Chronic Liver Disease

What is Chronic Liver Disease?

Chronic Liver Disease (CLD) is a set of diseases characterized by liver function deterioration due to chronic inflammation. At its most advanced stage, CLD also leads to development of Cirrhosis. Cirrhosis is characterized by the deep scarring of the liver tissue, caused by replacement of the healthy liver tissue scar tissue with damaged tissue as a result of the cell repair process done by the body. The damaged liver tissue would affect the liver functioning. The scar tissue leads to decreased flow of the blood through the liver and loss of liver cells slows down the liver functions. It hampers its ability to digest and process the various nutrients, medications, hormones, and natural toxins (poisons) that we consume in our day-to-day life. The liver also plays a vital role in producing proteins and other substances, which may be hampered due to loss of healthy active liver cells. At late stages, if liver care is not done in time, Cirrhosis can also be life threatening.

According to recent studies , CLD is a worldwide health concern with 844 million people impacted and over 2 million deaths annually.

Persons at risk of getting chronic liver disease, who have history of alcoholism, viral hepatitis, obesity, diabetes, history of fatty liver, autoimmune diseases.

Chronic Liver Disease Treatment

Symptoms

People in the initial stages may be very much asymptomatic, and it can just be noticed on routine body checkup. However, patients may go through a feeling of weakness, and there might be a sudden loss in weight without any reason. In the later stages, the patients may have jaundice.

  • There may be heaviness in the abdomen with fullness, and veins around the belly button may get enlarged.
  • There may be gastro-intestinal bleeding (blood in vomitus or blood in stools). The Excretion of dark black colored stool is also a visible symptom.
  • Patient would have jaundice, with yellow discoloration of skin and eyes, dark colored urine, darkness in complexion.
  • Patient may feel a sense of confusion all the time.

Stages of liver sell damage/ stages of fibrosis, as per biopsy

Stage 1: In the first stage the symptoms are rarely seen. There is a very little amount of damage. Mild fibrosis can be seen in this case and there is no scarring of walls visible at this stage of liver cirrhosis.

Stage 2: In this stage, the fibrosis starts to grow from mild to moderate. The scarring is slightly seen.

Stage 3: In the third stage the fibrosis starts to spread to various parts of the liver and the scarring spreads as well.

Stage 4: This is the last and final stage. It is in this stage where severe scarring is seen, and this condition is what is known as cirrhosis.

Stages of Cirrhosis can be divided as compensated and decompensated chronic liver diseases, as per clinical symptoms.

Compensated Cirrhosis, there are no noticeable signs of liver disease, no major abnormality in the blood tests. There can be a few features of chronic liver disease in radiological investigations and liver Biopsy.

Decompensated Cirrhosis, The symptoms and signs of chronic liver disease is very noticeable, with worsening of blood investigations with obvious features of CLD and worsening in radiological tests and biopsy (not routinely recommended). The chances of atleast one life threatening complications is higher in decompensated patients, needing immediate medical attention. Survival in such patients with decompensated cirrhosis is approximately 6-12 months.

Liver cirrhosis: Diagnosis, treatment, and recovery:

Diagnosis: The diagnosis of Liver Cirrhosis involves the following steps:

  • A brief look into the Medical History
  • A Physical Examination
  • A series of Blood Tests
  • Some Imaging Tests
  • A Liver Biopsy

Try consulting a best liver specialist doctor in Delhi, in case you are located in Delhi. If your doctor suspects that you are suffering from liver cirrhosis, he may recommend you undergo the following tests or scans as a diagnostic parameter for liver cirrhosis treatment.

  • Abdominal computed tomography (CT) scan
  • Abdominal ultrasound
  • Elastography
  • Body magnetic resonance imaging (MRI)
  • Biopsy
  • Liver function test

After the diagnostic tests reveal that you have been suffering from liver cirrhosis, your doctor may recommend various liver cirrhosis treatment options to help slow the liver tissue scarring and relieve the symptoms. Your gastro doctor may initially try to treat the underlying cause behind liver cirrhosis.

Preventive steps to avoid occurance of chronic liver disease includes the following:

  • Do not abuse alcohol. Limit drinking to 2 drinks for men or 1 drink for women. No dirnking of alcohol in presence of any liver disease.
  • Eating a well balanced, healthy, low fat diet
  • Maintain body weight
  • Regular exercise
  • Avoid high risk behaviors (IV drug abusing and multiple sex partners), that can lead to infection with hepatitis
  • Get vaccinations for Hepatitis B

Treatment depends upon the stage of the cirrhosis, its mainly medical in compensated stage. There is no permanent cure of chronic liver disease as damage to the liver is irreversible. Most of the treatment is based on removal of offending agent, precautions to slow down the damage, prevention and treatment of the complications. Such patients are advised to stop drinking alcohol, offending medications and are suggested to take balanced, healthy, low fat diet.

Lifestyle modifications: These may include dietary changes like intake of foods rich in fiber, low sodium content, antioxidants, and a plant-based diet. It is important to avoid or at least minimize the use of salt and all forms of sodium. The maximum amount of sodium intake should be less than 2,000 mg in a day. Alcohol must be completely avoided as it may be very harmful to the person suffering from Liver Cirrhosis.

Diuretics: It increases the production of urine which further helps in getting rid of any excess salt content and water as well.

Ammonia Reducer: It helps to reduce the ammonia content in the body and helps in stabilizing the impact of ammonia.

Beta Blocker: The pressure on eyes can be reduced with the help of beta blocker when taken in the form of eye drops. It also helps in slowing down the heart rate and the blood pressure of the patient.

Antibiotics and Antiviral Drugs: They help in the stopping of the growth of bacteria by killing them and help in not letting the viruses replicate and multiply.

Medications:

  • Rubber Band Ligation: It involves tying off the bleeding blood vessels and blocking the supply of blood. It is done with the help of a rubber band and it causes the blood vessel to dry up and eventually fall off.
  • Therapeutic Endoscopy: This endoscopic method uses a thin tube-like instrument with a light and camera on its tip. It is used in order to get a view of the inside of the body and removal of any foreign object which may cause trouble.
  • Trans jugular Intrahepatic Portosystemic Unit: It involves the placement of a tube or stent inside the liver which helps by providing a backup of blood in the veins.

Surgery:

While there is no cure for liver cirrhosis, and in severe cases, a liver transplant may help treat the damage caused due to liver cirrhosis. The surgical treatment involves the transplant of the liver in which a healthy donor can donate a part of their liver to the diseased person.