Cirrhosis occurs when the liver is damaged and healthy tissue is replaced with scar tissue. The liver gradually deteriorates and stops functioning properly. A normal liver regenerates new tissue in response to damage; however, end-stage cirrhosis prevents the liver from replacing damaged tissue. According to 2008 information from the National digestive Diseases Information Clearinghouse, cirrhosis is responsible for 27,000 deaths per year. Cirrhosis develops gradually, and signs and symptoms usually appear in the advanced stage of cirrhosis.
MELD Score
The MELD score was developed to assess the three-month survival rate for people with advanced cirrhosis. The score is calculated from blood tests that test the clotting tendency of blood, the amount of bile pigment present and kidney function. MELD scores range from six to 40. Lower scores are associated with lower mortality.
Symptoms
The liver produces albumin, a protein that helps keep fluid in the blood vessels. In advanced cirrhosis, albumin levels fall, which causes fluid to leak out of the blood vessels. This results in fluid accumulation in the legs and abdomen. The liver also produces bile, which helps digest fats. Bile accumulates in the blood and causes jaundice in a person with advanced cirrhosis. Yellow eyes and skin are a sign of jaundice. The proteins made by the liver to clot blood become deficient in a person with advanced cirrhosis and can cause excessive, prolonged bleeding and bruising. The liver cannot filter out toxins because of damage from cirrhosis. Toxins in the bloodstream can cause serious mental changes. Other symptoms of advanced cirrhosis include loss of appetite, weight loss, nausea, gallstones and massive internal bleeding, the MayoClinic.com states.
Causes
In the United States, excessive alcohol use and chronic hepatitis C are the two most common causes of cirrhosis. Hepatitis B and hepatitis C infect the liver, and over time, cause damage and cirrhosis. Some babies are born with abnormally formed biliary ducts that cause the bile flow from the liver to the gallbladder to become blocked. Biliary atresia can cause damage to the liver, which can eventually cause cirrhosis. Cirrhosis can also occur when the body's antibodies attack the liver cells and injure the liver. Wilson's disease causes an abnormal amount of copper to be stored in liver cells, which causes damage and cirrhosis. Large amounts of iron can also accumulate in the liver and cause cirrhosis. People with cystic fibrosis are also at risk of develop cirrhosis.
Treatment
There is no treatment to cure cirrhosis or repair scarring that has occurred. Treating the underlying cause of the cirrhosis can prevent further damage, and treatment can manage complications such as fluid retention, high pressure in the veins surrounding the liver, infections and large amounts of toxins in the blood. Some people with advanced cirrhosis may require a liver transplant.
Prevention
Some cases of cirrhosis are preventable. MayoClinic.com states that men should limit alcohol beverages to two a day, while women should drink no more than one alcoholic beverage a day. Eating fresh fruits, vegetable, whole grains and lean sources of protein can help prevent cirrhosis. Maintaining an appropriate weight can limit the amount of damage to a person's liver. Reducing the risk of hepatitis B and C by not sharing needles and having protected sex can also reduce the risk of developing advanced cirrhosis.
