Liver Damage

[taxexile]

Cirrhosis:

Many Causes

Basic facts about the liver

Your liver, the largest organ in your body, weighs about three pounds and is roughly the size of a football. It lies in the upper right side of your abdomen, situated mostly under the lower ribs. The normal liver is soft and smooth and is connected to the small intestine by the bile duct, which carries bile formed in the liver to the intestines.

Nearly all of the blood that leaves the stomach and intestines must pass through the liver. Acting as the body’s largest chemical factory, it has many functions, including:

The production of clotting factors, blood, proteins, bile and more than a thousand different enzymes

The metabolism of cholesterol

The storage of energy (glycogen) to fuel muscles

Maintenance of normal blood sugar concentration

The regulation of several hormones

The detoxification of drugs and poisons including alcohol

It is no wonder that liver disease can cause widespread disruption of body function. While many liver diseases can occur, one of the most important problems is cirrhosis.

What is cirrhosis?

Cirrhosis is a term that refers to a consequence of chronic liver diseases in which normal liver cells are damaged and replaced by scar tissue, decreasing the amount of normal liver tissue. The distortion of the normal liver structure by the scar tissue interferes with the flow of blood through the liver. It also handicaps the function of the liver, which, with the loss of normal liver tissue, leads to failure of the liver to perform some of its critically important functions.

What causes cirrhosis?

There are a number of conditions that can lead to cirrhosis:

Excessive intake of alcohol (most common)

Chronic vial hepatitis, types B, C, and D

Primary biliary cirrhosis - an autoimmune liver disease primarily affecting women

Primary sclerosing cholangitis - a disease of the bile ducts, most often seen in patients with colitis

Inherited of congenital disease

hemochromatosis - abnormal accumulation of iron in the liver and other organs due to the decreased excretion of iron from the liver

Wilson’s disease - abnormal accumulation of copper in the liver and other organs due to the decreased excretion of copper from the liver

alpha1-antitrypsin deficiency - inherited absence of a specific enzyme in the liver

Glycogen storage diseases - inability to properly utilize sugars

autoimmune hepatitis - progressive inflammation of the liver associated with an abnormality of the body’s immune system

Prolonged exposure to environmental toxins

Some forms of heart disease (cardiac cirrhosis)

Schistosomiasis (parasitic infection)

Can the condition responsible for cirrhosis be identified?

Cause of cirrhosis can be identified by certain factors:

In alcoholic cirrhosis:

History of regular and excessive alcoholic intake

Physical and behavioral changes

Examination of liver tissue obtained by needle biopsy under local anaesthesia

In active viral hepatitis infection:

Blood tests

Liver biopsy

Does heavy drinking always lead to cirrhosis?

While almost everyone who drinks excessive amounts of alcohol sustains some liver damage, it does not necessarily develop into cirrhosis. In those individuals who drink one-half to one pint (8 to 16 ounces) of hard liquor per day (or the equivalent in other alcoholic drinks), for 15 years or more, about one-third develop cirrhosis. Another third develop fatty livers, while the remained have only minor liver problems.

In general, the more you drink, the greater the frequency and regularity of excessive intake, the more likely that cirrhosis will result. A poor diet, long considered to be the main factor in the development of cirrhosis in the alcoholic, is probably only a contributing factor. Alcohol by itself, in large amounts, is a poison that can cause cirrhosis.

Can social drinkers get cirrhosis?

Some individuals who are “social drinkers,” not alcoholics, can develop cirrhosis. Factors affecting the development of cirrhosis include:

The amount of alcohol consumed

The regularity of intake

Natural tendency

Perhaps the state of nutrition

It is not known why some individuals are more prone to adverse reactions to alcohol than others. Women are less tolerant of alcohol than men. Researchers believe that this is because men have a greater ability than women to break down the alcohol for elimination. Studies show that a much higher percentage of women, consuming less alcohol than men, go on to cirrhosis.

Does hepatitis always result in cirrhosis?

Some patients with chronic viral hepatitis develop cirrhosis. There are five known types of viral hepatitis, each caused by a different virus.

Acute hepatitis A and acute hepatitis E do not lead to chronic hepatitis.

Acute hepatitis B leads to chronic hepatitis infection in approximately 5% of adult patients. In a few of these patients, the chronic hepatitis B progresses to cirrhosis.

Acute hepatitis D infects individuals already infected by hepatitis B.

Acute hepatitis C becomes chronic in approximately 80% of adults. A minority of these patients (20-30%) will progress to cirrhosis, typically over many years.

What are the signs and symptoms of cirrhosis?

The onset of cirrhosis is often “silent” with few specific symptoms to identify what is happening in the liver. As continued scarring and destruction occur, the following signs and symptoms may appear:

Loss of appetite

Nausea and vomiting

Weight loss

Enlargement of the liver

Jaundice - yellow discoloration of the whites of the eyes and skin occurs because bile pigment can no longer be removed by the liver

Itching - due to the retention of bile products in the skin

Ascites - abdominal swelling due to an accumulation of fluid caused by the obstruction of blood flow through the liver

Vomiting of blood - frequently occurs from swollen, ruptured varices (veins that burst) in the lower end of the esophagus due to the increased pressure in these vessels caused by scar tissue formation

Increased sensitivity to drugs - due to the inability of the liver to inactivate them

Encephalopathy (impending coma) - subtle mental changes advancing to profound confusion and coma

Many patients may have no symptoms and are found to have cirrhosis by physical examination and laboratory tests, which may have been performed in the course of treatment for unrelated illnesses.

How is cirrhosis treated?

Treatment depends on the type and stage of the cirrhosis. It aims to stop the progress of the cirrhosis, reverse (to whatever extent possible) the damage that has already occurred, and treat complications that are disabling or life-threatening.

Stopping or reversing the process requires removal of the case:

In alcoholic cirrhosis: Abstention from alcohol; an adequate, wholesome diet

In cirrhosis caused by primary biliary cirrhosis: ursodeoxycholic acid is recommended

In cirrhosis caused by viral hepatitis: Medication to improve immune responses to viral infection is an approved approach

In certain types of cirrhosis caused by autoimmune hepatitis: Corticosteroids alone or with azathioprine may be an effective treatment

In cirrhotic patients with jaundice: Supplemental fat soluble vitamins may be helpful

Wilson’s disease: Removal of excess copper by drugs that deplete the body’s copper

Hemochromatosis: Removal of excess iron by phlebotomy (removal of one pint of blood per week)

Most types of cirrhosis: Liver transplantation with replacement of the diseases organ when advances liver failure occurs

What are the complications of cirrhosis?

Complications of cirrhosis include ascites, coma and hemorrhage from esophageal varices.

Ascites is treated by reducing the intake of salt and the administration of drugs to improve excretion of salt and water (diuretics). In some instances, large amounts of fluids are removed by direct catheter drainage through the abdominal wall (large volume paracentesis).

Treatment of coma, or impending coma (encephalopathy), includes specific medication and control of intestinal hemorrhage.

Treatment of hemorrhage from varices (internal varicose veins) includes drugs to reduce the likelihood of bleeding or rebleeding, endoscopic band ligation of varices, and a radiological procedure called transjugular intrahepatic portosystemic shunt (TIPS).

How can I avoid cirrhosis?

Do not drink to excess: Avoid the use of alcoholic beverages. Alcohol destroys liver cells. How well damaged cells regenerate varies with each individual. Prior injury to the liver by unknown and unrecognizable viruses or chemicals can also affect the regeneration process.

Take precautions when using man-made chemicals: The liver must process many chemicals that were not present in the past. More research is needed to determine the effects on the liver of many of these compounds. When using chemicals at work, in cleaning your home, or working in your garden:

Be sure there is good ventilation

Follow directions for use of all products

Never mix chemical products

Avoid getting chemicals on the skin, where they can be absorbed, and wash promptly if you do

Avoid inhaling chemicals

Wear protective clothing

Seek medical advice.

Remain under supervision of a physician if you develop viral hepatitis until your recovery is assured.

How might cirrhosis affect other diseases I might have or treatment of them?

The responsibility of the liver for the proper functioning of the whole body is so great that the chronic disease of the liver may modify the body’s responses to a variety of illnesses. Abnormal function of the liver in cirrhosis may:

Affect the dose of medicine required in the treatment of other conditions

Affect the treatment of diabetes

Alter the response of the body to infection

Alter tolerance for surgical procedures

Patients with cirrhosis are particularly prone to develop fatal bacterial infections, kidney malfunctions, stomach ulcers, gallstones, a type of diabetes and cancer of the liver.

What are my prospects for reasonable health and survival with treatment?

Treatment at this stage, with proper adherence to the physician’s recommendations, leads to improvement in the majority of cases and the patient is able to pursue a normal life and activities.

When cirrhosis is not discovered until extensive damage has resulted, the outlook may be less favorable for improvement, and complications such as ascites and hemorrhage are more likely to be encountered.

The liver is a large organ and is able to perform its vital functions despite some damage. It also has the ability to repair itself to a limited degree. Cells that die are replaced by new cells. If the cause of cirrhosis can be removed, these factors provide hope for both improvement and carrying on a normal life.

An increasing number of scientific investigators conducting liver research give hope for new breakthroughs in treatment, management and cures for liver disease in the near future.

[Nam Kao]

Thats is, i am on the wagon

[udon]

Faarkenell Tax x, I hope there is no page 2.

[Head Snake]

Syd,

Carpe el diems!!

It seems others have the health side of it sussed in previous posts.

Now get mental and go out and get some Serotonin generator and get to smiling.

[Tolley]

Go the natural way and get into the fresh veggies juices , vitamins especially milk thistle....stop all refined sugars, fried foods, red meats etc and embark on an exercise regime......you might be surprised how the body can recover....good luck

[Abandon]

Thats is, i am on the wagon

4 me 9 years without a drop.

Stopped smoking 4 months ago.

Now I have to cut cholesterol

[Neeranam]

QUOTE(Nam Kao @ 2005-09-13 23:19:45)

Thats is, i am on the wagon ermm.gif

*

4 me 9 years without a drop.

Stopped smoking 4 months ago.

Now I have to cut cholesterol sad.gif

Respect!

You are one of the lucky ones. many can't give it up even with something like liver damage.

[ThaiPauly]

QUOTE(Nam Kao @ 2005-09-13 23:19:45)

Thats is, i am on the wagon ermm.gif

*

4 me 9 years without a drop.

Stopped smoking 4 months ago.

Now I have to cut cholesterol sad.gif

Respect!

You are one of the lucky ones. many can't give it up even with something like liver damage.

<{POST_SNAPBACK}>

You are so right. I was diagnosed with Liver problems and Hepititas a year ago and was told to stop drinking or face the consequences.

Well I did not, it's only now because I feel so rough ALL THE TIME, (although being in the operating treatre five times in 3 months has not helped much) I have quit and I hope I have done so before it's to late. It is so ###### hard, but has to be done. I am sick and tired of feeling sick and tired.

Syd, I wish you all the luck in the world. The good thing is you have age on your side, follow the advice of some of the posts here, these guys are so so helpful and supportive, ans we will be with you all the way through your recovery.

Chok Dee my freind

TP

[terdsak_12]

I've been taking these Thistle Milk tablets for the past 6 months, apparently they're good for regenerating your liver, or so I kid myself.

[johnh101]

Try these links for info on alternative medicines.

http://naam-liver.lle.org/

http://www.ayurveda-herbs.com/5.htm

Never listen to a death sentence, go and do research yourself, change your lifestyle and diet and you'll prove them all wrong.

Good Luck

John

[Crossy]

Syd, keep the pecker up and shelve the booze.

Plenty of good advice here so there's no need for me to add my feeble search results.

THEY ALL SAY THAT IF YOU GIVE UP DRINKING THE PROGNOSIS IS GOOD.

Go for it, and the very best of British luck!!

[dr_Pat_Pong]

Faarkenell Tax x, I hope there is no page 2.

<{POST_SNAPBACK}>

War and Peace

[Nam Kao]

Guys, i have cut down alot after reading this thread, thanks for posting it Syd

-nam

[Mighty Mouse]

At an early age I was told that the liver becomes damaged quickly when it is forced to cope with a constant flow of alcohol. In other words, it is far better to have a binge drink once per week and then nothing at all for the remainder of the week, as opposed to having just a few alcoholic drinks every day.

For that reason I only drink on weekends and stay alcohol free during the week.

Liver damage is not necessarily the end of the road. Transplants are quite common these days, and from what others have posted in this thread there is a good chance that the liver can repair itself.

Syd, I have no doubt that you will be posting here for many years to come, but you may have to switch to iced tea.

Whatever you do, be strong and don't let it beat you.

[dr_Pat_Pong]

At an early age I was told that the liver becomes damaged quickly when it is forced to cope with a constant flow of alcohol. In other words, it is far better to have a binge drink once per week and then nothing at all for the remainder of the week, as opposed to having just a few alcoholic drinks every day.

For that reason I only drink on weekends and stay alcohol free during the week.

Liver damage is not necessarily the end of the road. Transplants are quite common these days, and from what others have posted in this thread there is a good chance that the liver can repair itself.

Syd, I have no doubt that you will be posting here for many years to come, but you may have to switch to iced tea.

Whatever you do, be strong and don't let it beat you.

<{POST_SNAPBACK}>

[The_Moog]

A downside in Thailand, is that unless one drinks, its so much harder to have a social life, as so many social activities revolve around booze. (Far more so than in Hong Kong or London in my experience).

Going to Soi Cowboy and drinking cold tea is thoroughly miserable.

[Jockstar]

Going to Soi Cowboy and drinking cold tea is thoroughly miserable.

I didnt do that last night.

[Neeranam]

A downside in Thailand, is that unless one drinks, its so much harder to have a social life, as so many social activities revolve around booze. (Far more so than in Hong Kong or London in my experience).

Going to Soi Cowboy and drinking cold tea is thoroughly miserable.

I have to disagree, Mr Moog. When you accpept thaat you can't drink normally you can get a whole new group of friends, but you don't need to become a recluse. I have had very memorable nigths at soi comboy without drinking booze .

It is hard to begin with, but soon changes. I have been many times also with old drinking friends on special occasions. I had to leave early as they got way out of order, doing crazy things. man, if I had seen what rediculous stunts I got up to, I'd be totally embarassed.

[The_Moog]

I had to leave early as they got way out of order, doing crazy things.

Ah, you've been to a Thaivisa official or unofficial pissup.

[chuchok]

A downside in Thailand, is that unless one drinks, its so much harder to have a social life, as so many social activities revolve around booze. (Far more so than in Hong Kong or London in my experience).

Going to Soi Cowboy and drinking cold tea is thoroughly miserable.

I have to disagree, Mr Moog. When you accpept thaat you can't drink normally you can get a whole new group of friends, but you don't need to become a recluse. I have had very memorable nigths at soi comboy without drinking booze .

It is hard to begin with, but soon changes. I have been many times also with old drinking friends on special occasions. I had to leave early as they got way out of order, doing crazy things. man, if I had seen what rediculous stunts I got up to, I'd be totally embarassed.

<{POST_SNAPBACK}>

Is that a typo?

Edited October 27, 2005 by chuchok

[Ijustwannateach]

I had a friend once who lost something like 60% of his liver from a weird virus that had tagged along with a bad case of mono... he had to stop drinking completely for 2 years, but recovered completely and seemed perfectly fine the last 3-4 times he flew in to meet me. Don't give up hope. Do give up booze.

[Buff-horns]

how much is a replacement liver in LOS ?

there must be plenty of spare parts around .(due to the accidents)

[boppia]

Hang in there, you'll make.

Everyone should try to cut back on the stuff.

[merlin1]

Syd dude,

Hang in there and take advantage of alternative cures-- milk thistle, TCM, avurvedic, etc.

Here's a link to a review of some studies that have been done on cirrhosis. Some encouraging stuff there for sure.

https://ssl.adgrafix.com/users/lifestag/cir...lternative.html