Cirrhosis of the liver consists of a chronic and progressive destruction of healthy liver tissue and replaces tissue with scarred, nonfunctioning tissue. The liver performs several hundred functions vital to the body. These include metabolizing food, fighting infection, protection from bleeding and filtering toxins. When the liver becomes severely damaged, these functions fail and symptoms arise. In beginning stage cirrhosis, the body compensates for the damage and patients remain asymptomatic. When extensive damage occurs, cirrhosis reaches the symptomatic stage, called de-compensated cirrhosis.
Abdominal Discomfort
In end-stage cirrhosis, most patients experience some form of abdominal discomfort. "Medical Surgical Nursing" lists nausea, vomiting, indigestion, excess gas, diarrhea and abdominal pain as commonly experienced discomforts in the final stages of cirrhosis. A condition known as ascites contributes to discomfort. Ascites is the accumulation of fluid in the abdominal cavity. Discomforts caused by this condition include pressure, bloating, a full feeling, tightness of the skin, shortness of breath and pain.
Risk for Bleeding
Patients in the final stages of cirrhosis are at high risk for bruising, bleeding and hemorrhage. Blood flow in a major vein in the liver narrows and impairs blood flow. As a result, blood backs up into veins in the esophagus, stomach and intestines. These bulging veins may rupture and cause bleeding. The American Academy of Family Physicians says that 50 percent of cirrhosis patients develop these bulging veins in the esophagus. These are known as esophageal varices. The liver also aids in the clotting of blood. Damage due to cirrhosis impairs this ability, also contributing to increased risk of bleeding.
Jaundice and Skin Alterations
A substance called bilirubin builds up in the body due the liver's inability to filter excess amounts. As a result, the skin and sclera of the eyes take on a yellow or orange appearance. This is known as jaundice. "Medical Surgical Nursing" also reports spider veins, bruising, dryness, itching and red or purple spots on the skin as commonly suffered by those in the final stages of cirrhosis.
Weakness, Fatigue, Confusion
The Merck Manual reports that fatigue and weakness occur due to malnutrition due to the liver's inability to absorb nutrients. A condition known as hepatic encephalopathy commonly affects those with end-stage cirrhosis. Hepatic encephalopathy describes a condition where toxins build up in the blood and brain due to the liver's inability to filter them. This causes drowsiness, confusion, impaired thought processes, behavior changes and eventually coma and death.
References
- "Medical Surgical Nursing"; Ignatavicius, D. MSN, Workman, L. PhD.; 2002
- Merck Manual: Cirrhosis
- American Academy of Family Physicians: Cirrhosis and Chronic Liver Failure Part II
