The liver is essential for eliminating toxins and manufacturing many vitamins. Cirrhosis is scarring of the liver caused by inflammation from either toxins or disease. According to Donna D. Ignatavicius, MS RN, and M. Linda Workman, Ph.D, authors of "Medical-Surgical Nursing: Critical Thinking for Collaborative Care," alcohol is a primary cause of cirrhosis. Early symptoms of cirrhosis of the liver are vague; however, as the disease progresses, clinical symptoms become unmistakable.
Abdominal Pain
Abdominal pain is a vague symptom that patients with cirrhosis experience. Scott and White Hospital explains that a person with cirrhosis of the liver may have abdominal discomfort that presents itself as indigestion, tenderness over the right upper quadrant of the abdomen, or a sensation of fullness in the abdomen.
Nausea
The liver acts as a storage center for bile. Cirrhosis of the liver leads to blockage of passageways, called ducts, that empty bile into the common bile duct. From here, bile is secreted into the digestive tract. Bile is necessary for proper digestion of fats; without bile, fats cannot be broken down and this can cause nausea.
Clay-colored Stool
The lack of bile caused by cirrhosis leads to clay colored stool. Without bile, stool looks pale and grey like clay.
Jaundice
Another symptom of cirrhosis of the liver is jaundice. Jaundice is characterized by yellowing of the skin, the whites of the eyes, and the mucous membranes. Jaundice occurs because of the build-up of bile in the liver from the blocked bile ducts, which leads to high levels of bilirubin in the blood. The bilirubin causes the yellow discoloring of skin and tissues.
Malnutrition
As liver damage progresses, the liver cannot manufacture and store essential vitamins and nutrients as normal. This leads to malnutrition, which in turn can cause weakness, fatigue, and weight loss.
Bleeding
The liver plays an important role in synthesizing vitamin K, which is important for clotting. As cirrhosis worsens, a patient's hemoglobin and platelets (blood cells crucial to clotting) decrease, placing him at risk for bleeding. Nose bleeds and easy bruising are common. He may vomit blood or pass blood in his stools.
Edema
Early in cirrhosis, the liver gets enlarged from inflammation and scar tissue development. The enlarged liver puts pressure on the superior vena cava, a main vein that brings blood back to the heart. Pressure on this vein decreases the amount of blood returning to the heart, causing blood to pool in the legs and abdomen. A patient with cirrhosis will have edema or swelling in the lower extremities and the abdomen.
Spider Angiomas
Increased pressure in the venous system leads to the formation of spider angiomas. These are blood vessels visible on the surface of the skin that resemble small spiders.
Confusion
Confusion is a symptom of cirrhosis of the liver. Because liver damage interferes with detoxification of the blood, person with cirrhosis can have elevated circulating blood levels of toxins and waste products, which interfere with normal thought processes. As cirrhosis worsens, its effects on the brain can lead to coma and death.
References
- Scott and White Hospital: "Cirrhosis"
- "Medical-Surgical Nursing: Critical Thinking for Collaborative Care"; Donna D. Ignatavicius MS RN, & M. Linda Workman Ph.D; 2006
