• 02May

    What causes cirrhosis of the liver?

    Liver is the metabolic centre of human body. The metabolism of carbohydrates, fats, proteins and all other micronutrients takes place here. It provides energy to the entire body because of its ability to store and metabolize nutrients. It also secretes bile which is stored in the gall bladder and takes part in fat digestion. Any disease which involves liver has a systemic effect because the powerhouse of the body is affected. Cirrhosis is one such disease of importance which is prevalent worldwide. 

    Cirrhosis – A chronic disease

    Cirrhosis of liver is a disease in which there is destruction of hepatocytes due to various reasons. These functioning cells are replaced by fibrosis tissue which results in liver failure. To compensate for the loss of function, the remaining liver cells undergo multiplication or hyperplasia which results in nodule formation. So, a cirrhotic liver is a shrunken, nodular organ with diminished function.

    How does cirrhosis occur?

    Cirrhosis is an important cause of morbidity and mortality resulting in premature death of patient. Viral infections of liver and chronic alcohol consumption are the two most common causes. The causes of cirrhosis are listed below:

    Liver is the main organ for metabolism of alcohol.

    Liver is the main organ for metabolism of alcohol.

    Alcohol: Liver is the main organ for metabolism of alcohol. Chronic exposure to alcohol results in a spectrum of liver disorders. In mild cases, there is fatty infiltration of liver in which fat accumulates in all the liver cells. This results in an increase in the size of the liver. This is the earliest and most predictable effect of alcohol ingestion and is seen in majority of heavy alcohol drinkers. The good thing about this condition is that it is reversible, which means that with abstinence it disappears quickly without any residual damage to liver. If these people continue to drink alcohol, cirrhosis is likely to develop.

    Heavy drinkers develop alcohol induced hepatitis, which has been reported in 10 to 35% of such patients. This condition is an important precursor of cirrhosis of liver. In these patients, the risk of cirrhosis is nine times higher than those with fatty liver. Initially the cirrhosis has a very fine nodular pattern described as micro-nodular cirrhosis, which may evolve into macro-nodular variety. Cancer of liver may occur in these patients.

    Chronic hepatitis due to viruses: Chronic infection with hepatitis B virus occurs in up to 5% of patients out of which 25 to 30% develop cirrhosis and a high risk of liver cancer. The virus causes chronic inflammation and death of liver cells over a period of time. The prognosis also depends on the associated complications of cirrhosis like ascites, jaundice, encephalopathy or bleeding from oesophageal varices. Many of these patients become candidates for liver transplantation which improves their life expectancy.

    Hepatitis C virus leads to chronic infection because of its ability to evade immune response in majority of the infected patients. The resulting chronic infection can cause cirrhosis and carcinoma liver.

    Autoimmune diseases: In autoimmune liver disease, destruction of liver cells occurs due to many mechanisms which include cell-mediated cytotoxicity, antibody-dependent cell-mediated cytotoxicity, or a combination of both mechanisms.

    Immune system plays a key role in the pathogenesis of Primary sclerosing cholangitis as it is frequently associated with other autoimmune disorders like type-I diabetes mellitus and Graves’ disease. Abnormalities of both humoral and cellular immunity have been described in these patients which include an increase in circulating antibodies like antinuclear antibodies, anti-smooth muscle antibodies and atypical perinuclear antineutrophil cytoplasmic antibodies.

    Biliary diseases: Primary biliary cirrhosis is an autoimmune disease which leads to progressive destruction of bile ducts, chronic stasis of bile and finally biliary cirrhosis. There is the result of severe humoral and cellular response to an intracytoplasmic antigen, presence of antimitochondrial antibodies and involvement of T lymphocytes in the destruction of bile ducts. Secondary biliary cirrhosis occurs secondary to obstruction of biliary duct

     Genetic diseases: Haemochromatosis, Wilson’s disease, α1-antitrypsin deficiency are rare disorders associated with cirrhosis of liver. They require special investigations for diagnosis because of specific causes. They increase the risk for cirrhosis and cancer of liver.

    Cirrhosis of liver is a chronic disease of liver which leads to progressive deterioration of function. Prevention of hepatitis viral infection is an important issue and awareness is essential for healthcare workers. An early diagnosis and prompt initiation of treatment may delay the complications of cirrhosis including cancer.

    Anna L.

    It’s all about health!
    I have academic background in drugs related Chemical Technology, as well as extensive professional experience in pharma and medical companies. My main area of interest is everyday life medicine. The goal of my articles is to give people informative answers to the questions that bother them, to dispel doubts and some common misbeliefs and also to inspire everyone to keep healthy lifestyle.

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