Cirrhosis of the liver describes a condition of progressive destruction of liver tissue. Damaged liver tissue becomes replaced by hard fibrous nodules. According to the American Academy of Family Physicians, up to 40 percent of patients with cirrhosis show no signs early in their disease. The body is able to compensate for the damage to a certain point. When enough damage to the liver occurs, however, symptoms arise.
Risk of Bleeding
Cirrhosis increases the risk for bleeding in two different ways: First, when enough damage occurs in the liver, it becomes unable to absorb vitamin K. Vitamin K is partially responsible for clotting blood, and without the necessary vitamin K, there is an increased risk for bleeding. Second, high blood pressures in the portal vein of the liver cause a back up of blood in the stomach, intestines, and esophagus. The University of Maryland states that this back up of blood can cause bleeds called varices. Blood may also appear in vomit or stools.
Gastrointestinal and Nutritional Alterations
Several different gastrointestinal symptoms occur with the presence of cirrhosis. According to the American Academy of Family Practice, patients with cirrhosis often produce a sweet odored breath. The patient with cirrhosis also commonly suffers from nausea, vomiting, diarrhea, indigestion, bloating, abdominal pain, pale-colored stools, loss of appetite and weight loss.
Skin Alterations
Jaundice refers to the yellow or orange appearance the skin takes on because the liver no longer metabolizes and rids the body of a substance called bilirubin. The sclera of the eyes also appear yellow with jaundice. "Medical Surgical Nursing" reports that increased bruising occurs on the skin due to the body's lowered ability to clot blood. Other alterations to skin include itching, spider veins, purple or red spotting, and reddened palms.
Altered Mental State
Several mental status changes occur with the presence of cirrhosis. The impaired liver becomes unable to perform the function of ridding the body of toxins properly. As a result, these toxins build up and cause a condition known as hepatic encephalopathy. "Medical Surgical Nursing" states that symptoms of this condition include behavioral changes, drowsiness, weakness, confusion, impaired thought processes, and slowed or slurred speech. If cirrhosis advances, coma and death may also result from this encephalopathy.
Ascites and Swelling
Ascites refers to the fluid buildup from leakage of the liver into the abdominal cavity. This fluid collects and becomes trapped. As a result, the abdomen swells and becomes distended. Ascites causes a full or bloated feeling, pain or tightness, and shortness of breath. Swelling in feet and legs also occurs because severe ascites in the abdomen causes sodium and water retention in the rest of the body.
References
- American Academy of Family Physicians: Cirrhosis
- University of Maryland Medical Center: Cirrhosis
- "Medical Surgical Nursing"; Ignatavicius, D. MSN, Workman, L. PhD.; 2002
