Cirrhosis

Cirrhosis is a disease of the liver in which bands of fibrous tissue form throughout the liver, causing the organ to become hardened and to have an irregular surface. The growth of these fibrous bands is associated with the death of many liver cells, whereas other areas of the liver undergo regeneration.

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Causes of Cirrhosis

Cirrhosis is a leading cause of death in people between the ages of 25 and 65. In the United States, cirrhosis is commonly associated with alcoholism. Although alcoholic cirrhosis has been attributed to the malnutrition frequently associated with alcoholism, it has been shown that alcohol itself can lead to an excess deposition of fat in the liver (fatty Liver), and this condition is often followed by cirrhosis.

Recent research has also shown that the toxins produced by some fungi that contaminate food in tropical areas may cause cirrhosis. Occasionally, viral hepatitis may also lead to cirrhosis, and a prolonged obstruction of the bile ducts may cause secondary biliary cirrhosis. A similar condition, known as primary biliary cirrhosis, is thought to be due to an autoimmune reaction in the liver, although the exact cause is unknown. Rare causes of cirrhosis include severe heart failure, hemochromatosis (a disorder of iron metabolism), and Wilson's disease (a disorder of copper metabolism).

Symptoms and Treatment of Cirrhosis

Cirrhosis begins with a loss of appetite and general weakness. The disease, especially the alcoholic form, can be arrested at an early stage if the patient's consumption of alcohol ceases.

If the disease is not arrested, signs of impaired liver function later develop. The most conspicuous of these is a yellowing of the skin (jaundice) due to the liver's inability to rid the body of bilirubin, a bile pigment normally removed from the blood by the liver. Spider-shaped marks appear on the skin. The patient may also have a tendency to bleed, due to the lack of clotting factors normally produced by the liver. In men, there may be a development of the mammary glands accompanied by a wasting away of the testicles and impotence with a loss of pubic and axillary hair.

Because the flow of blood through the liver is obstructed, it may bypass the liver through veins that become enlarged in the wall of the abdomen or along the esophagus. These veins may rupture, often causing death. In some cases, surgery may be used to shunt the flow of blood from the portal vein (which carries blood from the intestine to the liver) to the vena cava (which empties into the heart). If ascites (the accumulation of fluid in the abdomen) develops due to high blood pressure in the portal veins, it is treated by restricting the patient's intake of salt and administering diuretics (drugs that increase the production of urine). Mental abnormalities (including coma) may result from the liver's inability to detoxify harmful substances originating in the intestine. Antibiotics are administered in such cases.

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