Cirrhosis

Information

Cirrhosis represents the end stage of liver damage, in which the liver has lost its normal structure as a result of chronic injury from various agents - alcohol, viruses, autoimmune diseases, metabolic diseases, genetic mutations - and as a consequence can no longer perform its normal functions.

In recent years, one of the most common causes of liver cirrhosis in developed countries is Metabolic Dysfunction-Associated Liver Disease (MASLD) - metabolic dysfunction-associated fatty liver disease.

The disease most commonly develops slowly - over months and years - and its first signs may be the manifestation of its complications - bleeding from oesophageal varices, increasing abdominal circumference due to the accumulation of ascites, etc.

Types:

There are various classifications - based on the cause - most commonly alcoholic, viral (hepatitis viruses), based on the pathomorphological picture, and on the macroscopic appearance - micro and macronodular - while the clinical picture is always similar.

Symptoms:

In the early stages, symptoms are non-specific - fatigue, weakness, loss of appetite, weight loss, and nausea. People may also feel discomfort in the upper right part of the abdomen around the liver.

As cirrhosis progresses, symptoms may include neurological changes. This may consist of cognitive impairment, confusion, memory loss, sleep disorders, and personality changes.

Worsening cirrhosis can cause fluid accumulation in various parts of the body, such as the legs (oedema) and abdomen (ascites). Other signs of advanced disease include skin itching, easy bruising, dark urine, and yellowing of the skin. Bleeding from dilated blood vessels in the lower part of the oesophagus (varices) is frequently observed as a manifestation, which represents an emergency life-threatening condition.

Treatment:

Treatment is aimed at eliminating the underlying cause of liver cirrhosis - cessation of alcohol consumption, treatment of viral hepatitis, chelating agents for rare causes of liver cirrhosis - Wilson's disease, haemochromatosis, etc. Symptomatic therapy is also important, aiming at maximum control of symptoms.

It is important to assess the patient and whether they are suitable for liver transplantation, as this is the only definitive method of treatment for liver cirrhosis.

Every patient with cirrhosis must be actively monitored by a gastroenterologist - complications must be controlled and the structure of the liver must be monitored with imaging methods, as cirrhosis itself is a risk factor for the development of primary liver cancer.