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Liver Cirrhosis

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Liver Cirrhosis

Liver is the largest internal organ of our body with complex functions which are essential to sustain life.  Liver cirrhosis refers to scarring of liver due to chronic liver injury  resulting in abnormal liver function. It is one of the leading cause of illness and death in United States . Reversal of cirrhosis is possible at early stages following treatment of the underlying causes.

Cause-  Most common causes  are Hepatitis C, alcoholic  liver disease and non alcoholic liver disease.   Viruses, inherited disorders, drug-related injury and environmental toxin exposure can also contribute to liver cirrhosis. Left untreated, any disease that causes on-going (chronic) liver injury can lead to cirrhosis.

Symptoms- The signs and symptoms of liver cirrhosis may be absent or non-specific at early stages. Early non-specific symptoms include fatigue and itching. As scar tissue replaces healthy tissue and liver function worsens, a variety of liver-related symptoms may develop, which are jaundice )yellow discoloration of the skin and whites of the eyes), tea colored urine, signs of upper GI bleeding, abdominal distention from ascites, confusion due to hepatic encephalopathy.

Treatment:

Goal of treatment include- Treating the underlying cause of liver disease, preventing complications  of cirrhosis and treating symptoms

Whenever possible, the underlying cause of cirrhosis should be treated. Some conditions improve with medial therapy and treatment can improve or delay worsening of liver function. In some cases, patients may not tolerate treatments for their underlying liver disease because their cirrhosis is too advanced.

Prevent alcohol intake. Alcohol abstinence improves survival in alcoholic cirrhosis .

Vaccinations like Hep A and B who are not already immune can help prevent superimposed insults to liver. Yearly Influenza vaccine is also recommended . Medications that can damage the liver , Over the counter  medications  including Ibuprofen, Aleeve, Motrin ,  Tylenol , supplements, alcohol,  herbal remedies should be avoided. Medications might need dose adjustments or should be excluded entirely. Talk to your doctor regarding your medications.

Patients with cirrhosis are at increased risk of developing primary liver cancer, known as hepatocellular carcinoma. The risk for liver cancer is increased  in  people with Hepatitis C infection. Early detection of liver cancer leads to successful treatment of liver cancer. Your doctor may recommend  imaging studies like liver ultrasound, CT scan or MRI of your liver every 6 months, to detect liver tumors. A blood test called alpha-fetoprotein (AFP) may also be used to help detect tumors.

Some life style modifications and medications might be recommended  to help control symptoms from complications of cirrhosis. These may include:

  • Dietary salt restriction and diuretic medications (commonly known as “water pills”) are prescribed for the control of ascites and edema. In some cases, a small needle may be inserted into the abdominal cavity under local anesthesia to drain ascites fluid, a procedure known as a paracentesis.
  • Patients with ascites who have experienced prior episodes of infection in the fluid (spontaneous bacterial peritonitis) or who have a high risk of infection (based on laboratory analysis of the fluid) are given long-term oral antibiotic medication to prevent future episodes of infection.
  • Various medications may be prescribed for patients with hepatic encephalopathy. These include lactulose and/or certain types of oral antibiotics.
  • Patients with esophageal varices may be treated with blood-pressure reducing medications or treatment may be applied directly to the varices during an endoscopy.

In some cases your doctor may recommend the insertion of a TIPS shunt. The placement of a TIPS shunt is an invasive procedure. A TIPS shunt is a metal tube (also called a stent) placed within the liver under x-ray guidance through an incision in the jugular vein in the neck. A TIPS shunt works by decreasing the pressure against which blood must flow within the liver (that is to reduce portal hypertension). TIPS shunts are used to treat patients with severe difficulty with ascites or bleeding from varices that is not able to be controlled with medication or endoscopy. Not all patients should receive a TIPS shunt. TIPS shunt insertion has associated risks and the placement of TIPS shunt can lead to new or worsening hepatic encephalopathy.

Do you need treatment for Liver Cirrhosis? Call Gastroenterology Institute of Orlando, FL at 407-201-3686 to learn more about treatment!


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