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Cirrhosis

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Complications of Cirrhosis

Cirrhosis - pronounced suh-ROH-sis.

As liver function deteriorates, one or more complications may develop. In some people, complications may be the first signs of the disease.

Edema and Ascites

When liver damage progresses to an advanced stage, fluid collects in the legs, called edema, and in the abdomen, called ascites. Ascites can lead to bacterial peritonitis, a serious infection.

Bruising and Bleeding

When the liver slows or stops producing the proteins needed for blood clotting, a person will bruise or bleed easily.

Normal Liver Liver with Cirrhosis

Portal Hypertension

Normally, blood from the intestines and spleen is carried to the liver through the portal vein. But cirrhosis slows the normal flow of blood, which increases the pressure in the portal vein. This condition is called portal hypertension.

Esophageal Varices and Gastropathy

When portal hypertension occurs, it may cause enlarged blood vessels in the esophagus, called varices, or in the stomach, called gastropathy, or both. Enlarged blood vessels are more likely to burst due to thin walls and increased pressure. If they burst, serious bleeding can occur in the esophagus or upper stomach, requiring immediate medical attention.

Splenomegaly

When portal hypertension occurs, the spleen frequently enlarges and holds white blood cells and platelets, reducing the numbers of these cells in the blood. A low platelet count may be the first evidence that a person has developed cirrhosis.

Jaundice

Jaundice occurs when the diseased liver does not remove enough bilirubin from the blood, causing yellowing of the skin and whites of the eyes and darkening of the urine. Bilirubin is the pigment that gives bile its reddish yellow color.

Gallstones

If cirrhosis prevents bile from flowing freely to and from the gallbladder, the bile hardens as gallstones.

Sensitivity to Medications

Cirrhosis slows the liver's ability to filter medications from the blood. When this occurs, medications act longer than expected and build up in the body. This causes a person to be more sensitive to medications and their side effects.

Hepatic Encephalopathy

A failing liver cannot remove toxins from the blood, and they eventually accumulate in the brain. The buildup of toxins in the brain, called hepatic encephalopathy, can decrease mental function and cause coma. Signs of decreased mental function include:

  • Confusion
  • Personality changes
  • Memory loss
  • Trouble concentrating
  • A change in sleep habits

Insulin Resistance and Type 2 Diabetes

Cirrhosis causes resistance to insulin, a hormone produced by the pancreas that enables the body to use glucose as energy. With insulin resistance, the body's muscle, fat, and liver cells do not use insulin properly. The pancreas tries to keep up with the demand for insulin by producing more, but excess glucose builds up in the bloodstream causing type 2 diabetes.

Liver Cancer

Hepatocellular carcinoma is a type of liver cancer that can occur in people with cirrhosis. Hepatocellular carcinoma has a high mortality rate, but several treatment options are available.

Other Problems

Cirrhosis can cause immune system dysfunction, leading to the risk of infection. Cirrhosis can also cause kidney and lung failure, known as hepatorenal and hepatopulmonary syndromes.


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References:
National Digestive Diseases Information Clearinghouse (NDDIC)
December 2008
digestive.niddk.nih.gov

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