Cirrhosis of the liver
The term 'cirrhosis' refers to advanced liver damage, characterised by dense scarring where the lobes are covered with fibrous tissue. Cirrhosis is the end point of many types of liver damage.
While cirrhosis usually takes many years to develop, it can also develop in a few months. Once cirrhosis has developed, it is irreversible, but that damage may stabilise if the underlying cause is removed or treated.
Some causes include excessive alcohol consumption, iron overload, chronic viral hepatitis, autoimmune diseases, and chronic bile duct obstruction.
The symptoms of cirrhosis include: yellowing of the skin (jaundice); circulatory changes - reddening of the palms (palmar erythema), cyanosis, spider veins; endocrine changes - loss of libido and hair loss, males could experience breast enlargement (gynaecomastia), testicular atrophy and impotence while females may have breast atrophy, irregular menses or absence of periods (amenorrhoea). Bruising is also a symptom of cirrhosis and other symptoms may relate to portal hypertension - bleeding in the veins, an enlarged spleen etc.
Complications of cirrhosis include: build up of pressure in the veins that go to the liver (portal hypertension); collection of fluid in the abdominal cavity (ascites); alteration to the brain function caused by toxins not removed by the liver (hepatic encephalopathy); bleeding from dilated veins in the oesophagus (oesophageal varices); infection in the ascitic fluid (spontaneous bacterial peritonitis); malnutrition, and liver cancer.
The diagnosis is made by microscopic examination of the liver (liver biopsy).
Treatment involves treating the cause of the cirrhosis, if known, maintenance of nutrition and treatment of the complications of cirrhosis.
Chronic liver failure due to cirrhosis can also be treated by liver transplantation.