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Cirrhosis

Cirrhosis, also known as liver cirrhosis or hepatic cirrhosis, is the impaired liver function caused by the formation of scar tissue known as fibrosis, due to damage caused by liver disease. Damage causes tissue repair and subsequent formation of scar tissue, which over time can replace normal functioning tissue leading to the impaired liver function of cirrhosis. Typically, the disease develops slowly over months or years. Early symptoms may include tiredness, weakness, loss of appetite, unexplained weight loss, nausea and vomiting, and discomfort in the right upper quadrant of the abdomen. As the disease worsens, symptoms may include itchiness, swelling in the lower legs, ascites (fluid build-up in the abdomen), jaundice, bruising easily, and the development of spider-like blood vessels in the skin. The fluid build-up in the abdomen may become spontaneously infected. Other serious complications include hepatic encephalopathy, bleeding from dilated veins in the esophagus or stomach, and liver cancer.Cirrhosis is most commonly caused by alcoholic liver disease, non-alcoholic fatty liver disease (NAFLD), chronic hepatitis B, and chronic hepatitis C. Typically, more than two or three alcoholic drinks per day over a number of years is required for alcoholic cirrhosis to occur. NAFLD has a number of causes, including obesity, diabetes, high blood lipid levels, and high blood pressure. A number of less common causes of cirrhosis include autoimmune hepatitis, primary biliary cholangitis, iron overload, certain hepatotoxic medications, and gallstones. Diagnosis is based on blood testing, medical imaging, and liver biopsy.Hepatitis B vaccine can prevent hepatitis B and the development of cirrhosis, but there is no vaccination against hepatitis C. There is no specific treatment for cirrhosis but many of the underlying causes may be treated by a number of medications that may slow or prevent worsening of the condition. Avoiding alcohol is recommended in all cases. Hepatitis B and C may be treatable with antiviral medications. Autoimmune hepatitis may be treated with steroid medications. Ursodiol may be useful if the disease is due to blockage of the bile ducts. Other medications may be useful for complications such as abdominal or leg swelling, hepatic encephalopathy, and dilated esophageal veins. In severe cirrhosis, a liver transplant may be an option.Cirrhosis affected about 2.8 million people and resulted in 1.3 million deaths in 2015. Of these deaths, alcohol caused 348,000, hepatitis C caused 326,000, and hepatitis B caused 371,000. In the United States, more men die of cirrhosis than women. The first known description of the condition is by Hippocrates in the 5th century BCE. The term cirrhosis was invented in 1819, from a Greek word for the yellowish color of a diseased liver.