Cirrhosis of the liver 

Overview  

Cirrhosis of the liver is a severe form of liver disease that occurs when the liver’s healthy tissue is gradually replaced by scar tissue. This condition can arise from various liver diseases and factors, such as chronic alcoholism or hepatitis. 

Whenever the liver is harmed, whether by excessive alcohol consumption or other factors like infections, it attempts to repair itself, leading to the formation of scar tissue. As cirrhosis progresses, more scar tissue forms, hampering the liver’s ability to function properly. Advanced cirrhosis can be life–threatening. 

The liver damage caused by cirrhosis is generally irreversible. However, if cirrhosis is detected early and its underlying causes are treated, further damage can be limited. In rare cases, it may be reversed. 

Symptoms  

Cirrhosis often develops without noticeable symptoms until significant damage to the liver has occurred. When symptoms do appear, they may include: 

• Tiredness. 
• Reduced appetite. 
• Nausea. 
• Accumulation of abdominal fluid (ascites). 
• Swelling (edema) in the legs, feet, or ankles. 
• Unexplained weight loss. 
• Red palms. 
• Itchy skin. 
• Jaundice, evident from yellowing of the skin and eyes. 
• Pale fingernails, particularly in the thumb and index finger. 
• Spider–like blood vessels on the skin. 
• Confusion, drowsiness, or slurred speech. 
• Fingers becoming rounder at the tips (clubbing). 
• Irregular or absent periods unrelated to menopause in females. 
• Diminished sex drive, testicular shrinkage, or breast enlargement (gynecomastia) in males. 
• Increased tendency to bleed or bruise. 

If you notice any of these symptoms, it’s advisable to make an appointment with a healthcare provider.  

Causes  

Cirrhosis, characterized by liver damage, can result from a variety of diseases and factors. Some of these contributing factors include: 

• Persistent viral hepatitis (hepatitis B, C, and D). 
• Prolonged and excessive alcohol consumption. 
• Nonalcoholic fatty liver disease, where fat accumulates within the liver. 
• Hemochromatosis, leading to an excess of iron in the body. 
• Autoimmune hepatitis, an immune system–triggered liver ailment. 
• Cystic fibrosis. 
• Abnormal bile duct development, referred to as biliary atresia. 
• Inherited disorders affecting sugar metabolism, like galactosemia or glycogen storage disease. 
• Alagille syndrome, an inherited digestive disorder. 
• Damage to bile ducts due to primary biliary cholangitis. 
• Fibrosis and narrowing of bile ducts caused by primary sclerosing cholangitis. 
• Wilson’s disease, characterized by copper accumulation in the liver. 
• Alpha–1 antitrypsin deficiency. 
• Infections like syphilis or brucellosis. 
• Certain medications, including methotrexate or isoniazid. 

Risk factors  

Several risk factors may contribute to a higher risk of cirrhosis, such as:  

• Age: People over the age of 50 are at a higher risk of this condition.  
• Excessive alcohol consumption: Heavy alcohol use significantly increases one’s risk of cirrhosis.  
• Obesity: Nonalcoholic fatty liver disease and nonalcoholic steatohepatitis are conditions that can lead to cirrhosis and being obese increases one’s risk of developing them.  
• Having chronic viral hepatitis infection: This condition is one of the primary causes of liver disease worldwide.