Cirrhosis and alcoholism

The First Year: Cirrhosis: An Essential Guide for the Newly DiagnosedCirrhosis is relatively common disease especially among alcoholics. Unlike with the case of kidneys where it is possible to live when one kidney fails we have only one liver and when that liver fails, the patient has to face life threatening complications as the liver is responsible for performing numerous vital functions. When the liver fails no other organ does its work.

Cirrhosis is a irreversible change that takes place in the liver due to various causes. In Cirrhosis liver cells are destroyed and replaced by fibrous tissues. These tissues gradually contract so that the liver decreases in size. However before this irrevocable stage is reached there is a stage where further deterioration can be prevented by taking necessary precautions.

What causes Cirrhosis?

Most common cause of Cirrhosis is consumption of excessive amounts of alcohol. Different people have varying capacities of consuming alcohol without harming themselves. The fact that one person remains unaffected by regular consumption of alcohol over a long period of time is no guarantee that another person’s body will behave in the similar way.

However no doubt at the vast majority of people consuming unlimited amount of alcohol will end up with liver diseases. Most such people do not take an adequate diet as their hunger is satisfied by the empty calories provided by alcohol.

There is a mistaken belief that wine and beer are less harmful than ‘strong’ drinks such as arrack or whisky. A person consuming larger quantities of wine or beer ends up doing similar harm to himself as a person taking lesser amount from stronger drink. Although a small drink at irregular interval may not be harmful it should be emphasized that alcohol is not at all essential for a healthy life or normal social activities.

The popular propaganda that alcohol is good for high blood pressure is also misleading. Therefore it is wiser to advice a person who has never taken alcohol to get his blood pressure checked rather than persuading him to take a small drink of alcohol even occasionally.

There are few patients including females who do not take alcohol but still develop Cirrhosis. Viral hepatitis B and C are the likely causes. The common hepatitis A never causes a permanent damage to the liver. Patients are not likely to give a history of having had hepatitis in the past. For this purpose there are several blood tests available to identify the virus in the blood. It has been also found out there is an increased tendency of developing liver cancers in these patients.

Other rare causes are hereditary diseases where the metabolism of copper and iron is disturbed. And there are few more rare causes.

How to recognise Cirrhosis.

Patient develops swelling of ankles followed by distension of the abdomen due to the accumulation of fluid. Complaints of discomfort in upper abdomen and feeling of general ill health, lethargy, weakness, tiring out easily and unexplained weight loss are early features. Some develop low grade fever which may be associated with other complications of alcohol. Symptoms can be explained on the basis of disturbed liver functions. Insomnia, numbness and tingling feeling in feet occur due to the affects or alcohol on the nervous system. With time the patient become jaundiced (yellowing of palm nails and skin)

Other complications associated with Cirrhosis.

Burning abdominal pain are associated with gastro-enteritis. With fibrosis tissues described earlier blood circulation through the liver get disturbed. This lead to blood vessels inside the stomach to distend (similar to the varicose veins in legs.) These blood vessels rupture easily giving rise to the blood vomiting and passage of blood in faeces which are the most frightening symptoms of Cirrhosis. Many bleed to death.

Gastric ulcer is another source of bleeding in cirrhotic patients. Repeated vomiting after alcohol lead to tearing of lining at the lower end of oesophagus or the gullet (tube that carries food from mouth to stomach). Bleeding may occur from such tears. Bleeding from varicose veins in the stomach may be stopped by tying them up or by injecting drugs that closes them or by combination of both.

These are done through an endoscope. Very occasionally the bleeding may stop spontaneously only to recur later. As the liver is responsible for the manufacturing proteins, required for the clotting of blood when the liver is diseased bleeding will be exaggerated due to the poor clotting of blood. The liver removes toxins or poisons (naturally occurring ) which if allowed to build up could be life threatening. This process known as detoxification, fails when the liver is diseased. When the liver damage is extensive hepatic or liver coma results due to the accumulation of toxins in blood.

This can be precipitated by extensive consumption of protein, continued intake of alcohol, constipation bleeding etc. Certain drugs used to get rid of body swelling and to induce sleep are known to cause coma. It is essential such things are avoided to prevent coma.

Another vital function the liver is removing bile products (by products of red blood cell breaking down) and excreting them into intestine. When this function is impaired patient develops the condition is known as Jaundice. The liver breaks down almost all hormones. When this function is weakened hormones accumulated in the blood resulting swelling of the body, enlargement of male breasts, shrinking of testes etc.

The message to the reader.

As always prevention is better than cure. In the case of Cirrhosis no cure is available apart from liver transplant, which is of course beyond most people, and was carried out few times only in developed countries. Avoiding alcohol is no doubt is the best possible way of preventing Cirrhosis. Even after the onset of disease abstention is known to delay the complications associated with the disease.

Apart from that an average healthy diet with adequate proteins, vitamins may have a favourable impact on the outcome. Drugs are available for the relief of body swellings, loss of appetite and other undesirable symptoms. But these things are all temporary measures. Thus Cirrhosis though common and taken for granted by many, especially by alcoholics, is a serious disease and causes death in matter of few years. Thus taking alcohol is a way of committing suicide slowly but surely.