Hepatic cirrhosis, also referred to as liver cirrhosis or just cirrhosis, is a chronic degenerative disease of the liver. It is characterized by fibrosis, loss of structure, and the presence of regenerative nodules on microscopic examination of the liver. Many different diseases or pathologic processes, including alcoholism and viral hepatitis, can cause this condition. Complications such as loss of liver function and alternations in the flow of blood in the body can cause affected patients to have many health problems. Treatment of the disease focuses on eliminating the reason why the cirrhosis developed and preventing possible complications.
The term hepatic cirrhosis is used to describe a certain pathologic state of the liver. Various behaviors and diseases cause damage to the liver cells, resulting in fibrosis and cell death. This process decreases the mass of the liver and disrupts its normal structure. As a result of this destructive process, the liver attempts to regrow some of the diseased cells, leading to the presence of regenerative nodules within the body of the liver. The characteristic findings of cirrhosis, including the extensive fibrosis, loss of normal structure, and presence of regenerative nodules, can be seen on microscopic examination of a liver biopsy.
There are a number of different causes of hepatic cirrhosis. Perhaps one of most common causes of this condition is alcoholism, as chronic exposure to alcohol can cause the characteristic fibrosis and loss of liver function that is associated with cirrhosis. Another common cause is chronic viral hepatitis, usually either due to infection with hepatitis B or hepatitis C. Nonalcoholic steatohepatitis, also called nonalcoholic fatty liver disease, can develop in patients with risk factors such as obesity or diabetes mellitus type 2. Rarer causes of hepatic cirrhosis can include genetic diseases such as cystic fibrosis, hemochromatosis, Wilson's disease, and alpha-1 antitrypsin deficiency.
A variety of complications can develop as a result of hepatic cirrhosis. With end-stage disease, patients lose all liver function, and therefore cannot process toxins properly and are unable to make certain proteins important for good health. They can develop swelling in their legs, increased bleeding risks, and limitations in the ability to think clearly. Other complications develop as a result of portal hypertension, which is a condition that develops when the hepatic fibrosis restricts blood flow into the liver, causing alterations in blood flow patterns throughout the body. This can cause complications such as enlarged veins in the esophagus and hemorrhoids.
Treatment for hepatic cirrhosis focuses on two goals: first, stopping the process causing the hepatic cirrhosis, and second, minimizing the complications that develop as a result of the liver damage. For example, a patient with liver dysfunction as a result of alcohol abuse would be advised to stop drinking. Patients with portal hypertension can benefit from medications that will help redistribute the body's blood flow. With advanced disease, the only true treatment for this hepatic cirrhosis is liver transplantation.
