Opinions on Cirrhosis

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Cirrhosis /sɪˈrsɪs/ is a condition in which the liver does not function properly due to long term damage. Typically the disease comes on slowly over years. Early on there is often no symptoms. As the disease worsens a person may become tired, weak, itchy, swelling in the lower legs, develop yellow skin, bruise easily, have fluid build up in the abdomen, or develop spider-like blood vessels on the skin. The fluid build up in the abdomen may become spontaneously infection. Other complications include hepatic encephalopathy, bleeding from dilated esophageal veins, and liver cancer. Hepatic encephalopathy results in confusion and possibly unconsciousness.

Cirrhosis is most commonly caused by alcohol, hepatitis B, hepatitis C, and non-alcoholic fatty liver disease. Typically more than two or three drinks per day over a number of years is required for cirrhosis to occur. Non-alcoholic fatty liver disease is due to a number of reasons including being overweight, diabetes, high blood fats, and high blood pressure. A number of less common causes include autoimmune hepatitis, primary biliary cirrhosis, hemochromatosis, certain medications, and gallstones. Cirrhosis is characterized by replacement of normal liver tissue by scar tissue. These changes lead to loss of liver function. Diagnosis is based on blood testing, medical imaging, and liver biopsy.

Some causes of cirrhosis such as hepatitis B can be prevented by vaccination. Treatment partly depends on the underlying cause. The goal is often to prevent worsening and complications. Avoiding alcohol is recommended. Hepatitis B and C may be treatable with antiviral medications. Autoimmune hepatitis may be treated with steroid medications. Ursodiol may be useful if disease is due to blockage of the bile ducts. Other medications maybe useful for complications such as swelling, hepatic encephalopathy, and dilated esophageal veins. In severe cirrhosis a liver transplant maybe an option.

Cirrhosis resulted in 1.2 million deaths in 2013 up from 0.8 million deaths in 1990. Of these alcohol caused 384,000, hepatitis C caused 358,000, and hepatitis B caused 317,000. 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 word cirrhosis is from Greek: κίρρωσις; neologism from kirrhos κιρρός "yellowish" and the suffix -osis (-ωσις) meaning "condition".

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