Damaged livers, ruined lives

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By DR Y.L.M.

Liver cirrhosis can lead to some very nasty complications.

MY father had a hepatitis B infection once. Recently, he had an ultrasound done as part of a routine check-up, and the report came out that his liver had cirrhosis. What is cirrhosis?

Cirrhosis of the liver is what happens to your liver as a complication of many diseases. It is how your liver looks anatomically – with a lot of scar tissue manifested in nodules and fibrous tissue that is hard.

A cirrhotic liver looks much like liver pate! Instead of a smooth clear surface, the liver is riddled with scar and fibrous tissue.

This is what happens to your liver:

1. Your liver is damaged by chronic liver disease.

2. There is a lot of damaged liver tissue, leading to inflammation and subsequent repair and replacement by fibrous or scar tissue.

3. There is regeneration of liver tissue from the cells that are still remaining, but it doesn’t go quite normally, leading to regenerative nodules.

If it were only the structure of the liver that is affected, cirrhosis would just be an ugly feature on an ultrasound. Unfortunately, your liver function is also affected and that’s when the problem starts.

What sort of problems can I have if I have cirrhosis? How will my liver function be affected?

The liver does a lot of things that are essential to life.

1. Controls levels of fats, amino acids and glucose in your blood. Stores glycogen (glucose in another form), iron, vitamins and other essential nutrients.

2. Manufactures bile and aids in your digestive process, especially in the breakdown of fats.

3. Detoxifies your blood by clearing it of toxic wastes, breaking them down and getting rid of them either through your faeces or releasing them into your blood in smaller particles to be further cleared by your kidneys.

4. Manufactures and regulates various hormones, enzymes and clotting factors.

5. Fights infections, especially through macrophages.

In cirrhosis, because the liver anatomy is so scarred, this interferes with the liver cells’ functions, and thus the liver is not able to perform many of its functions well.

How will I know I have cirrhosis? Is it only through ultrasound?

That’s the trouble with cirrhosis. You may have no symptoms at all, or very few which are nondescript, like tiredness or fatigue. So you don’t know you have it till liver failure creeps up on you.

But some symptoms associated with it are fatigue, weakness, loss of appetite, itching, and sometimes jaundice if there is accumulation of bilirubin in your blood. If your clotting factors are affected, you can have easy bruising of your skin.

Usually, when cirrhosis becomes severe, then you develop complications. These complications are a lot more clear in their symptoms and usually are the first physical sign that something is wrong.

What sort of complications?

You begin to retain water, leading to a condition called ascites, where there is excessive water in your peritoneal cavity (cavity within your abdomen). There is also a lot of water accumulated in your ankles and feet, manifested by swelling. The ascites is a magnet for bacteria to grow, and you may have an infection.

You can also have bleeding from oesophageal veins. In cirrhosis, the scar tissue blocks the flow of blood from the intestines to the heart, resulting in the distension of the portal vein. (This is the vein that is very important in the digestive process.) The back pressure leads to distension of your veins in the lower part of your oesophagus. These veins can bleed, leading to you vomiting blood (haematemesis). This can be life-threatening.

This pressure can also cause your spleen to distend and become so swollen that it sometimes becomes a hard mass in your abdomen. This gigantic spleen traps your blood cells and causes you to have anaemia and prolonged bleeding.

Because your liver cannot detoxify your body, this can lead to toxic substances in your blood. This goes to your brain and causes sleepiness during the day, irritability, confusion, loss of concentration, and finally coma and death.

Cirrhosis greatly increases the risk of you getting liver cancer.

What a terrible disease to get! What are its causes?

There are a few causes of liver cirrhosis. Alcohol consumption leads to damage of your liver cells, resulting in a fatty liver (something which is heightened by obesity); chronic viral hepatitis (B,C); genetic liver disorders; and anything that can damage your liver can cause cirrhosis.

Avoid excessive alcohol consumption, and make sure you have your hepatitis jabs, especially in Malaysia where viral hepatitis is endemic. Lose any excess weight, and ensure you go for frequent check-ups.

Dr YLM graduated as a medical doctor, and has been writing for many years on various subjects such as medicine, health advice, computers and entertainment. The information contained in this column is for general educational purposes only. Neither The Star nor the author gives any warranty on accuracy, completeness, functionality, usefulness or other assurances as to such information. The Star and the author disclaim all responsibility for any losses, damage to property or personal injury suffered directly or indirectly from reliance on such information.

(Source: The Star Online.)