Overview
Cirrhosis is a slowly progressing disease in which healthy liver tissue is replaced with scar tissue, eventually preventing the liver from functioning properly. The scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, hormones, drugs, and naturally produced toxins. It also slows the production of proteins and other substances made by the liver.
Symptoms may develop gradually, or there may be no symptoms. When symptoms do occur, they can include:
- Confusion or problems thinking
- Impotence, loss of interest in sex, and breast development (gynecomastia) in men
- Loss of appetite
- Nausea and vomiting
- Nosebleeds or bleeding gums
- Pale or clay-colored stools
- Small, red spider-like blood vessels on the skin
- Swelling or fluid buildup of the legs and in the abdomen
- Vomiting blood or blood in stools
- Weakness
- Weight loss
- Yellow color in the skin, mucus membranes, or eyes
- Hepatitis C infection (long-term infection)
- Long-term alcohol abuse
- Autoimmune inflammation of the liver
- Disorders of the drainage system of the liver (the biliary system), such as primary biliary cirrhosis and primary sclerosing cholangitis
- Hepatitis B (long-term infection)
- Medications
- Metabolic disorders of iron and copper (hemochromatosis and Wilson's disease)
- Nonalcoholic fatty liver disease (NAFLD) and nonalcoholic steatohepatitis (NASH)
All patients with cirrhosis can benefit from certain lifestyle changes, including:
- Stop drinking alcohol.
- Limit salt in the diet.
- Eat a nutritious diet.
- Get vaccinated for influenza, hepatitis A and hepatitis B, and pneumococcal pneumonia (if recommended by your doctor).
- Tell your doctor about all prescription and nonprescription medications, and any herbs and supplements you take now or are thinking of taking.
Other treatment options are available for the complications of cirrhosis:
- Bleeding varices -- upper endoscopy with banding and sclerosis
- Excess abdominal fluid (ascites) -- take diuretics, restrict fluid and salt, and remove fluid (paracentesis)
- Coagulopathy -- blood products or vitamin K
- Confusion or encephalopathy -- lactulose medication and antibiotics
- nfections -- antibiotics
A procedure called Transjugular Intrahepatic Portosystemic Shunt (TIPS) is sometimes needed for bleeding varices or ascites. When cirrhosis progresses to end-stage liver disease, patients may be candidates for a liver transplant.
Non-cancerous (benign) tumors are quite common and usually do not produce symptoms. Often, they are not diagnosed until an ultrasound, computed tomography (CT) scan, or magnetic resonance imaging (MRI) scan is performed. There are several types of benign liver tumors, including the following:
Hepatocellular adenoma: This benign tumor occurs most often in women of childbearing age. Most of these tumors remain undetected. Sometimes, an adenoma will rupture and bleed into the abdominal cavity, requiring surgery. Adenomas rarely become cancerous.
Hemangioma: This type of benign tumor is a mass of abnormal blood vessels. Up to five percent of adults have small liver hemangiomas that cause no symptoms. Treatment is usually not required. Sometimes, infants with large liver hemangiomas require surgery to prevent clotting and heart failure.
Cancerous (malignant) tumors in the liver have either originated in the liver (primary liver cancer) or spread from cancer sites elsewhere in the body (metastatic liver cancer). Most cancerous tumors in the liver are metastatic.
The following are the most common symptoms of a liver hepatoma. However, each individual may experience symptoms differently. Symptoms may include:
- Abdominal pain
- Weight loss
- Nausea
- Vomiting
- Large mass can be felt in upper, right part of abdomen
- Fever
- Jaundice – yellowing of the skin and eyes.
The symptoms of a liver hepatoma may resemble other medical conditions or problems. Always consult your physician for a diagnosis.
In addition to a complete medical history and physical examination, diagnostic procedures for a liver hepatoma may include the following:
Liver Function Tests: A series of special blood tests that can determine if the liver is functioning properly.
Abdominal ultrasound (Also called sonography): a diagnostic imaging technique, which uses high-frequency sound waves to create an image of the internal organs. Ultrasounds are used to view internal organs of the abdomen such as the liver, spleen, and kidneys and to assess blood flow through various vessels.
Computed tomography scan (CT or CAT scan): a diagnostic imaging procedure using a combination of x-rays and computer technology to produce cross-sectional images (often called slices), both horizontally and vertically, of the body. A CT scan shows detailed images of any part of the body, including the bones, muscles, fat, and organs. CT scans are more detailed than general x-rays.
Hepatic arteriography: X-rays taken after a substance in injected into the hepatic artery.
Liver biopsy: A procedure in which tissue samples from the liver are removed (with a needle or during surgery) from the body for examination under a microscope.
Physicians will be able to determine the right treatment for patients suffering from liver hepatoma based on:
- Age, overall health, and medical history
- Extent of the disease
- Tolerance of specific medicines, procedures, or therapies
- Expectations for the course of the disease
- Your opinion or preference
Treatment may include:
- Surgery: Surgery may be necessary to remove cancerous tissue, as well as nearby non- cancerous tissue. Total surgical removal of the liver lobe or removal of segments of the liver may be performed.
- Radiation Therapy: Radiation therapy uses high-energy rays to kill or shrink cancer cells.
- Chemotherapy: Chemotherapy uses anticancer drugs to kill cancer cells.
- Liver Transplantation: Transplant the whole liver with a new one from a donor.
Other Conditions & Treatments
- Acute Liver Failure (ALF)
- Alcoholic Liver Disease
- Hepatitis A & E
- Hepatitis B
- Hepatitis C
- Liver Tumour Cancer