Cirrhosis is a liver disease, characterized by a progressive destruction of liver cells (hepatocytes); these are then replaced with fibrous tissue, which gradually leads to hardening and less effectiveness of the organ. Clumps of small nodules give the cirrhotic liver a knobbly appearance.
Causes of Cirrhosis.
The most common cause of cirrhosis is alcoholism. The quantity of alcohol necessary to damage the liver varies with each individual, but it is generally accepted that drinking for ten years at the rate of five pints a day or ten single whiskies can cause cirrhosis.
Viral hepatitis (there are two types, A and B) can also lead to cirrhosis. The virus responsible may be transmitted in blood from hypodermic needles or blood transfusions, and in drinking contaminated water. Virus A virtually never causes cirrhosis.
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In mild cirrhosis there are usually no symptoms. The onset of the disease is gradual, and many of the symptoms are the result of toxic chemicals accumulating in the body. Internal bleeding, due to lack of clotting factors in the blood.
Brain function is impaired, bile accumulates in the skin causing severe itching, followed by jaundice and the contraction of the liver. The abdomen swells, and fine red lines caused by smaller veins, appear on the skin.
In men, the testicles may atrophy and breasts begin to grow as the liver is no longer able to cope with the small amounts of female hormone normally present in the body.
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In the worst cases of cirrhosis, death can result either from coma, or from bleeding, which is caused by the rupturing of the enlarged veins around the esophagus. When bleeding is torrential, the patient will die within minutes of the rupture.
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When the cause of the disease is alcohol abuse, then the treatment is abstinence. Protection against B virus hepatitis can be given by vaccination or on an emergency basis by an injection of gamma globulin, rich in antibodies against the virus.
Sufferers of viral hepatitis isolated until they are no longer infectious as demonstrated by blood tests and should abstain from alcohol for six to twelve months.
Once the cirrhotic process is established, there is no effective treatment, though diuretics and steroid drug therapy to build tissues might be used to protect liver.
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The liver cells possess a remarkable capacity to repair damage, but ultimately a point of no return is reached beyond which cell destruction outstrips cell replacement. Once the cirrhotic process is past this point, the disease progresses relentlessly, even if the original cause is removed, and death follows usually within ten years.
Frequently Asked Questions.
1. How much alcohol can I drink before I develop cirrhosis of the liver?
French experts estimate that the consumption of 40 g of pure alcohol a day for up to ten years will cause cirrhosis in most people. This is the equivalent of drinking five pints of beer, or ten whiskies, every day for that period of time. What matters is the total quantity of alcohol consumed: it makes little difference whether it is taken in the form of wine, whisky or beer.
2. I have been a heavy drinker for some time. How do I know whether I have damaged my liver?
There are usually no symptoms in mild cirrhosis, and simple blood tests will not indicate how much permanent damage has been done to the liver cells. The only certain way of making a diagnosis is to have a small piece of the liver examined under the microscope, and in your case this may not be necessary. Talk to your doctor about your problem and cut down your drinking. Better, stop altogether.
3. My father has been told that his heavy drinking has affected his liver. Is there any chance that it may recover?
This very much depends on the severity of the damage. Liver cells do possess a tremendous capacity to repair damage, but it is unlikely that a cirrhotic liver will be able to replace all the lost tissue. Once the cirrhotic process takes hold, the disease is irreversible regardless of whether the original cause is removed.
4. I had cirrhosis over a year ago and am now quite better. Can I start to drink again?
Certainly not if you truly have cirrhosis of the liver, regardless of the cause. The disease is not reversible and you should seek advice from your doctor if you feel you cannot control your drinking. If, however, you had a bout of jaundice without permanent damage due to hepatitis, you may resume drinking if your doctor says there is no serious risk involved.
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Although cirrhosis of the liver can develop after a bout of infectious hepatitis, it mostly affects heavy drinkers. If detected early enough, treatment can be effective.