It tends to occur after 10 or more years of heavy drinking. It is not clear why some people are more prone to their liver cells becoming damaged by alcohol and to developing cirrhosis.
There may be an inherited genetic tendency. Women who are heavy drinkers seem to be more prone than men to cirrhosis.
Persistent chronic infection with the hepatitis C virus causes long-term inflammation in the liver. This can eventually lead to liver 'scarring' and cirrhosis. Up to 1 in 5 people with chronic hepatitis C develop cirrhosis but this usually takes about 20 years or even longer from the initial infection. There are an estimated 30, people living with 'scarring' of the liver cirrhosis in the UK and at least 7, new cases being diagnosed each year.
The numbers of people living with both alcoholic cirrhosis and non-alcohol-related cirrhosis seem to be rising. In the early stages of the condition, often there are no symptoms. You can get by with a reduced number of working liver cells. However, as more and more liver cells die and more and more scar tissue fibrosis builds up, the liver:. Also, the scar tissue restricts the flow of blood through the liver. As the cirrhosis becomes worse, this causes back pressure in the portal vein known as portal hypertension.
The portal vein is the vein that takes blood from the gut to the liver - it contains digested foods. Increased pressure in this vein can cause swellings varices to develop in the branches of the vein in the lining of the gullet oesophagus and stomach. These varices have a tendency to bleed easily into the gut. If a bleed occurs, you may vomit blood or pass blood with your stools faeces.
A doctor may suspect, from your symptoms and a physical examination, that you have 'scarring' of the liver cirrhosis. For example, a doctor may detect that your liver is enlarged or that you are retaining fluid. A doctor may especially think of cirrhosis as a cause of your symptoms if you have a history of heavy alcohol drinking or have had a previous episode of hepatitis. Blood tests may show abnormal liver function. See the separate leaflet called Liver Function Tests for more details. To confirm the diagnosis, a small sample biopsy of the liver may be taken to be looked at under the microscope.
See the separate leaflet called Liver Biopsy for more details. The scarring of the liver and the damage to liver cells can be seen on a biopsy. If the underlying cause of the cirrhosis is not clear, further tests may be done to clarify the cause. For example, to check for antibodies to hepatitis viruses, to check for autoantibodies that may have attacked your liver cells, to look in a blood sample for excess iron or copper, etc.
The need for guidance
In general, once the damage is done the scarring is not able to reverse. Therefore, the aim of treatment is, if possible, to prevent further liver scarring or to slow the progression of the scarring process. Treatments that may be advised include the following. Whatever the cause of cirrhosis, you should stop drinking alcohol completely.
Drinking alcohol will increase the rate of progression of cirrhosis from whatever cause. Always tell your doctor or pharmacist that you have cirrhosis if you take any prescribed or over-the-counter medicines. Some medicines that are processed in the liver may need their dose adjusted if you have liver problems, or even should not be used at all. Some of the underlying causes of cirrhosis can be treated.
This may slow down, or halt, the progression of cirrhosis. For example:.
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Various treatments may be advised, depending on the severity of the cirrhosis and the symptoms that develop. A bleed from swellings varices - described above - is a medical emergency. The general rule is to consume roughly half your ideal body weight in ounces of water daily from a clean water source.
Each year, about , people die in the United States alone as a result of cigarette use, reports the Center for Disease Control and Prevention. One often-overlooked consequence of being overweight is fat buildup that accumulates around the liver and can lead to non-alcoholic fatty liver disease NAFLD. This disease refers to a wide spectrum of liver diseases that range from fatty liver to nonalcoholic steatohepatitis NASH , and cirrhosis, or permanent scarring of the liver as a result of chronic inflammation. Learn more about NASH and what to look at out for. The main problem lies with high fructose corn syrup, an extremely popular substance in the standard American diet SAD.
The majority of your liver functions happen at night, so indulging in heavy foods will only create more work for the organ—think those that contain margarine, shortening, or canola oil. You can find them in most baked goods, pre-packaged snacks like chips and microwave popcorn and fried foods. The liver is roughly triangular and consists of two lobes: a larger right lobe and a smaller left lobe. The lobes are separated by the falciform ligament, a band of tissue that keeps it anchored to the diaphragm.
A layer of fibrous tissue called Glisson's capsule covers the outside of the liver.
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This capsule is further covered by the peritoneum, a membrane that forms the lining of the abdominal cavity. Unlike most organs, the liver has two major sources of blood. The portal vein brings in nutrient-rich blood from the digestive system, and the hepatic artery carries oxygenated blood from the heart. The blood vessels divide into small capillaries, with each ending in a lobule.
Lobules are the functional units of the liver and consist of millions of cells called hepatocytes. The liver is classed as a gland and associated with many functions. It is difficult to give a precise number, as the organ is still being explored, but it is thought that the liver carries out distinct roles. Because of the importance of the liver and its functions, evolution has ensured that it can regrow rapidly as long as it is kept healthy.
This ability is seen in all vertebrates from fish to humans. The liver is the only visceral organ that can regenerate.
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It can regenerate completely, as long as a minimum of 25 percent of the tissue remains. One of the most impressive aspects of this feat is that the liver can regrow to its previous size and ability without any loss of function during the growth process. In mice, if two-thirds of the liver is removed, the remaining liver tissue can regrow to its original size within 5 to 7 days. In humans, the process takes slightly longer, but regeneration can still occur in 8 to 15 days - an incredible achievement, given the size and complexity of the organ.
Over the following few weeks, the new liver tissue becomes indistinguishable from the original tissue. This regeneration is helped by a number of compounds, including growth factors and cytokines.
Some of the most important compounds in the process appear to be:. An organ as complex as the liver can experience a range of problems. A healthy liver functions very efficiently. However, in a diseased or malfunctioning liver, the consequences can be dangerous or even fatal. Fascioliasis: This is caused by the parasitic invasion of a parasitic worm known as a liver fluke, which can lie dormant in the liver for months or even years. Fascioliasis is considered a tropical disease. Cirrhosis: This sees scar tissue replace liver cells in a process known as fibrosis.
This condition can be caused by a number of factors, including toxins, alcohol, and hepatitis. Eventually, fibrosis can lead to liver failure as the functionality of the liver cells is destroyed. Hepatitis: Hepatitis is the name given to a general infection of the liver, and viruses, toxins, or an autoimmune response can cause it. It is characterized by an inflamed liver.
Drinking too much alcohol
In many cases, the liver can heal itself, but liver failure can occur in severe cases. Alcoholic liver disease: Drinking too much alcohol over long periods of time can cause liver damage. It is the most common cause of cirrhosis in the world. Primary sclerosing cholangitis PSC : PSC is a serious inflammatory disease of the bile ducts that results in their destruction.
There is currently no cure, and the cause is currently unknown, although the condition is thought to be autoimmune. Fatty liver disease: This usually occurs alongside obesity or alcohol abuse. In fatty liver disease, vacuoles of fat build up in the liver cells.
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