Cirrhosis: cirrhosis of the liver scarred

21 October 2017

© Jupiter Images / iStockphoto

Cirrhosis is the final stage of various liver diseases in which the normal, healthy architecture of the liver destroyed and was replaced by loose connective tissue function. Because of the steady deterioration of the liver tissue hardens the liver, scarred and shrinks. Cirrhosis of the liver is therefore referred to as "cirrhosis of the liver",

Most times (more than half of all cases) cirrhosis of the liver caused by excessive consumption of alcohol over many years.

In about 20 to 25 percent of cases, cirrhosis is the result of chronic inflammation of the liver - also known as viral hepatitis. But other causes are eligible, such as diabetes mellitus. 

Especially at the beginning of the disease, the symptoms are very unspecific - in some cases, cirrhosis of the liver also makes long time not noticeable. 

As common signs for liver cirrhosis following general symptoms are for example:

Through the scarred rebuilding less blood flows through the liver and liver function decreases. This leads, for example, to the fact that nutrients, hormones, drugs, toxins and bile pigment bilirubin can only be slowed dismantled. The result: the whites of eyes and skin discolored yellowish (jaundice or jaundice).

in the final stage the liver can no longer meet, eventually leading to liver failure and death their duties.

Facts about liver cirrhosis

The liver is the largest and heaviest internal organ of man - it weighs about 1.2 to 1.8 kilograms.

Of the severity cirrhosis of the liver is measured by the so-called Child-Pugh score: With the Child-Pugh classification Doctors can assess the liver function uses five criteria for which to place in a fixed pattern points. In the end, all the points are added. cirrhosis of the liver can be divided into three different stages, depending on the total number of points:

The result Child C describes the end-stage liver cirrhosis and has the worst prognosis, Child A is the best.

Cirrhosis of the liver can different causes to have. In Germany, most liver cirrhosis caused due

The Number one cause is Alcohol: In up to 60 percent of cases, cirrhosis occurs as a result of nonalcoholic fatty liver disease. Alcohol damages individual components of the liver cells, whereby the fatty acid and Triglyceridstoffwechsel is disturbed in the liver. This means that the fats accumulate in the liver cells. With continued alcohol consumption, the liver is so badly damaged that the healthy liver tissue is converted into functionless connective tissue. 

It is not always the reason for alcohol fatty liver. The main causes of non-alcoholic fatty liver severe obesity (adiposity) and diabetes mellitus: Almost one in five obese diabetics developed cirrhosis of the liver in the course of his life.

About 20 to 25 percent of cases go to a chronic viral hepatitis back. A viral hepatitis is produced - as the name suggests - by infection with viruses. Depending on which virus causes the inflammation of the liver, a distinction is hepatitis A, B, C, D or E. Hepatitis A and hepatitis E but rarely lead to liver cirrhosis. 

Sometimes it also comes to an inflammation of the liver, because the body considers its own liver as a foreign body and therefore fighting against the liver (so-called. Autoimmune hepatitis). Untreated autoimmune hepatitis can also turn into a liver cirrhosis. 

The picture shows the illustration of a normal liver and liver in cirrhosis. © iStock

Cirrhosis is the final stage of various liver diseases. Because of the steady deterioration of the liver tissue hardens the liver, scarred and shrinks - until it can no longer meet sometime their duties.

Only in a few cases, a liver cirrhosis other causes. Among the rare releases of cirrhosis of the liver include specific hereditary metabolic diseases as:

Cirrhosis causes various Symptoms completely different degrees may be - depending on what stage of cirrhosis of the patient. Especially in the early stage symptoms can also completely absence. In contrast, cirrhosis is the final stage by clear signs of the liver damage in.

Typical of cirrhosis are more general symptoms. The affected

Often cirrhosis caused also a Pressure or fullness in the area above the navel. In addition, the so-called can Liver skin sign occur. These are, among others:

In addition, in men hormonal disorders such potency problems and a modified male Behaarungstyp occur - in this case arises, among other so-called belly bald. Possibly the mammary gland of the man may increase (so-called. Gynecomastia). In women sometimes occur irregularities in the menstrual period to (menstrual disorders).

In the advanced stage, cirrhosis of the liver often shows the following symptoms:

In cirrhosis of the liver is to reliable diagnosis Strictly speaking, a liver biopsy needed: Here, the doctor punctures the liver with a needle to obtain a sample of liver tissue. Only in this way it is possible to detect the abnormal condition of the liver, featuring a cirrhosis directly.

In general, however, it is sufficient liver cirrhosis according to their symptoms diagnose: For this, the doctor initially asked for the history of complaints (so-called. Anamnesis) And performs a physical examination by. also help imaging procedures and various laboratory values, to assess the condition of the liver:

In the early stage of cirrhosis provides for diagnosing a Ultrasound examination of the upper abdomen to: In the ultrasound image the liver tissue appear dissimilar and the liver surface irregular; is also (so-called. caudate lobe) of the small lobe of the liver increased. To diagnose liver cirrhosis, is also the newer ultrasound procedure called transient elastography helpful: Allows the doctor can determine how big the Proportion of connective tissue in the liver (at cirrhosis of the liver, the liver converts increasingly in cicatricial connective tissue around).

In the blood test For example, a to small number of platelets (Platelets) in the blood indicate an advanced liver disease with early cirrhosis. To diagnose the liver values ​​are also interesting: Thus, for example, the values ​​for the enzymes Albumin and cholinesterase decreased, when the function of the liver is disturbed by the cirrhosis. And when the liver can no longer perform adequately their detoxification function due to cirrhosis of the liver, in the blood, for example, the values ​​for the bile pigment bilirubin increased.

Suspicion of cirrhosis it belongs always to diagnose, and the underlying cause clarify: Cirrhosis of the liver caused by alcohol abuse, drugs or toxic substances (eg chemicals) has been created, the doctor can usually diagnose already using the information on the prehistory of the complaints. on the other hand is a chronic viral hepatitis responsible for cirrhosis of the liver, found in the blood corresponding antibodies against these viruses and so-called active viral material. In some cases, however, it is difficult to find the cause of the pathological condition of the liver.

Depending on how the liver looks exactly doctors can liver cirrhosis three different types divide:

Alcohol abuse usually the small nodular form of liver cirrhosis, at a viral hepatitis, the large nodular or mixed shape.

Did the doctor detected an incipient cirrhosis, there is a therapy especially in avoiding liver-damaging substances such as alcohol or cigarettes. Moreover, one should on a

respect, think highly of. 

In patients with advanced liver cirrhosis special high-calorie food supplements with a high proportion verzweigkettiger amino acids (BCAA: isoleucine, leucine, lysine, valine) and a low proportion of aromatic amino acids (phenylalanine, tyrosine, tryptophan). Sufferers should these preparations as possible late in the evening or at night take - then they can more effectively improve the body protein status.

To support the detoxification function of the liver and the bowel movements, one should eat high fiber as possible to move much and drink enough. 

If an increased iron uptake and storage connected (by the hereditary hemochromatosis) behind the liver cirrhosis, it is necessary to remove the excess iron by blood-letting from the body. If the copper storage disease Wilson's disease caused the cirrhosis, the therapy aims to reduce the copper intake and increase copper excretion. This is achieved with the active substance D-penicillamine, which binds the excess copper in the blood - the body excretes it then in the urine from.

To step acute complications such as neurological symptoms (hepatic encephalopathy) or a bleeding from esophageal varices associated with liver cirrhosis is immediately initiate a medical therapy.

In severe cases helps with liver cirrhosis only therapy: the liver transplantation. A prerequisite for the operation that that defined by a transplant center criteria are met for a transplant.

A Cirrhosis is a chronic liver disease that can seriously affect the health and quality of life. Learn more in the video!

Has a chronic, induced by viral hepatitis (e.g., hepatitis B or C) causes cirrhosis of the liver, which is directed Therapy for hepatitis according to certain Criteria: Hepatitis treatment is only recommended in liver cirrhosis usually when

In that case, the patient received a liver cirrhosis for causal therapy Drug that inhibits the proliferation of hepatitis virus. For hepatitis B in particular interferon alpha, peginterferon alpha 2a and antiviral agents come (so-called antivirals.) Such as lamivudine, entecavir, telbivudine; Adefovir or tenofovir for use. 

In hepatitis C apply depending on the virus genotype sofosbuvir, ribavirin and peginterferon alfa-2 as recommended - possibly in cirrhosis with Daclatasvir. 

Possible side effects This hepatitis treatments are temporarily altered blood count, flu-like symptoms and increased liver enzymes.

In cirrhosis, the course of hanging Reason, the stage of liver damage as well as a reasonable and timely therapy from: While it is Not possible to repair the damage caused entirely (i.e., the liver cirrhosis is not fully cured). With appropriate treatment, the liver but can at least partially recover.

For example, if an excessive alcohol consumption is responsible for cirrhosis of the liver, it is crucial for the course to forego future on alcohol: With complete abstinence the prognosis is good.

To the severity cirrhosis of the liver (and thus their course and their prognosis) assess to, is the so-called Child-Pugh classification helpful: It allows physicians to assess liver function in terms of five criteria for which to place in a fixed pattern points. Depending on the point value is the result of Child A, Child B or C. The Child favorable prognosis has a liver cirrhosis A Child.

The functional ability of the liver decreases with a untreated Cirrhosis of the liver in the course from increasing. In advanced stages, cirrhosis can also various complications cause. Unless action is taken cirrhosis acts as a negative impact on life expectancy and quality of life of those affected.

Often occur in liver cirrhosis among others following complications on:

Liver cirrhosis may also in its course liver cancer and to liver failure to lead. In severe cases, the changes of the liver tissue in cirrhosis in the final stage are so advanced that the liver can no longer fulfill their function. Ultimately, the cirrhosis is fatal by these complications.

one prevent cirrhosis means above all: All avoid what could cause liver disease!

You can protect your liver by, for example, following tips follow:

Against another common cause of cirrhosis - hepatitis C - is far no Vaccination is available. However, you can prevent an infection with hepatitis C virus (as well as hepatitis B virus) and subsequent liver cirrhosis by general industrial hygiene practices take (for example, during sexual intercourse use condoms, in the care of injured gloves, etc.).

Do you have a hereditary disease, which may be associated with liver damage and cause cirrhosis of the liver, it is a preventive measure recommended that you genetic counseling and investigate early allow.

Self-help liver of transplanted Germany e.V. The association is aimed at patients and their relatives and interested people who want to learn about the topics liver, liver disease and organ donation. It is not only the opportunity to share in the forum or chat, but also to find a personal contact in the region.


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