The liver is the largest gland in the human body. 'Cirrhosis' of liver is a condition wherein the normal liver tissues get damaged and replaced by scar tissue.

Healthy liver cells get substituted with fibrotic scar tissue in a very slow and gradual process. Conditions leading to recurrent inflammation of the liver cells (hepatitis) heal with fibrosis and scar tissue formation.

How does cirrhosis affect the liver?

Cirrhosis can disrupt many vital functions of the liver. Any condition that can damage the liver cells can cause cirrhosis. The liver gets its major supply of blood from the venous system of the intestines. The presence of scar tissues can reduce the effective circulation of blood within the liver. This slows down the transport and elimination of the various products of liver metabolism. The liver breaks down many substances including red blood cells and drugs and toxins. With chronic inflammation & scar tissue formation, the liver function becomes very sluggish leading to accumulation of various harmful substances.

The liver performs many important roles.

• Breakdown and elimination of many chemicals like alcohol, drugs and toxins.
• Breakdown and metabolism of red blood cells.
• Formation of cholesterol and breakdown of saturated fats.
• Formation and storage of important clotting factors.
• Manufacture bile - an important substance for digesting foods.
• Production and storage of sugar in the form of glycogen.
• Storage of vital nutrients like vitamins and providing them when their levels in the body are low.

Causes of Cirrhosis of Liver

Cirrhosis is an outcome of several conditions harmful to the liver. The most common causes of cirrhosis are: -

• Alcohol
• Chronic viral infections - hepatitis (types B, C and D)
• Drugs and toxins.
• Autoimmune hepatitis
• Hereditary conditions like
• hereditary hemochromatosis
• Wilson's disease
• Cystic fibrosis
• Alpha-1 antitrypsin deficiency
• Cystic fibrosis
• Conditions affecting the biliary system
• Primary sclerosing cholangitis
• Primary biliary cirrhosis
• Infections with parasites
• Schistosomiasis (snails)
• Cardiac failure - causes a condition called 'cardiac cirrhosis'.

Symptoms of Cirrhosis of Liver

Cirrhosis in its early stages has no prominent symptom.

• Weakness/fatigue/exhaustion
• Loss of appetite
• Weight loss or sudden weight gain
• Nausea
• Jaundice
• Itching of skin (pruritis)
• Swelling or distention of the abdomen
• Ascites » collection of excess fluid within the abdomen
• Swelling of the ankles
• Easy bruising
• Spider naevi » dilated capillaries on the upper chest, arms and forearms.
• Slow healing of wounds
• Palms appear very red and warm
• Asterexis » sudden, involuntary, violent twitching of the hand when it is held outstretched.
• Gynaecomastia » enlargement of breast in males
• Changes in personality
• increased irritability
• inability to concentrate
• weakness of memory
• indifference to personal appearance

Complications of Cirrhosis of Liver

• Ascites and generalized swelling (edema) of body
• Ascites and generalized swelling (edema) of body
• Bleeding from varices. Varices are abnormally lengthened and dilated blood vessels. Cirrhosis causes stagnation in blood circulation, making the blood vessels engorged. with increasing pressures within the vessel, it may rupture and lead to bleeding. Blood vessels in the esophagus (food pipe), the umbilical vessels (vessels in central abdomen),
• Hypersplenism » condition where an enlarged spleen
• Infection

Diagnosis of Liver Cirrhosis

The diagnosis of cirrhosis may be missed in the initial stages of the condition. A history of medical conditions that can injure the liver is an indicator of possible cirrhosis in the future.

Your doctor will conclude a diagnosis of cirrhosis based on:

• Physical exam
• Liver function tests » the liver enzymes may show mild to moderate elevation.
• Ultra Sonography studies » non-invasive, sensitive indicator of any abnormal size of the liver.
• CAT scan » non-invasive and sensitive test which can specify the severity of cirrhosis as well as detect cancer even at its onset.
• Liver biopsy » considered a 'gold standard' for diagnosis. A small specimen of liver is obtained by performing either laparoscopic, percutaneous or transjugular approach.

Though a 'liver biopsy' is often considered the gold standard of diagnosing cirrhosis, it need not be performed, if clinical examination, laboratory workup and radiological studies indicate it.

Treatment of Cirrhosis of Liver

Conventional treatment

Treatment of liver cirrhosis depends upon the type and stage of cirrhosis. It mainly revolves around:

• Preventing further degeneration and loss of liver cells
• Prevent complications
• Treatment of complications
• Identify cancer at an early stage
• Surgery » liver transplant.

Preventing further degeneration of liver cells

Cirrhosis is the most advanced stage of most liver diseases. However, this progression can be stalled, and made very slow by effective treatment of the presenting condition.

• Have alcohol in moderation. It's definitely better to avoid it altogether if you can.
• Hepatitis B is a significant cause for cirrhosis. Talk to your physician about vaccinations against the Hepatitis B virus.
• Avoid indulging in high risk sexual behavior. Both HBV and HCV infections are largely spread through multiple sex partners, indiscriminate use of needles, syringes, & other drug addiction paraphernalia like use of nasal cocaine.
• Avoid exposure to chemicals and toxins that harm the liver. When working with toxic substances, wear appropriate, protective covering.
• Avoid using tobacco. Eat a well balanced diet. Avoid having saturated fats and greasy foods (French fries, cheeseburgers etc.) since they increase the load on the liver.
• Keep your weight within the range normal for your age and gender.
• Avoid foods containing colors and chemical preservatives.
• Be cautious when opting for vitamin and other supplements. Some of the supplements can actually increase stress on an already overburdened liver.

Other treatment options available are:

• Medications
• Liver transplant

Medications

• Interferons » drugs used in chronic viral infections of the liver. It helps by enhancing the body's immune system against the viruses.
• Corticosteroids » indicated in cirrhosis caused by any autoimmune liver disease process. The steroids prevent the immune cells from attacking the liver cells. However, their long-term use result in many adverse side-effects in nearly all organ systems in the body.
• Certain conditions like Wilson's disease and Hereditary Hemochromatosis require effective removal of the substance deposited in excess in the liver. Copper gets deposited in excess in Wilson's disease, and Hereditary Hemochromatosis results in excess iron deposition. Hence, treating the underlying condition can prevent the progress of established cirrhosis.
• Nutritional supplements, especially fat-soluble vitamins to prevent deficiencies.

Liver Transplant

Though expensive, a liver transplant can increase the survival rate by 80 - 90%. Cirrhosis progressive despite appropriate treatment; presence of multiple complications which are life-threatening are all indications for a liver transplant.

Homeopathic Treatment for Liver Cirrhosis

Homeopathic medicines treat the underlying cause of Cirrhosis of Liver, such as viral infection, genetic tendency, bad effects of alcohol, metabolic changes, etc. and thus help to treat effects of Cirrhosis of Liver.

Homeopathy helps to control further cellular damage. It cannot cure the scarred tissues, as such, as it is not possible to regenerate scarred tissues.

When introduced at an early stage of cirrhosis, homeopathic medicines can effectively reduce the viral count (in Hepatitis caused by HBV and HCV) as well as give symptomatic relief without side effects.

Homeopathic medications can prevent the progress of cirrhosis and in very early cases of liver cirrhosis, the medicines restore majority of the normal functions of the liver.