Cirrhosis - Introduction

Highlights	Diagnosis	References
Introduction	Treatment	Ascites
Causes	Treatment of Complications	Bleeding Episodes
Symptoms	Liver Transplantation	Resources
Complications	Resources	References

Introduction

Cirrhosis is an irreversible result of various disorders that damage liver cells over time. Eventually, damage becomes so extensive that the normal structure of the liver is distorted and its function is impaired.

Cirrhosis is a chronic liver disease that is the result of damage to liver tissue with scarring of the liver (fibrosis - nodular regeneration) causing progressive decrease in liver function, excessive fluid in the abdomen (ascites), bleeding disorders (coagulopathy), increased pressure in the blood vessels (portal hypertension), and brain function disorders (hepatic encephalopathy). Excessive alcohol use is the leading cause of cirrhosis.

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The disease process often takes the following path:

Scarring. The main damage in cirrhosis is triggered by scarring (fibrosis) that occurs from injuries due to alcohol, viruses, or other assaults. The scar tissue and other changes in liver cells gradually replace healthy liver tissue and act like small dams to alter the flow of blood and bile in and out of the liver.

Altered Blood and Bile Flow. The changes in blood and bile flow have significant consequences, with both the liver and other organs responding to the altered flow:

The spleen overproduces nitric oxide, a chemical that causes blood vessels in the spleen to widen (dilate).
The small blood vessels and bile ducts in the liver itself, however, narrow (constrict). Blood vessels in other organs, including the kidney, also narrow.
Blood flow coming from the intestine into the liver is slowed by the narrow blood vessels. It backs up through the portal vein and seeks other routes.
Enlarged, abnormally twisted and swollen veins called varices form in the stomach and lower part of the esophagus in order to compensate for the backup blood.
Bilirubin also builds up in the bloodstream, resulting in jaundice, a yellowish cast in the skin and eyes, as well as dark-colored urine.
Fluid buildup also occurs in the abdomen (called ascites), and swelling in the legs is common.

Functions of the Liver

The liver is the largest internal organ in the body. In the healthy adult, it weighs about 3 pounds. The liver is wedge-shaped, with the top part wider than the bottom. It is located right below the diaphragm and occupies the entire upper right quadrant of the abdomen.

The liver performs over 500 vital functions. Damage to the liver can impair these and many other processes. Among them are the following: