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Cirrhosis - Progression Of Cirrhosis

liver patients alcohol hepatitis

Cirrhosis is a progressive disease. In cases of alcoholic cirrhosis, it begins with a condition called alcoholic fatty liver. In this condition, fat accumulates in the liver. The liver enlarges, sometimes to as much as 10 lb (5000 g), and appears yellow and greasy. Patients with this condition often have no symptoms beyond low blood sugar or some digestive upset. Some patients have more severe symptoms, such as jaundice (a condition caused by the accumulation of a yellowish bile pigment in the blood; patients with jaundice have yellow-tinged skin) and weight loss. Complete recovery is possible at this stage of liver disease if the patient abstains from alcohol.

The next stage in the progression of cirrhosis is often a condition called hepatitis. Hepatitis is a general term meaning inflammation of the liver. Hepatitis may be caused by alcohol, a virus, or other factors. In acute alcoholic hepatitis, the inflammation is caused by alcohol. Fibrous tissue is deposited in the liver, the liver cells degenerate, and a type of connective tissue called hyaline infiltrates the liver cells. Regardless of the cause, patients with hepatitis have serious symptoms, including general debilitation, loss of muscle mass, jaundice, fever, and abdominal pain. The liver is firm, tender, and enlarged. Vascular "spiders," or varicose veins of the liver, are present. Again, no definitive treatment is available, although some patients respond well to corticosteroids. General treatment for this condition includes treatment of symptoms and complications.

Acute alcoholic hepatitis often progresses to cirrhosis. In cirrhosis, the fibrous tissue and fat accumulation is prominent. Collagen is deposited around the veins of the liver, leading to impairment of blood flow. The liver cells degenerate further and die, leading to formation of nodules in the liver, and the liver atrophies (shrinks). Symptoms of cirrhosis include nausea, weight loss, jaundice, and esophageal varices. Gastrointestinal symptoms, such as diarrhea and gastric distention, are also features of cirrhosis. The mortality rate of cirrhosis is high. Five year survival of patients with cirrhosis is 64% for patients who stop drinking, and 40% for patients who continue to drink. Death results from kidney failure, coma, malnutrition, and cardiac arrest.


Treatment of cirrhosis depends on the type and cause. For patients with alcoholic cirrhosis, it includes general support, treatment of complications, a nutritious diet, and abstention from alcohol consumption. In selected patients, liver transplant may be indicated. Although the liver has a remarkable ability to regenerate, the damage that cirrhosis inflicts on the liver may be so severe that recovery is not possible. In cirrhosis caused by viral hepatitis, the use of experimental drugs has had some success.


Resources

Periodicals

Cohen, Carl, et. al. "Alcoholics and Liver Transplantation." Journal of the American Medical Association 265 (March 1991): 1299.

Hegarty, Mary. "The Good News (Preventing Cirrhosis of the Liver)." Health 5 (March-April 1991): 11.

Mann, Robert E.G. and Reginald G. Smart. "Alcohol and the Epidemic of Liver Cirrhosis." Alcoholic Health and Research World 16 (Summer 1992): 217.

Parrish, Kiyoko M., et al. "Average Daily Alcohol Consumption During Adult Life among Descendants with and without Cirrhosis: The 1986 National Mortality Followback Survey." Journal of Studies on Alcohol 54 (July 1993): 450.

Poynard, Thierry, et al. "Evaluation of Efficacy of Liver Transplantation in Alcoholic Cirrhosis by a Case Control Study and Simulated Controls." The Lancet 344 (August 1994): 502.


Kathleen Scogna

KEY TERMS

. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Acute alcoholic hepatitis

—Inflammation of the liver caused by excessive alcohol consumption.

Collagen

—A type of protein that comprises connective tissue; infiltrates the liver in cirrhosis.

Fatty liver

—A condition in which the liver accumulates fat due to excessive alcohol consumption.

Fibrous tissue

—Connective tissue composed primarily of collagen.

Hepatitis

—General inflammation of the liver; may be caused by viral infection or by excessive alcohol consumption.

Jaundice

—A condition in which a yellowish bile pigment increases in the blood; patients with jaundice have a characteristic yellow tinge to their skin.

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almost 2 years ago

Maybe this is what Michael should read instead of comparing symptoms.

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over 3 years ago

good.

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almost 6 years ago

Good brief content, helpful.