Cirrhosis of the liver

Cirrhosis of the liver

During the progression of liver cirrhosis the hepatocytes and liver lobules are destroyed. This causes the metabolic functioning of the liver to decline. The functional liver tissue is replaced by scar tissue, forming nodules that are wrapped with the scar tissue. As scar tissue is very fibrous, it essentially strangles the functional tissue. The constriction within the lobules of the liver then causes the flow of bile and blood to be restricted. The restriction of blood flow causes an increased pressure in the portal venous system (portal hypertension), due to the blood not having a free flow through the liver and into the inferior vena cava.

Alcoholic Cirrhosis

Alcoholic Cirrhosis is caused by an excessive amount of alcohol consumption over a long period of time. The metabolism of the liver is altered by alcohol and causes an increased production of triglycerides and fatty acids. This eventually leads to the hepatocytes being filled with fat, at this stage it is reversible.

Post-necrotic Cirrhosis

Post-necrotic cirrhosis or post-hepatic cirrhosis is an advanced liver disease which has been caused by chronic hepatitis B, chronic hepatitis C, or from a cause that is not known. 

Biliary Cirrhosis

Biliary cirrhosis is caused by a blockage in the flow of bile within the liver. The retention of bile destroys some of the functional liver tissue, namely near the bile ducts.

Treatment is multifaceted and is designed to slow down the progression of the disease.

Possible Diet Restrictions

• A restricted salt intake to help reduce fluid retention.

• Fluid restrictions, also to reduce fluid retention.

• Possible vitamin supplements including the B group vitamins and vitamins A, D and E.

Some Medications Used

• Diuretics to increase urine output.

• Laxatives to remove excess ammonia from the colon and bowel.

• Antibiotics if an infection is present.

• Beta blocker to lower hepatic venous pressure.

• Vitamin K, folic acid and ferrous sulphate for anaemia and to lower the bleeding risk.

Paracentesis

To reduce the amount of fluid accumulation in the peritoneal cavity (abdominal cavity) fluid is drawn out in a procedure called paracentesis. This can be done in an attempt to reduce shortness of breath the person may be experiencing due to extra pressure being placed on the lungs, or to reduce the ascites if diuretics are not working, or for diagnostic testing of the fluid. A doctor provides local anaesthesia and has the patient sitting up comfortably so that the organs are sitting towards the posterior of the body. The doctor then inserts a catheter or needle into the abdominal cavity to draw out the fluid.

Read more about liver cirrhosis.