Cirrhosis, the eighth leading cause of death in the United States with a prevalence rate of 0.27%, is the end result of a hepatocellular injury that leads to both fibrosis and regenerative nodules throughout the liver. In its advanced stages, it is often considered to be irreversible. Nevertheless, specific medication aimed at the fundamental cause of liver disease may enhance or even reverse cirrhosis at earlier stages.
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Causes of cirrhosis include chronic viral hepatitis; alcohol; drug toxicity; autoimmune and metabolic liver diseases, including non-alcoholic fatty liver disease; and miscellaneous disorders (Papadakis & McPhee, 2019). Celiac disease appears to be associated with an increased risk of cirrhosis. Many patients have several risk factors, for example, hepatitis and alcohol use; regarding the pathophysiology of cirrhosis, there two primary components: hepatic fibrosis and regenerating liver cells. Cirrhosis is a diffuse process in which the normal lobules are substitute by architecturally abnormal nodules separated by fibrous tissue (Muriel, 2017). The nodules are usually caused by regenerative hyperplasia following hepatocellular injury (Muriel, 2017). Such nodules are functionally less efficient than normal hepatic parenchyma, and there is a serious disturbance of vascular relationships (Muriel, 2017). The clinical manifestations of cirrhosis are the consequences of hepatocyte dysfunction, portosystemic shunting, and portal hypertension. Cirrhosis may have no signs or symptoms until liver damage is extensive. The common symptoms are fatigue, muscle cramps, and weight loss. When cirrhosis is advanced, anorexia is usually present, with associated nausea and occasional vomiting.
Patients diagnosed with cirrhosis should be informed about the necessity to refrain from alcohol, keep to a low-salt diet, eat sugar and fat in moderation. The diet should be palatable, with adequate calories and protein, and, in cases of fluid retention, sodium restriction. General treatment includes the HAV, HBV, and pneumococcal vaccines and a yearly influenza vaccine (Papadakis & McPhee, 2019). Liver transplantation in suitable candidates is curative.
Alcoholic fatty liver disease and non-alcoholic liver disease are two common illnesses that lead to cirrhosis. Although both diseases have similar pathological spectra, their epidemiological and clinical characteristics are different. The main cause of alcoholic liver disease is the excessive intake of alcohol, whereas the principal causes of nonalcoholic liver disease are obesity, diabetes mellitus, and hypertriglyceridemia (Papadakis & McPhee, 2019). In general, the information about the alcohol consumption of a patient can help to differentiate nonalcoholic fatty disease from alcoholic liver disease. Exceptions are the cases when a patient has strong risk factors for NAFLD while consuming alcohol excessively at the same time.
Muriel, P. (Ed.). (2017). Liver pathophysiology: Therapies and antioxidants. New York, NY: Academic Press.
Papadakis, M.A., & McPhee, S.J. (2019). Current medical diagnosis and treatment (58th ed.). New York, NY: McGraw-Hill Education.