- In Romania, more than 70,000 thousand adults suffer from liver cirrhosis, the statistics being on the rise, the specialists announce.
- Worldwide, more than 1.32 million deaths were caused by liver cirrhosis in 2017, according to the National Library of Medicine.
- We learn essential information for the prevention and treatment of liver cirrhosis from Dr. Gabriel Preda, specialist in Endoscopy-Gastroenterology at MedLife Constanța.
Liver cirrhosis, an often “hidden” disease that is often not discovered until it is too late, was responsible for the deaths of more than 1.32 million people in 2017, according to National Library of Medicineand of these deaths approximately two-thirds were recorded among men and about one-third among women.
In Romania, over 70,000 thousand adults suffer from cirrhosis of the liver, the statistics are increasing, he announces specialists.
Given the nature of the disease, which may not make its presence felt for years on end, it is important to know what liver cirrhosis is, what are the symptoms that should make us think, and what we can do to protect the health of the liver.
We learn essential information for the prevention and treatment of liver cirrhosis from Dr. Gabriel Preda, specialist in Endoscopy-Gastroenterology at MedLife Constanța.
Doctor, please explain to us what liver cirrhosis is.
Liver cirrhosis is the final stage of evolution of a chronic liver disease, namely a chronic liver disease, a chronic hepatitis, over decades.
Any aggressive factor on the liver, over time, in 20-30 years, can lead to liver cirrhosis.
It is manifested by the accumulation of fibrosis and the modification of the structure of the liver architecture, i.e. the formation of regeneration nodules, necrosis, local inflammation.
What are the causes of this disease?
The most common causes are alcohol consumption, viral hepatitis with B virus, Delta virus, C virus, while non-alcoholic causes include non-alcoholic steatohepatitis, respectively an attack on the liver caused by high cholesterol or blood sugar, diabetes and years of days.
There can also be rare diseases such as autoimmune hepatitis that can lead to liver cirrhosis. Or it can be primary biliary cholangitis, primary sclerosing cholangitis, Wilson’s disease, hemochromatosis, cardiac causes – heart failure that can eventually lead to cardiac cirrhosis, and others.
In our country, among the predominant causes are alcohol consumption, followed by viral causes, then nonalcoholic metabolic causes.
Often, cirrhosis of the liver is regarded as a hidden disease, its symptoms appearing quite late compared to the onset of the disease. What are the signals from the body that we need to pay attention to?
One of the signals that it is good to pay attention to is represented by appearance of yellow coloration in the eyes and skin, the so-called sclero-integumentary jaundice.
We also need to pay attention to calf swellingwhich can mean a cardiac cause, but also a liver-renal cause – are so-called lower limb edema.
In addition, some may appear vascular starsmore precisely, some red blood vessels, at the level of the chest, but sometimes they can also be on the face or back, or on the abdomen.
At the same time, the abdomen increases due to ascites fluid, that is, effectively, it increases in volume, being fluid in the abdomen.
Very importantly, one of the signals can be the fact that the man becomes confusedhe does not know the day in which he or the people around him are, he has memory problems, he reverses his sleep – he sleeps during the day, he does not sleep at night.
These are the main symptoms, to which are added problems with urination, and along the way certain complications can occur.
In addition, cirrhosis can manifest directly as a complication in the form of vomiting blood or black stoolsrespectively upper digestive hemorrhage.
At the same time, some patients may have non-specific symptomsconsisting of mild fatigue or mild abdominal pain.
How is the disease diagnosed?
There are several methods by which the disease can be diagnosed, the first step being imaging examinations, respectively ultrasounds.
Via ultrasoundsyou can see changes in the liver, changes in structure, changes in its outline (irregular outline), if there are nodules in the liver, if there is fluid in the abdomen.
The ANALYSISin the case of patients with this disease, there are changes at the level of TGO, TGP, cholestasis and other specific analyzes of the liver, which indicate increased values.
Also, when appropriate, more in-depth investigations can be done, such as examinations of computer tomograf (CT) or MRIwhich may indicate changes or a liver with a cirrhotic appearance.
Another investigation that is carried out in the case of these patients is upper digestive endoscopywhich indicate esophageal or gastric varices, that is, some vessels that fill, enlarge, increase in volume and can burst, which is one of the complications and one of the causes of mortality of cirrhosis.
The disease can also be diagnosed by puncture in the abdomen for the ascites fluid, which is collected for certain specific analyses.
Last but not least, there is also metoda fibroscan, fibromax. This method measures the density of the liver, is used occasionally and is recommended especially in the causes of viral hepatitis and cirrhosis. The method is very effective especially in the initial stage of the disease.
Is there a cure for liver cirrhosis?
Treatment depends on each individual case and the cause that produced the disease. It is necessary to stop the consumption of alcohol, the treatment of viral hepatitis B, C, D, the treatment of rare diseases, such as autoimmune hepatitis, for example.
Also, the final treatment, which is difficult to access in Romania, but not impossible, is liver transplantation. This is the only curative treatment, through which the patient can actually get rid of cirrhosis.
Depending on the cause, the disease can be kept under control with a diet – no salt, no fat, fried foods, minced meat, or other specific treatment recommended by the attending physician.
It is recommended to evaluate every six months, remove fluid if necessary, effectively treat the complications of the disease, depending on the state of the disease from one patient to another.
What are the complications of this disease?
One of the complications is represented by haptic encephalopathy: irritability, confusion, the person in question does not recognize the people around him, sleeps during the day, does not sleep at night, has a sluggishness – speaks hard, slowly, does not know what is happening. And this can progress to coma.
Another complication is upper digestive hemorrhage: rupture of esophageal or gastric varices, manifested by actual vomiting of red or black blood or black stools, which represent digested blood. All of these can lead to the person’s death.
Ascites itself is a manifestation, but, moreover, a complication of the disease: increase in volume by liquid of the abdomen – there are cases in which people reach tens of liters and then the liquid is removed with a needle, there is a specific treatment.
There is more hepatorenal syndrome – kidney damage caused by the stage of cirrhosis: diuresis, more precisely, the amount of daily urine is reduced. It is only treated in hospital and, unfortunately, there is a very high mortality.
Liver cancer – hepatocarcinoma – is another complication of cirrhosis. It is less common, but it does occur, especially with viral causes.
Jaundice it is also a complication and can reach spectacular values, the man can actually turn orange at some point.
There are other complications, including hepatopulmonary syndromebut this one, for example, is less common.
How can we prevent the occurrence of the disease or, better said, how can we take care of our liver?
In the case of alcohol consumption, it must be reduced to zero, even stopped, especially if we are talking about chronic hepatitis, cirrhosis.
Moreover, for any of the causes that can lead to cirrhosis, patients are advised to stop drinking alcohol.
In the case of viral hepatitis, they must be treated according to their cause, namely B, C or D.
Obese people, who have nonalcoholic liver cirrhosis, must lose weight, keep cholesterol, diabetes, triglycerides under control.
If we talk about rare causes, rare diseases, they are treated with corticosteroids or other forms of therapy.
Also, for the prevention of this disease, our diet is very important and it is good to keep in mind that we must consume the least amount of fried foods, fats, fatty meats, minced meat, sweets and, as I have already said above, of alcohol.
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This article is sponsored by MedLife.
*Dr. Gabriel Preda is an Endoscopy-Gastroenterology specialist at MEDLIFE CONSTANțA HYPERCLINIC, a multidisciplinary medical unit, where a team of 80 doctors works, covering over 30 specialties. The hyperclinic is equipped with a medical analysis laboratory, a medical imaging department with a 3 Tesla MRI, 2 analysis collection rooms, 1 small surgery room and 15 medical offices.
