Chronic liver disease and their development to becoming an liver cirrhosis

The most common cause for the liver cirrhosis is long-term alcohol abuse as well as virus infections (liver inflammation by a hepatitis virus B, C and D infection. But liver cirrhosis can also be triggered by chronic infections eg. congestion of the bile ducts, by an autoimmune process, by a chronic congestion of the venous blood of the liver as well as metabolic disorders like iron-storage and copper-storage disease, a special albumin insufficiency (α1-antitrypsin (A1AT)) or medication poisoning. Even a severe fatty liver due to overweight and wrong nutrition can lead to liver cirrhosis.

In the case of alcohol abuse an absolute abnegation is indicated and there are vaccines against hepatitis A and hepatitis B. Unfortunately, up to know there has no vaccine been developed against hepatitis C. Here we recommend absolute strict hygienic measurements when dealing with human products like blood, liquids, and sperm and so on…When it comes to other rarer causes a medical diagnose made in time is the only effective preventive measure. However, by finding the cause of infection a specific therapy for preventing the patient from liver cirrhosis can be initiated.

Exhaustion, fatigue, decreased resilience, lower performance level, at an advanced stage also jaundice, skin alterations, shaking, disorders of consciousness, less body hair, development of a male bosom. Alarming symptoms are the development of bowel water with an increasing bowel abdominal girth and an increasing bleeding tendency together with disorders of the coagulation metabolism.

Besides a thorough laboratory testing for diagnosing the liver cell necrosis as well as the liver dysfunction in coagulation and albumin metabolism also indirect parameters of the blood picture and the gall bladder metabolism give indications for the disease. Also a diagnosis of the tumour marker alpha-fetoprotein should absolutely not be forgotten in order to diagnose the development of liver cancer at an early stage of the disease (sensitivity of 70%). With a thorough ultrasound examination of the abdomen, structure, quality and size of the liver as well as the vessels and the surrounding organs can be evaluated. As patients with liver cirrhosis tend to suffer from varicose veins within the oesophagus, a gastroscopy has to be made regularly to diagnose the magnitude of the extension of the varicose veins and to verify also the bleeding tendency. The procedure with the highest diagnostic security is the puncture of the liver that is normally very uncomplicated and with a low risk for the patient, made by means of ultrasound navigated insertion of a hypodermic needle into the liver.

Only the underlying disorder and reason for the chronic liver damage that was leading to the cirrhosis is susceptible to any specific therapy. In addition, an absolute alcohol leave shall be adhered to, any medications should be firstly examined on having and liver toxic side effects and if so, should be avoided, a balanced nutrition with a orderly rhythm of life shall be observed. In some cases a liver transplantation is an option but this also depends on the causes of damage to the liver.

Complications:
Portal hypertension with collateral circulation and the development of varicose veins in the oesophagus but also in the area of the middle abdomen like spleen, gastric fundus, omphalic vein or haemorrhoids in the area of the anus. By means of the increased portal pressure, water is developing in the abdomen (oedema), however, this must be observed thoroughly because patients suffering from oedema tent to suffer from infections of the bowel water, the oesophagus stomach-vault bleeding out of varices together with a decreased blood clotting, neurological-psychiatric symptoms with progressive liver failure and an impairment of the handwriting and the coordination as well as a damage to the kidney with a rapid failure of the kidney function up to renal failure. Alterations to the marrow by a decrease of platelets often in connection with an enlarged spleen and finally the development of liver cell cancer (70% of patients suffering from liver cell cancer suffer from liver cirrhosis).