Credits: NATSCI 112 students of Mrs. Luz Badoria

1. Cirrhosis of the Liver

2. What is a liver?
The liver weighs about 3 pounds and is the largest solid organ
in the body. It performs many important functions, such as:
Manufacturing blood proteins that aid in clotting, oxygen transport,
and immune system function
Storing excess nutrients and returning some of the nutrients to the
bloodstream
Manufacturing bile, a substance needed to help digest food
Helping the body store sugar (glucose) in the form of glycogen
Ridding the body of harmful substances in the bloodstream,
including drugs and alcohol
Breaking down saturated fat and producing cholesterol

3. What do you know
about Cirrhosis?

4.  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.
According to the National Institutes of Health, cirrhosis is
the 12th leading cause of death by disease.
What is Cirrhosis?

5. What Causes Cirrhosis?
Hepatitis C, fatty liver, and alcohol abuse are the most
common causes of cirrhosis of the liver in the U.S., but
anything that damages the liver can cause cirrhosis,
including:
 Fatty liver associated with obesity and diabetes
 Chronic viral infections of the liver
 Hepatitis types B, C, and D
 Hepatitis D is extremely rare

6. What Causes Cirrhosis?
 Blockage of the bile duct, which carries bile formed in the
liver to the intestines, where it helps in the digestion of fats; in
babies, this can be caused by biliary atresia in which bile
ducts are absent or damaged, causing bile to back up in the
liver. In adults, bile ducts may become inflamed, blocked, or
scarred, due to another liver disease called primary biliary
cirrhosis.
 Repeated bouts of heart failure with fluid backing up into the
liver

7. What Causes Cirrhosis?
Certain inherited diseases such as:
 Cystic fibrosis
 Glycogen storage diseases, in which the body is unable to process glycogen, a
form of sugar that is converted to glucose and serves as a source of
energy for the body
 Alpha 1 antitrypsin deficiency, an absence of a specific enzyme in the liver
 Diseases caused by abnormal liver function, such as hemochromatosis, a
condition in which excessive iron is absorbed and deposited into the
liver and other organs, and Wilson's disease, caused by the abnormal
storage of copper in the liver

8. Keep in Mind..!!
Although less likely,
other causes of cirrhosis
include reactions to
prescription drugs,
prolonged exposure to
environmental toxins, or
parasitic infections.

9. Take into Notice

11. Do People Who Drink A Lot of Alcohol Always Get
Cirrhosis of the Liver?
Most people who drink large amounts of alcohol
harm their livers in some way, but not all of these people
get cirrhosis of the liver. Women who are heavy drinkers
are at higher risk than men. People who have hepatitis
B or hepatitis C are more likely to suffer liver damage
from alcohol.

12. What Are the Symptoms of Cirrhosis?
The symptoms of cirrhosis of the liver vary with the stage of the illness. In the
beginning stages, there may not be any symptoms. As the disease worsens,
symptoms may include:
Loss of appetite
Weight loss or sudden weight gain
Bruises or Itchy skin
Yellowing of skin or the whites
of eyes (jaundice)
Fluid retention (edema) and swelling in
the ankles, legs, and abdomen
(often an early sign)
A brownish or orange tint to the urine
Light colored stools
Confusion, disorientation, personality
changes
Blood in the stool
Fever
Lack of energy (fatigue), which may
be debilitating

13. How is Cirrhosis Diagnosed?
1. Physical exam - During a physical exam, your doctor can observe changes in
how your liver feels or how large it is (a cirrhotic liver is bumpy and irregular
instead of smooth).
2. Blood tests - If your doctor suspects cirrhosis, you will be given blood tests to
find out if liver disease is present.
3. Biopsy - Your doctor may decide to confirm the diagnosis by taking a sample
of tissue (biopsy) from the liver.
4. Other tests. In some cases, other tests that take pictures of the liver are
performed, such as a computerized tomography (CT scan),ultrasound, or another
specialized procedure called a radioisotope liver/spleen scan.
5. Surgery. In some cases, cirrhosis is diagnosed during surgery when the
doctor is able to see the entire liver. The liver also can be inspected through a
laparoscope, a viewing device that is inserted through a tiny incision in the
abdomen.

14. What Complications Are Caused by Cirrhosis?
Complications associated with cirrhosis of the liver include:
 Variceal bleeding - is caused by portal hypertension, which is an
increase in the pressure within the portal vein (the large vessel that
carries blood from the digestive organs to the liver). This increase in
pressure is caused by a blockage of blood flow through the liver as a
result of cirrhosis. Increased pressure in the portal vein causes other
veins in the body to enlarge (varices), such as those in
the esophagus and stomach, to bypass the blockage. These varices
become fragile and can bleed easily, causing severe hemorrhaging and
fluid in the abdomen.

15. What Complications Are Caused by Cirrhosis?
 Confused thinking and other mental changes (hepatic
encephalopathy). Hepatic encephalopathy most often occurs
when cirrhosis has been present for a long time. Toxins produced
in our intestines are normally detoxified by the liver, but once
cirrhosis occurs, the liver cannot detoxify as well. Toxins get into
the bloodstream and can cause confusion, changes in behavior,
and even coma.

16. What Complications Are Caused by
Cirrhosis?
Other serious complications of cirrhosis of the liver include:
Kidney failure
Reduced oxygen in the
blood
Diabetes
Changes in blood counts
Increased risk of
infections
Excessive bleeding and
bruising
Breast enlargement in
men
Premature menopause
Loss of muscle mass

17. Most of these complications can initially be
treated with medicines or dietary changes. Once
treatment for these complications becomes
ineffective, a liver transplant is considered. Almost all
of the complications can be cured by liver
transplantation; however, in many circumstances,
careful management can reduce the harmful
effects of cirrhosis and delay or even prevent the
need for a liver transplant.
What Complications Are Caused by Cirrhosis?

18. What is the Treatment
for Cirrhosis?

19. Although there is no cure for cirrhosis of the liver, there are treatments
available that can stop or delay its progress, minimize the damage to liver
cells, and reduce complications. The treatment used depends on
the cause of cirrhosis of the liver.
1. For cirrhosis
caused by alcohol
abuse, the person
must stop drinking
alcohol to halt the
progression of
cirrhosis.

20. 2. If a person has hepatitis, the doctor may prescribe
steroids or antiviral drugs to reduce liver cell injury.
3. For people with cirrhosis caused by autoimmune
diseases, Wilson's disease, or hemochromatosis, the
treatment varies.

21. 4. Medications may be given to control the symptoms of cirrhosis.
 Edema (fluid retention) and ascites (fluid in the abdomen) are
treated, in part, by reducing salt in the diet. Drugs called
DIURETICS are used to remove excess fluid and to prevent edema
from recurring.
 Diet and drug therapies can help improve the altered mental function that
cirrhosis can cause. LAXATIVES such as lactulose may be given to help absorb
toxins and speed their removal from the intestines.

22. 5. Liver transplantation may be needed for some
people with severe cirrhosis.

24.  Don't abuse alcohol. If
you do drink alcohol,
limit how much you drink
and how often.

25.  Avoid high-risk
sexual behavior
such as unprotected
sexual contact with
multiple partners.

26.  Be careful around synthetic
chemicals, such as cleaning products
and pesticides. If you come into
contact with chemicals often, wear
protective clothing and a facemask.

27.  Get vaccinated
against hepatitis B

28.  Eat a well-balanced, low-fat diet high
in fruits and vegetables and take
vitamins.

29.  Maintain a healthy
weight, because
excess body fat can
cause fatty liver,
which may lead to
liver disease.

30. Current issues and researches
about Cirrhosis

31. Daily drinking increases risk of alcoholic
cirrhosis
Summary: Although alcohol is the most important risk factor of alcoholic
cirrhosis of the liver, less is known about the significance of different
patterns of drinking. Currently scientists believe that cirrhosis is a
function of the volume of alcohol consumed irrespective of patterns of
drinking. Investigators have now established that alcohol drinking
pattern has a significant influence on the risk of cirrhosis and that daily
drinking increases that risk compared with drinking less frequently.

32. Paternal alcohol problems, death from liver
disease, signal offspring risk for cirrhosis
Summary: While heavy drinking is known to lead to liver
cirrhosis, not all heavy drinkers develop the disease.
Variation in susceptibility may go beyond quantity of
alcohol to also involve genetics, gender, and obesity. New
findings show having a father with alcohol problems who
died from liver disease is a significant red flag.

33. Standard nursing assessments improve
ability to predict survival in cirrhosis
patients
Summary: Standard assessments that nurses already use
to care for patients can be mined for data that significantly
improve the ability to predict survival following liver
transplantation and may help improve patient outcomes, a
new study suggests.

34. Liver injury in non-alcoholic steatohepatitis
leads to a leaky gut
Summary: Non-alcoholic steatohepatitis (NASH), the more
severe form of non-alcoholic fatty liver disease that can
progress to liver fibrosis and cirrhosis, is associated with
leakiness of the intestinal wall, which in turn may worsen
liver disease, according to research.

35. Mouth, as well as gut, could hold key to
liver disease flare-ups
Summary: In a recent study, researchers predicted which
cirrhosis patients would suffer inflammations and require
hospitalization by analyzing their saliva, revealing a new
target for research into a disease that accounts for more
than 30,000 deaths in the United States each year.

36. Liver cirrhosis more common than
previously thought, study finds
Summary: Cirrhosis of the liver is more common than
previously thought, affecting more than 633,000 adults
yearly. And surprisingly, 69 percent of the adults identified
as possibly having cirrhosis may not know they have this
disease, researchers report.

37. To read the full articles, click
the hyperlink
Current issues and
researches about
Cirrhosis

38. Bibliography

39. American Gastroenterological Association. (2015, April 2). Liver injury in non-alcoholic
steatohepatitis leads to a leaky gut. ScienceDaily. Retrieved April 24, 2015 from
www.sciencedaily.com/releases/2015/04/150402101527.htm
Beth Israel Deaconess Medical Center. (2015, April 8). Standard nursing assessments
improve ability to predict survival in cirrhosis patients. ScienceDaily. Retrieved
April 24, 2015 from
www.sciencedaily.com/releases/2015/04/150408153740.htm
Virginia Commonwealth University. (2015, April 17). Mouth, as well as gut, could
hold key to liver disease flare-ups. ScienceDaily. Retrieved April 24, 2015
from www.sciencedaily.com/releases/2015/04/150417130724.htm
Alcoholism: Clinical & Experimental Research. (2015, April 14). Paternal alcohol
problems, death from liver disease, signal offspring risk for
Cirrhosis. ScienceDaily. Retrieved April 24, 2015 from
www.sciencedaily.com/releases/2015/04/150414212302.htm

40. Elsevier. (2015, January 26). Daily drinking increases risk of alcoholic
cirrhosis.ScienceDaily. Retrieved April 24, 2015 from
www.sciencedaily.com/releases/2015/01/150126083810.htm
Loyola University Health System. (2015, January 4). Liver cirrhosis more common
than previously thought, study finds. ScienceDaily. Retrieved April 24, 2015
from www.sciencedaily.com/releases/2015/01/150104152406.htm
Centers for Disease Control and Prevention. National Digestive Diseases Information
Clearinghouse. American Cancer Society. Reviewed by Jennifer Robinson,
MD on September 16, 2014. © 2014 WebMD, LLC. All rights reserved.
Retrived from April 8, 2015 from
http://www.webmd.com/digestive-disorders/cirrhosis-liver?page=3