Damaged livers form new tissue to heal themselves, but cirrhotic livers cannot regenerate properly because the tissue they make is fibrous, thus altering the liver structure.  X Research source  X Research source The early stages of cirrhosis can be reversed by treating the original cause, but the later stages are usually incurable and the only solution is liver transplantation. Untreated cirrhosis can lead to liver failure and / or cancer. When you learn to recognize the symptoms of cirrhosis, you can recognize such a condition in time, at a stage when it is still treatable.
Be aware of risk factors
Think about how much alcohol you drink. Alcohol damages the liver by blocking its ability to process carbohydrates, fats and proteins. When these substances accumulate in the liver in too high a concentration, the body can respond with reactive inflammation, which in turn causes jaundice, fibrosis or cirrhosis. However, excessive alcohol consumption alone is not enough to cause liver disease. Only 1 in 5 drinkers will get alcoholic jaundice and 1 in 4 will develop cirrhosis.
Men are considered “heavy drinkers” if they consume 15 or more units of alcohol per week. Women are considered alcoholics if they drink 8 or more units of alcohol a week.
Cirrhosis can occur even after you stop drinking. In addition, alcohol abstinence is recommended for all people who suffer from cirrhosis. This will support treatment and healing no matter what stage of cirrhosis you are at.
Although cirrhosis is more common in men, it is more common in women because of alcoholism.
Get tested for hepatitis B and C. Chronic hepatitis or viral damage can also result in cirrhosis over decades.
Risk factors for hepatitis B include unprotected sex, blood transfusions, and injecting drug use with a contaminated needle. This type of jaundice is much less common today due to vaccination in the developed world.
Risk factors for hepatitis C include needle-borne infections, blood transfusions, and piercings and tattoos.
Cirrhosis caused by jaundice type C is the most common reason for liver transplantation.
Keep in mind that there is a link between cirrhosis of the liver and diabetes. Approximately 15-30% of people with cirrhosis are diagnosed with “non-alcoholic steatohepatitis” (NASH) due to diabetes. Diabetes is also common in chronic hepatitis C – probably due to reduced pancreatic function.
Another cause of cirrhosis, often associated with diabetes, is hemochromatosis.
This disorder is manifested by the deposition of iron in the skin, heart, joints and pancreas. The deposited iron in the pancreas then leads to diabetes.
Consider your current weight. Obesity is linked to many health problems, from type 2 diabetes and heart disease to arthritis and stroke. Excess fat in the liver can then cause inflammation and damage to the liver, which develops into non-alcoholic steatohepatitis.
To find out if you have a healthy weight, find an online BMI (body mass index) calculator.
BMI calculators take into account your age, height, gender and weight.
Be aware of the risks associated with autoimmune diseases and heart disease. Be careful if you suffer from an autoimmune disease such as an inflammatory stomach disease, rheumatoid arthritis or a thyroid disorder. Although this condition does not in itself contribute to cirrhosis, it increases the risk of complications in other diseases that lead to cirrhosis. Heart disease is also a risk factor for non-alcoholic steatohepatitis, which later often leads to cirrhosis. What’s more, heart disease, which is associated with right heart failure, can cause blockage of the liver and thus cardiac cirrhosis.
Examine your family history. Some types of liver disease that cause cirrhosis are hereditary. Think about your family’s medical history and look for the following diseases that significantly increase the risk of cirrhosis:
Deficience alfa-1 antitrypsinu (AAT)
Recognize the symptoms
Learn to recognize the symptoms of cirrhosis. If you notice these symptoms, you should tell your doctor as soon as possible. He will then be able to make a professional diagnosis and start the treatment process immediately. If you are trying to find out if someone other than you has cirrhosis, be sure to involve that person in your assessments, because some symptoms cannot be recognized from the outside. Symptoms of liver cirrhosis include:
Fatigue or feeling tired
Easy to bruise or bleed
Swelling of the end parts of the hands and feet
Yellow skin and eyes (jaundice)
Anorexia or weight loss
Intense itching (pruritus)
Severe abdominal pain
Look for enlarged veins (whisks). This symptom is technically called angioma, cobweb nevus or telangiectasiasis. Whisks are abnormal, crowded veins that emanate from a central vein like a lesion. They usually appear on the torso, face and upper limbs.
To identify the whisks, press a piece of glass on the suspect area with the crowded veins.
The red dot in the middle will look as if it is pulsing – red when blood enters it, and then fades as the blood spills into the smaller veins.
Large and multiple whiskers are a symptom of more severe cirrhosis.
However, varicose veins also occur, for example, during pregnancy or severe malnutrition. Sometimes they have otherwise completely healthy people.
Examine your palms for redness. Palmar erythrema looks like scattered fields of redheads, appears on the palms of the hands and is caused by altered sex hormone metabolism. Palmar erythrema most often affects the outer edges of the palms along with the thumb and little finger, and the middle part of the palm remains unchanged.
Other possible causes of reddening of the palms are pregnancy, rheumatoid arthritis, overactive thyroid gland and hematopoietic disorders.
Notice any changes to your nails. Liver disease generally affects the skin, but if you notice your nails, you will get useful extra information. If pale, horizontal streaks or lines appear on your nails near the nail bed, this is due to the uneven production of albumin, which is only produced in the liver. When you squeeze the affected fingernail, the strips fade and disappear, and then they quickly return.
The so-called Terry symptom on the nails is manifested by the fact that approximately two thirds of the nail towards the bed is white. The remaining third towards the tip appears red. This symptom is also caused by incorrect albumin secretion.
Another symptom is roundness and / or enlargement of the nail bed and fingertip. In a very serious condition, the fingers may appear as drumsticks or hammers. This condition is most often associated with biliary tract cirrhosis.
Check the joints of the long bones for swelling. If you notice that your knees or ankles, for example, are likely to be swollen, this may be a sign of “hypertrophic osteoarthropathy”. The joints of the fingers and shoulders can also get arthritis. It is the result of chronic inflammation of the connective tissue surrounding the bone, which can be very painful.
Remember that the most common cause of long bone swelling is lung cancer, which must first be ruled out.
Make sure your fingers are not twisted. “Dupuytren’s contraction” is the thickening and shortening of the palm ligaments – the tissue that connects different parts of the palm. This leads to problems with the flexibility of the fingers, which remain permanently bent. This condition is most often seen on the little finger and ring finger, often accompanied by pain, itching and tension. One has difficulty grasping objects because the condition of the palm affects the grip strength.
Dupuytren’s contraction is very common in alcoholic liver cirrhosis and occurs in about one-third of all cases.
This symptom is also often seen in smokers, non-cirrhosis alcoholics, or people who work monotonously with their hands at work, as well as diabetics and patients with Peyronie’s disease.
In the case of men, make sure that solid tissue is present in the chest. Gynecomastia is the growth and thickening of the male mammary gland, which extends from the nipple outwards. This condition is caused by elevated levels of the hormone estradiol, and occurs in about two-thirds of patients with cirrhosis. Gynecomastia can easily be mistaken for pseudogynecomastia, but it is due to obesity and the amount of adipose tissue, not the growth of the breast.
To distinguish each other, lie on your back and place your thumb with your index finger on the side of each breast.
Slowly press your fingers towards you. Try to feel the firm, rubber-like tissue just below the nipple.
If you feel this tissue, it is gynecomastia. If you do not feel anything like this and the tissue is soft, it is pseudogynecomastia.
The formation in the millet can also occur in other diseases, such as cancer, but it is almost always deposited asymmetrically (ie not evenly directly under the nipple).
If you are a man, watch for signs of hypogonadism. Men with chronic liver problems may often experience a decrease in testorterone production. Symptoms of hypogonadism include impotence, infertility, loss of sexual appetite, and decreased testicles. The cause may be a testicular injury, or a problem with the hypothalamus or pituitary gland.
Notice the pain in the lower abdomen and bloating. This may be a sign of ascites, which is an accumulation of fluid in the peritoneal (abdominal) cavity. If fluids accumulate, you may also have trouble breathing.
Look at the lower abdomen and look for prominent veins. The so-called caput medusa is a condition in which the umbilical vein opens and blood flows from it back into the portal venous system. This results in blood being forced into the umbilical vein and subsequently into the veins of the lower abdomen. Because of this, the veins are very visible in this place. The name caput medusa gained this symptom because it resembles the head of the mythological Greek Medusa.
Think about whether you have bad breath. this is indicated by the so-called “fetor hepaticus”, a condition caused by the same high pressure behind the caput medusa and the so-called Cruveilhier-Baumgarten murmur. The cause of the odor is an increased amount of dimethyl sulfide, which causes high blood pressure.
The murmur subsides when the doctor flattens the veins that are in the area by applying pressure to the skin above the navel.
Note if you do not have yellow skin or whites of the eyes. It is a symptom caused by elevated bilirubin levels – this occurs when the liver is unable to process it effectively. Mucous membranes may also turn yellow and urine may appear darker.
Beware, yellowed skin can also be caused by excessive intake of carotenes, which is contained in carrots. However, carotene cannot color the whites of the eyes as bile can.
Test yourself or another for asterixis. Ask a person you think may have cirrhosis to stretch their arms straight in front of them, palms flat up. The hands begin to move and “slap” like bird wings.
Asterixis also occurs in uremia and severe heart failure
Ask for a professional diagnosis
Ask your doctor to check for changes in the size of your liver or spleen. On examination, the cirrhotic liver appears firm and nodular. Splenomegaly (enlarged spleen) is caused by high blood pressure that clogs the spleen. Both of these conditions are a symptom of liver cirrhosis.
Have a doctor check the Cruveilhier-Baumgarten murmur. most general practitioners do not control this symptom. It is a murmur made by the veins and can be heard with a stethoscope in the epigastric abdomen (upper part). Like the capusa medusa, it is caused by a problem with how the venous systems in the body are interconnected when there is high venous pressure.
The doctor will perform a so-called Valsalva maneuver – a technique that will increase the pressure in the lower abdomen. As a result, it recognizes any murmur better.
Allow your doctor to do blood tests for cirrhosis of the liver. The doctor will take your blood and have it tested in a laboratory for signs of cirrhosis. These tests may include:
Complete red blood cell tests for anemia, leukopenia, neutropenia and thrombocytopenia, which commonly – among other things – accompany cirrhosis.
Test for elevated serum aminotransferase enzyme levels, which may indicate alcoholic cirrhosis. In alcoholic cirrhosis, the AST / ALT level is usually higher than 2 2.
Measurement of aggregate bilirubin so that your level can be compared to an acceptable baseline. In the early stages of cirrhosis, the results may be normal, but as it worsens, bilirubin levels begin to rise. However, be aware that increasing bilirubin is a poor diagnostic tool in the early stages of bile duct cirrhosis.
Measurement of albumin value. Cirrhotic, failing livers are unable to synthesize albumin, leading to low levels of albumin. However, this symptom can also be observed in patients with heart failure, nephrotic syndrome, malnutrition and some intestinal diseases.
Other assays may include alkaline phosphatase, gamma-glutamyl transpeptidase (GGT), prothrombin, globulins, serum sodium, and hyponatremia.
Ask your doctor to perform visual tests. Examination of the body can reveal cirrhosis and is also useful in identifying associated complications such as ascites.
Ultrasound is a non-invasive and widely used test. The cirrhotic liver appears small and nodular on ultrasound. A typical finding in cirrhosis is a reduced right lobe and an enlarged left lobe. The nodules in the liver that appear on the ultrasound can be both malignant and non-malignant and need to be biopsied. Ultrasound can also detect an enlarged diameter of the portal vein or the presence of parallel veins that accompany portal hypertension.
Computed tomography is not routinely performed in cirrhosis because it provides the same information as ultrasound. In addition, it works with radiation and contrast media. If your doctor suggests this procedure, ask for another opinion and ask him or her the reasons for such an examination.
MRI is rarely used, mainly because of its high cost and the fact that some patients do not tolerate it – it is a relatively inconvenient and time-consuming examination. The low signal intensity in the T1 figures indicates an excess of iron due to hereditary hemochromatosis.
Only a biopsy can determine the final diagnosis. Symptom observations and blood tests are relatively reliable methods to confirm suspected cirrhosis. However, the only way to be sure if you have cirrhosis is to ask your doctor for a biopsy. After processing and testing a small liver sample under a microscope, the doctor can only determine the diagnosis with certainty.
Treatment of cirrhosis of the liver
Ask your doctor to suggest a suitable treatment. With a few exceptions, most mild to moderate cases of cirrhosis can be treated. If the patient has major gastrointestinal bleeding, severe infection or sepsis, renal failure, or a mental disorder, hospitalization is necessary.
If you have an affected liver, your doctor will probably advise you to avoid alcohol, drugs and medication. It depends on the specific medical condition of each patient. Even some herbs, such as mistletoe, can further damage the liver. Discuss all herbal / alternative treatments you are currently taking with you doctor.
Your doctor will also probably recommend vaccinations against pneumococcal diseases, influenza and jaundice type A and B.
The next step may be to draw up a professional plan for weight loss, exercise and optimal control of lipids and glucose (fats and sugars / carbohydrates).
Take the prescribed medication. As stated in previous sections of the article, cirrhosis can have many different causes. The medication your doctor prescribes will correspond exactly to your problem and will treat the specific cause (hepatitis B, hepatitis C, gallbladder cirrhosis, etc.), as well as the symptoms of cirrhosis and possible liver failure.
Be prepared for a surgical solution. Doctors do not always suggest surgery, but if you are concerned about some of the specific consequences of cirrhosis, they may recommend such a solution. The most common reasons for surgery are:
Varicose veins, or dilated vessels, which can be solved by so-called ligation (surgical strengthening of the vessel walls).
Ascites, which is the accumulation of fluid in the abdomen, which is solved by paracentesis, ie its suction.
Fulminant liver failure, rapid onset of encephalopathy (changes in brain function / structure within 8 weeks of diagnosis of cirrhosis). This condition already requires a liver transplant.
Hepatocellular carcinoma is a form of liver cancer. Attempts at treatment today include radiofrequency ablation, resection (surgical removal of the tumor), and liver transplantation.
Understand your prognosis. After being diagnosed with liver cirrhosis, people can usually expect 5-20 years of life with the disease with little or no symptoms. If severe symptoms or complications related to cirrhosis occur, death occurs within 5 years if there is no liver transplant.
Hepatorenal syndrome is one of the serious complications associated with cirrhosis. It means renal failure that develops in cirrhotic patients and requires treatment focused on it.
Hepatopulmonary syndrome, another serious complication, is a way of dilating blood vessels in the lungs of patients with liver disease. It causes shortness of breath and hypoxemia (low levels of oxygen in the blood). The only treatment option is a liver transplant.