Liver Cirrhosis and its Complications
The liver is an important organ in the human body as it is involve in a lot of chemical pathways and exchanges. The liver is involved in carbohydrate metabolism as it plays a role in glycogenesis, glycogenolysis and gluconeogenesis. It is also involved in the metabolism of lipids as it is involved in the synthesis of cholesterol and formation of triglycerides. It is also part in the production of coagulation factors which are part in the coagulation cascade. The liver is also part of digestion through the production of bile which aids in the digestion of fats. These are just some of the important liver functions of the body, there are still more that our liver can do.
Liver cirrhosis is defined as a condition wherein normal liver cells are being replaced with fibrotic tissues and regenerative nodules. This replacement will eventually lead to decreased liver mass and decreased in liver function. Liver cirrhosis is usually cause by chronic alcoholism, viral hepatitis infection like your hepatitis B and hepatitis C, fatty liver disease, biliary cirrhosis, metabolic disorders and some more. A damage liver would lead to irregularities in the different metabolic pathways it is involved. Let’s dig into liver cirrhosis and know its complications.
Complications of Liver Cirrhosis
Portal Hypertension – the liver is supplied by the portal vein and the hepatic artery. Liver cirrhosis could lead to an increase in pressure in the portal vein causing portal hypertension. The increase in pressure in the portal vein eventually lead to other complications of liver cirrhosis, your esophageal varices, ascites, bacterial peritonitis, splenomegaly, etc. This complications if left untreated are life threatening.
Esophageal Varices – an increased in the pressure in the portal vein will caused your esophageal vessels to swell up leading to varices. This varices have the tendency to rupture and cause massive upper GI bleeding which could send someone to hypovolemic shock. Treatment is aim at lowering portal vein pressure to also lower pressure in the esophageal vessels. Prophylactic clipping of esophageal varices can be done to patients who are high risk for rupture of their varices. Prompt blood transfusion and ligation of the bleeding varices should be promptly done when they rupture.
Splenomegaly – since the splenic vein is part in the formation of the portal vein, an increased in the pressure of the portal vein would revert back pressure to the splenic vein and eventually to the spleen. Impairment in the functions of the spleen can occur when portal hypertension sets in and usually manifests with left upper quadrant pain, palpable spleen, decreased in white blood cell count and platelets.
Ascites – is a complication of liver cirrhosis defined as the accumulation of fluid within the peritoneal cavity. Portal hypertension could add to the formation of ascites, and a derangement in protein levels could also lead to ascites. If left untreated, fluid in the abdominal cavity would eventually increase and cause abdominal distention and compression of other organs like your kidneys and your lungs. Ascites is usually removed by paracentesis.
Bacterial Peritonitis – massive ascites could lead to an infection in the peritoneal cavity term as bacterial peritonitis. When infection sets in, mortality for this patients are usually high. Sometimes in the setting of ascites, prophylactic antibiotics are usually given targeting bacteria that cause peritonitis.
Hepatic Encephalopathy – since one of the liver functions is to clear ammonia (toxic waste in the body), its damage would lead to build up of ammonia in the body. Increase in ammonia levels would lead to hepatic encephalopathy. Patient with hepatic encephalopathy are usually drowsy, difficult to arouse, confused, agitated, and with behavioral changes. These symptoms could be reverse once ammonia levels are decreased and the precipitating factor for the encephalopathy is treated.
Hepatorenal Syndrome – this is a syndrome wherein liver cirrhosis would eventually lead to renal failure. This usually manifests with increasing creatinine levels and decreasing urine output. Patients with hepatorenal syndrome usually have a high mortality rate.
Liver cirrhosis could also lead to bone disease, abnormality in blood and malnutrition. With this long list of complications, one should keep in mind to take good care of your liver so you want experience life threatening complications. Be a liver lover.
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.