Cirrhosis refers to toughening, or fibrosis, of the liver. Many different conditions lead to cirrhosis, including alcohol dependence and hepatitis. The symptoms of cirrhosis are a result of reduced functioning of the liver as well as mechanical obstruction to blood flow. The effects of cirrhosis are the same regardless of which disease caused it.
Portal Hypertension
Portal hypertension refers to increased blood pressure in the vein that leads blood to the liver. Symptoms include accumulation of fluid in the abdomen, or ascites, which can cause discomfort and pressure on the lungs, leading to shortness of breath. Ascites can also lead to bacterial peritonitis, an infection of the tissues in the abdomen. Another complication is esophageal varices, which are dilated veins at the junction of the esophagus and stomach. These varices may bleed massive amounts of blood, leading to collapse of the circulatory system and death.
Hepatic Encephalopathy
Hepatic encephalopathy is caused by toxins that affect the brain. These toxins that would normally be cleared from the blood by the liver. Symptoms of hepatic encephalopathy include confusion, impaired concentration and a change in personality. Patients may become violent. They can become sleepy and difficult to wake. As encephalopathy progresses, the patient eventually sinks into a coma.
Increased Bleeding
The liver produces clotting factors that support the formation of blood clots. Blood clots are essential in preventing unchecked bleeding from minor bruises or trauma. In cirrhosis, production of clotting factors is reduced, as is the number of platelets, a condition known as thrombocytopenia. An increased tendency to bleed leads to bruising, exacerbates the bleeding from esophageal varices and increases the risk of bleeding in the brain, for example, after falls.
Digestive Problems
The liver plays an important role in the body's metabolism of foods. Cirrhosis can lead to loss of appetite, malnutrition, weight loss, weakness and fatigue.
Weakening
Cirrhosis increases the risk of infections. Osteoporosis and weak bones can occur. Anemia is common. The risk of liver cancer is increased.
References
- "Harrison's Principles of Internal Medicine, 17th edition"; Anthony Fauci et al.; 2008
- MayoClinic.com: Cirrhosis
