Liver Cirrhosis and its Causes
The liver occupies the right upper quadrant of the abdomen and extends up to the 5th intercostal space for this right margin and it usually weighs 1.8 kg in men and 1.4kg in women. The liver has many roles in our body from carbohydrate metabolism, clotting factors and protein metabolism. One could imagine if the liver will fail and all it’s work are halted; the whole body would malfunction and eventually lead to its demise.
Liver cirrhosis is a pathologic condition characterized by development of fibrosis in the liver to the point the liver could not regenerate and formation of regenerative nodules. These changes in the liver would lead to decrease liver mass, decrease in its blood flow and eventually decrease in liver function. Long time ago it has been thought that liver cirrhosis is irreversible, but recent developments have shown that when the underlying cause has been removed there could be a possibility of reversing the fibrosis. In line with these, knowing the different causes of liver cirrhosis is essential in the treatment of this life-threatening disease.
Cause of Liver Cirrhosis
Alcoholism – excessive and chronic alcohol intake could be devastating to the liver. It could cause fatty liver, alcoholic hepatitis and alcoholic cirrhosis. Statistics have shown that more than two-thirds of adults drink alcohol each year, 30% had a drinking binge within the past month and a big 7% of adults consume more than 2 drinks per day. With this statistical numbers, a lot are at risk of developing alcoholic liver cirrhosis. In patients with alcoholic liver cirrhosis, abstinence from alcohol intake have shown to improve prognosis.
Viral Hepatitis – Chronic hepatitis B and hepatitis C infection are risk factors for having liver cirrhosis. Patients with liver cirrhosis secondary to viral hepatitis usually present with the common symptoms of chronic liver disease like fatigue, body malaise, vague abdominal pain (right upper quadrant) and laboratory abnormalities. Aside from treating the hepatitis infection, it should also focus on the complications present in the patient.
Autoimmune Hepatitis – patients with autoimmune hepatitis could eventually develop liver cirrhosis. Patients should have positive autoimmune markers to clinch the diagnosis for this type of liver cirrhosis. Immunosuppresive therapy could be beneficial for patients with autoimmune hepatitis, liver cirrhosis, and active inflammation.
Non Alcoholic Fatty Liver Disease – patients with non-alcoholic fatty liver disease are usually associated with obesity. Patients with non-alcoholic fatty liver disease would eventually lead to fibrosis and eventually to liver cirrhosis. Treatment of this type of liver cirrhosis is similar to other forms of liver cirrhosis.
Biliary Cirrhosis – this type has pathologic features different from alcoholic liver cirrhosis but has the same manifestations. Major causes of biliary cirrhosis are primary biliary cirrhosis (PBC), autoimmune cholangitis (AIC), primary sclerosing cholangitis (PSC), and idiopathic adulthood ductopenia
Cardiac Cirrhosis – patients who have right sided heart failure could develop liver cirrhosis. However cases with this cause have decreased in number due to advances in the treatment of heart failure.
Other Causes of Cirrhosis – other causes of liver cirrhosis include hemochromatosis, Wilson’s disease, Alpha 1 antitrypsin deficiency and cystic fibrosis.
Sleisenger & Fordtran's Gastrointestinal and Liver Disease, 8th ed
Harrison’s Principles of Internal Medicine 18th ed
The liver is involved in many pathways in the body making it a vital organ in the body. With liver cirrhosis, its functions are altered and a long list of complications usually set in. Knowing and understanding the complications would help you against this disease.