuel. To perform these critical functions, the liver cells are functioning normally and have an intimate relationship with blood and the substances that are added or removed by the liver, are transported to and from the liver through the blood.

The ratio of liver to blood is unique. Unlike most organs in the body, only a small amount of blood supplied to the liver through the arteries. Most liver supply of blood comes from the intestinal veins return blood to the heart. The main vein that returns blood from the intestine is called the portal vein. That the portal vein through the liver, the veins have been divided into smaller and smaller. The smaller veins (called sinusoids because of its unique structure) are in close contact with liver cells. In fact, the liver cell line along the length of the sinusoids. This close relationship between liver cells and blood of the portal vein allows liver cells to remove and add substances in the blood. Once the blood has passed through the sinusoids, it is collected in the veins become larger and eventually to form a single vein, hepatic vein that returns blood to the heart.

In hepatic cirrhosis (also known as la cirrosis hepática, cirrosi epatica, cirrhose hépatique), it destroys the relationship between blood and liver cells. Although liver cells that survive or are newly formed, may be able to produce and eliminate substances in the blood are not normal, intimate relationship with the blood, which interferes with the ability of liver cells “for add or remove substances in the blood. In addition, the cirrhotic liver scarring obstructs the flow of blood through the liver and liver cells. Because of the obstruction to blood flow in the liver, blood “Returns” in the portal vein, and increases the pressure in the portal vein, a condition called portal hypertension. Due to the obstruction to flow and high pressure in the portal vein, blood from the portal vein to veins other than return to the heart, veins with lower pressures that pass through the liver. Substances Unfortunately, the liver is unable to add or remove the blood flowing through it. It is a combination of reduction in the number of liver cells, loss of normal contact between the blood through the liver and liver cells and blood bypassing the liver which leads to many manifestations of cirrhosis.

A second reason for the problems caused by the cirrhosis altered the relationship between liver cells and the channels through which the flow of bile. Bile is a liquid produced by the cells of the liver has two important roles in digestion and helps remove and eliminate toxic substances from the body. The bile produced by liver cells is secreted in very small channels that run between the cells of liver sinusoids, called canaliculi. The canaliculi drain into small ducts which then merge to form ducts of larger and larger. Ultimately, all channels combined in a tube that enters the small intestine. Thus, the bile into the intestine, where it can help to digest food. Meanwhile, the toxic substances contained in bile in the intestine and then excreted in feces. In cirrhosis, the tubules are abnormal and the relationship between liver cells and canaliculi is destroyed, as the relationship between liver cells and blood in the sinusoids. Consequently, the liver is unable to eliminate toxic substances that normally, and can accumulate in the body.  To a lesser extent of digestion in the intestine is also reduced.

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Definition and Question About Cirrhosis

This is cirrhosis definition, some people ask what’s liver cirrhosis ? Cirrhosis is a complication of many liver diseases characterized by a structure and abnormal liver function. Cirrhosis of the liver in United Kingdom or United States, also known as liver cirrhosis, liver fibrosis, hepatic cirrhosis, Cirrhose du foie en France, Cirrosi epatica in Italia, Leberzirrhose in Deutschland, Cirrose van de lever in Nederland, цирроз печени в России, la cirrosis del hígado en España, Türkiye’de karaciğer sirozu.

The diseases that cause cirrhosis do so because they injure and kill liver cells, and inflammation and repair that is associated with liver cells die causes scarring. Liver cells do not die, they multiply in an attempt to replace cells that have died. The resulting newly formed groups of liver cells (regenerative nodules) in scar tissue.

There are many causes of cirrhosis, they include chemicals (such as alcohol, fat, and certain drugs), viruses, toxic metals (such as iron and copper accumulate in the liver following genetic diseases), and autoimmune disease of the liver, which attacks the immune system attacks the body in the liver.

I will give explanation more detail at next articles about hepatic cirrhosis (liver cirrhosis), also cirrhosis signs and symptoms, liver fibrosis treatment, hepatic fibrosis diagnosis and causes, prevention from liver cirrhosis also hepatic cirrhosis doctor, hospital, also medical center.

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