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Cirrhosis
Classification and external resources

Micrograph showing cirrhosis. Trichrome stain.
ICD-10 K70.3, K71.7, K74.
ICD-9 571
DiseasesDB 2729
eMedicine med/3183 radio/175
MeSH D008103
.Cirrhosis (pronounced /sɪˈroʊsɪs/, si-ROH-sis) is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrosis, scar tissue and regenerative nodules (lumps that occur as a result of a process in which damaged tissue is regenerated),[1][2][3] leading to progressive loss of liver function.^ Liver cirrhosis is a term that refers to a group of chronic diseases of the liver in which normal liver cells are damaged and replaced by scar tissue.
  • Liver Cirrhosis: symptoms, cause, treatment, long-term outlook, prevention, complications 10 February 2010 13:27 UTC www.mamashealth.com [Source type: Academic]

 ^ CONDITIONS LEADING TO LIVER TRANSPLANT Cirrhosis: Irreversible damage to liver cells.
  • MoonDragon's Health & Wellness: Cirrhosis of the Liver 12 September 2009 4:14 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

 ^ Once scarring of the liver occurs, it is permanent.

 .Cirrhosis is most commonly caused by alcoholism, hepatitis B and C, and fatty liver disease but has many other possible causes.^ Cirrhosis is most commonly caused by alcoholism, hepatitis B and ...
  • Cirrhosis - Kosmix : Reference, Videos, Images, News, Shopping and more... 10 February 2010 13:27 UTC www.kosmix.com [Source type: Academic]

 ^ The most common cause of cirrhosis is drinking too much alcohol.
  • Cirrhosis and Portal Hypertension -- familydoctor.org 10 February 2010 13:27 UTC familydoctor.org [Source type: General]
  • http://familydoctor.org/online/famdocen/home/articles/188.printerview.html 10 February 2010 13:27 UTC familydoctor.org [Source type: FILTERED WITH BAYES]
  • Alcoholic Cirrhosis - Ethanol Induced Hepatic Cirrhosis 10 February 2010 13:27 UTC www.diseasesatoz.com [Source type: FILTERED WITH BAYES]

 ^ Cirrhosis is the most severe type of alcoholic liver disease.
  • Alcohol-induced cirrhosis 10 February 2010 13:27 UTC hcd2.bupa.co.uk [Source type: General]

 .Some cases are idiopathic, i.e., of unknown cause.^ However, in some cases, antibodies may improperly form against certain of the body's own tissues, causing autoimmune disease.
  • CIGNA - Cirrhosis, Primary Biliary 10 February 2010 13:27 UTC www.cigna.com [Source type: Academic]

 ^ In some cases an infectious force (such as malaria or flu virus) was a causative factor.
  • CIRRHOSIS OF THE LIVER : Edgar Cayce Health Remedies: Cirrhosis of the liver 10 February 2010 13:27 UTC www.edgarcayce.org [Source type: Academic]
  • CIRRHOSIS OF THE LIVER 10 February 2010 13:27 UTC www.edgarcayce.org [Source type: Academic]

 ^ The added pressure in these blood vessels, called varices can cause them to enlarge and, in some cases, rupture.
  • HIPUSA.COM - eTools 10 February 2010 13:27 UTC www.hipusa.com [Source type: FILTERED WITH BAYES]
.Ascites (fluid retention in the abdominal cavity) is the most common complication of cirrhosis and is associated with a poor quality of life, increased risk of infection, and a poor long-term outcome.^ It also addresses the complications and risks of cirrhosis.

 ^ Ascites is the most adjectives complication of cirrhosis and is associated with a poor element of life, increased risk of infections, and a poor long permanent status outcome .
  • what is cirrhosis of the liver? 12 September 2009 4:14 UTC dcqna.com [Source type: Academic]

 ^ Long-term compliance with BCAA was poor.
  • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

 .Other potentially life-threatening complications are hepatic encephalopathy (confusion and coma) and bleeding from esophageal varices.^ Complications of cirrhosis include ascites, coma and hemorrhage from esophageal varices.
  • Hepatitis C, Cirrhosis, Current Information On Hepatitis C & treatments for the medical professional and patient. 10 February 2010 13:27 UTC www.hepatitis-central.com [Source type: Academic]

 ^ Potential Complications Complications include bleeding esophageal varices, which can lead to massive hemorrhage; hepatorenal syndrome, which leads to renal failure; and hepatic encephalopathy, which leads to coma and death.
  • Cirrhosis | Medical Encyclopedia 10 February 2010 13:27 UTC www.4gg.info [Source type: Academic]

 ^ These varices can tear and bleed, and this bleeding can be life threatening.

 .Cirrhosis is generally irreversible, and treatment usually focuses on preventing progression and complications.^ Progress in the management and prevention of cirrhosis continues.

 ^ Cirrhosis is irreversible, but its progression and the complications it causes can, possibly, be avoided.
  • Cirrhosis - Erewhon Natural Foods 10 February 2010 13:27 UTC www.erewhonmarket.com [Source type: Academic]
  • Statesman Health : Integrative Medicine  :  Conditions   :  Cirrhosis 12 September 2009 4:14 UTC www.statesman.com [Source type: Academic]

 ^ The focus of treatment is to prevent or delay progression of the disease and to prevent or reduce complications.

 .In advanced stages of cirrhosis the only option is a liver transplant.^ Liver transplantation is only therapeutic option for patients who have end-stage disease.
  • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

 ^ In advanced stages of cirrhosis , the condition is irreversible and the only risk would be a liver transplant .
  • what is cirrhosis of the liver? 12 September 2009 4:14 UTC dcqna.com [Source type: Academic]

 ^ Liver tansplantation is becoming an important option for patients with advanced cirrhosis.
.The word "cirrhosis" derives from Greek κίρῥος, meaning tawny (the orange-yellow colour of the diseased liver).^ Cirrhosis: Advanced liver disease.

 ^ Cirrhosis of the liver is a common disease that can ...
  • Cirrhosis Liver pictures ::Disease Gallery 10 February 2010 13:27 UTC health.bayaw.com [Source type: Academic]

 ^ (The word "hepatic" derives from the Latin word for liver.

 .While the clinical entity was known before, it was René Laennec who gave it the name "cirrhosis" in his 1819 work in which he also describes the stethoscope.^ Compensated cirrhosis might have no symptoms, since the liver can lose three-quarters of its cells before clinical signs of liver failure become apparent.

 ^ Although there are multiple causes of liver injury, the common result - cirrhosis - is associated with well-known and highly consistent clinical manifestations.
  • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]

 ^ Alcohol-induced cirrhosis (also known as alcoholic cirrhosis) is the term used to describe cirrhosis which has been brought on by consuming large amounts of alcohol, usually over many years.
  • Alcohol-induced cirrhosis 10 February 2010 13:27 UTC hcd2.bupa.co.uk [Source type: General]

 [4]

Contents

Signs and symptoms

.Some of the following signs and symptoms may occur in the presence of cirrhosis or as a result of the complications of cirrhosis.^ Signs of advanced cirrhosis may include: .
  • Dr Sandra Cabot's Liver Doctor - Love your Liver and Live Longer 10 February 2010 13:27 UTC www.liverdoctor.com [Source type: Academic]

 ^ As the liver develops advanced cirrhosis the following symptoms may occur: .
  • http://www.lola-national.org/infosheets/cirrhosis_liver2.html 10 February 2010 13:27 UTC www.lola-national.org [Source type: Academic]

 ^ What signs and symptoms of complications should I be alert for?

 .Many are nonspecific and may occur in other diseases and do not necessarily point to cirrhosis.^ Other diseases associated with cirrhosis .
  • Cirrhosis: eMedicine Gastroenterology 10 February 2010 13:27 UTC emedicine.medscape.com [Source type: Academic]

 ^ Many types of liver disease may lead to cirrhosis.
  • Cirrhosis of the Liver Treatment of Children at Mayo Clinic 10 February 2010 13:27 UTC www.mayoclinic.org [Source type: Academic]

 ^ Cirrhosis may entail other complications: .
  • Cirrhosis and Liver Disease: Online References For Health Concerns 10 February 2010 13:27 UTC www.lef.org [Source type: Academic]

 .Likewise, the absence of any does not rule out the possibility of cirrhosis.^ Ruling out cirrhosis?

 ^ Yet when it does occur, cirrhosis can be life-threatening because it interferes with the liver's ability to carry out essential functions.
  • Primary biliary cirrhosis: Complications - MayoClinic.com 12 September 2009 12:21 UTC www.mayoclinic.com [Source type: FILTERED WITH BAYES]
  • georgiahealthinfo.gov 10 February 2010 13:27 UTC georgiahealthinfo.gov [Source type: FILTERED WITH BAYES]

 ^ EEG may be helpful in the initial workup of a patient with cirrhosis and altered mental status when ruling out seizure activity may be necessary.
  • Cirrhosis: eMedicine Gastroenterology 10 February 2010 13:27 UTC emedicine.medscape.com [Source type: Academic]
  • Spider angiomata or spider nevi. .Vascular lesions consisting of a central arteriole surrounded by many smaller vessels due to an increase in estradiol.^ HCCs are very vascular (containing many blood vessels) tumors.
    • Cirrhosis | Oncology and Neuroscience Blog from Elekta 10 February 2010 13:27 UTC blog.elekta.com [Source type: Academic]

     ^ The naevi consists of a central arteriole with radiating capillaries.
    • Cirrhosis Of Liver | Liver Cirrhosis Diagnosis | Causes Of Liver Cirrhosis 12 September 2009 12:21 UTC www.tandurust.com [Source type: Academic]

     ^ The most common risk of the aspiration or biopsy is bleeding, especially because HCC is a tumor that is very vascular (contains many blood vessels).
    • Cirrhosis | Oncology and Neuroscience Blog from Elekta 10 February 2010 13:27 UTC blog.elekta.com [Source type: Academic]

     .These occur in about 1/3 of cases.^ Severe acute hepatitis B can occur in about 1% of cases, and often is linked to the simultaneous transmission of another hepatitis virus, called hepatitis delta virus.

     ^ When these substances escape into the bloodstream, as occurs in severe cases of cirrhosis, a variety of changes in mental function can develop.
    • Sterling Rock Falls Clinic :: Gastroenterology :: Cirrhosis 10 February 2010 13:27 UTC www.srfc.com [Source type: Academic]
    • psc_cirrhosis 10 February 2010 13:27 UTC www.psctrust.com [Source type: Academic]
    • IMA Endoscopy Surgicenter 10 February 2010 13:27 UTC www.gimed.com [Source type: Academic]

     ^ About 95% of primary biliary cirrhosis cases occur in women, mostly between the ages of 30 and 50.

     [5]
  • Palmar erythema. .Exaggerations of normal speckled mottling of the palm, due to altered sex hormone metabolism.
  • Nail changes.^ It also damages the liver by altering normal metabolism of proteins, fats, and carbohydrates.

     ^ Palmar erythema is an exaggeration of the normal spotty redness on the palms of the hands.
    • Cirrhosis 10 February 2010 13:27 UTC janis7hepc.com [Source type: Academic]

     .
    • Muehrcke's nails - paired horizontal bands separated by normal color due to hypoalbuminemia (inadequate production of albumin).
    • Terry's nails - proximal two-thirds of the nail plate appears white with distal one-third red, also due to hypoalbuminemia
    • Clubbing - angle between the nail plate and proximal nail fold > 180 degrees
  • Hypertrophic osteoarthropathy.^ In this case, the two-thirds of nail plate closest to the hand appears white whereas the furthest one-third is red.
    • Cirrhosis 10 February 2010 13:27 UTC janis7hepc.com [Source type: Academic]

     ^ Muehrcke’s nails are characterized by paired horizontal white bands separated by normal color in the nail.
    • Cirrhosis 10 February 2010 13:27 UTC janis7hepc.com [Source type: Academic]

     ^ Low fever, white opaque nails, clubbing of nails, cyanosis and ‘faetor hepaticus’ are infrequent features.
    • Cirrhosis Of Liver | Liver Cirrhosis Diagnosis | Causes Of Liver Cirrhosis 12 September 2009 12:21 UTC www.tandurust.com [Source type: Academic]

     .Chronic proliferative periostitis of the long bones that can cause considerable pain.
  • Dupuytren's contracture.^ Is cirrhosis something that causes chronic pain after a while??
    • Questions about Causes Cirrhosis - Ask.com 10 February 2010 13:27 UTC www.ask.com [Source type: General]

     ^ Common causes of chronic liver disease in the US include hepatitis C infection and long-term alcohol abuse (see Alcoholic liver disease ).
    • Cirrhosis - Delnor, Geneva and Fox Valley, IL 10 February 2010 13:27 UTC www.delnor.com [Source type: Academic]
    • HowStuffWorks "Cirrhosis - Medical Dictionary" 10 February 2010 13:27 UTC healthguide.howstuffworks.com [Source type: Academic]

     ^ Common causes of chronic liver disease in the US include hepatitis C  infection and long-term alcohol abuse  (see Alcoholic liver disease ).
    • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]

     Thickening and shortening of palmar fascia that leads to flexion deformities of the fingers. Thought to be due to fibroblastic proliferation and disorderly collagen deposition. It is relatively common (33% of patients).
  • Gynecomastia. Benign proliferation of glandular tissue of male breasts presenting with a rubbery or firm mass extending concentrically from the nipples. .This is due to increased estradiol and can occur in up to 66% of patients.
  • Hypogonadism.^ It is important to diagnose noncirrhotic causes of ascites such as malignancy, tuberculosis, and pancreatic ascites since these occur with increased frequency in patients with liver disease.
    • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

     ^ Abdominal infection occurs in up to 25% of patients with cirrhosis within a year of diagnosis.

     ^ Albumin was introduced initially in the treatment of patients with cirrhosis and ascites to increase serum albumin concentration due to its oncotic effect.
    • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

     .Manifested as impotence, infertility, loss of sexual drive, and testicular atrophy due to primary gonadal injury or suppression of hypothalamic or pituitary function.
  • Liver size.^ Cirrhosis is the consequence of injury to the liver due to: .
    • DHMC | Gastroenterology and Hepatology | Cirrhosis 10 February 2010 13:27 UTC www.dhmc.org [Source type: FILTERED WITH BAYES]

     ^ Some patients present with menstrual abnormalities, impotence, and loss of sexual drive or painfully enlarged breasts (in men).
    • Texas Liver Coalition - What is cirrhosis? 10 February 2010 13:27 UTC www.texasliver.org [Source type: Academic]

     ^ Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function.
    • Symptoms of Liver Disease, Problems 12 September 2009 12:21 UTC www.y2khealthanddetox.com [Source type: FILTERED WITH BAYES]
    • Cirrhosis of the Liver - Associated Content - associatedcontent.com 10 February 2010 13:27 UTC www.associatedcontent.com [Source type: General]

     .Can be enlarged, normal, or shrunken.
  • Splenomegaly (increase in size of the spleen).^ Increased spleen size.
    • WellSpan Health Library 10 February 2010 13:27 UTC www.wellspan.org [Source type: FILTERED WITH BAYES]
    • Health Information 10 February 2010 13:27 UTC www.sutterhealth.org [Source type: FILTERED WITH BAYES]
    • Health Information 10 February 2010 13:27 UTC www.mmc.org [Source type: FILTERED WITH BAYES]

     ^ This blocks the normal flow of blood, causing the spleen to enlarge.
    • Cirrhosis of the Liver 10 February 2010 13:27 UTC www.dccc.edu [Source type: FILTERED WITH BAYES]
    • Texas Liver Coalition - What is cirrhosis? 10 February 2010 13:27 UTC www.texasliver.org [Source type: Academic]

     ^ Splenomegaly is an enlargement of the spleen beyond its normal size.
    • Cirrhosis | LIVESTRONG.COM 10 February 2010 13:27 UTC www.livestrong.com [Source type: General]

     .Due to congestion of the red pulp as a result of portal hypertension.
  • Ascites.^ These can occur as a result of portal hypertension.
    • Cirrhosis | Doctor | Patient UK 10 February 2010 13:27 UTC www.patient.co.uk [Source type: Academic]

     ^ Ascites is usually caused by portal hypertension, but it can result from other conditions.
    • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
    • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]
    • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

     ^ Increased hepatic resistance to portal flow due to cirrhosis causes the gradual development of portal hypertension, collateral-vein formation, and .
    • NEJM -- Management of Cirrhosis and Ascites 10 February 2010 13:27 UTC content.nejm.org [Source type: Academic]

     .Accumulation of fluid in the peritoneal cavity giving rise to flank dullness (needs about 1500 mL to detect flank dullness).^ Ascites is defined as the pathologic accumulation of fluid in the peritoneal cavity.
    • Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment - September 1, 2006 - American Family Physician 10 February 2010 13:27 UTC www.aafp.org [Source type: Academic]

     ^ Ascites is defined as an abnormal accumulation of fluid in the peritoneal cavity.
    • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]

     ^ Ascites is the accumulation of fluid within the peritoneal cavity.
    • Hepatic Cirrhosis, liver Cirrhosis, Notes on Cyber Gastroenterology, Dr. Julio Murra Saca, El Salvador. 10 February 2010 13:27 UTC www.murrasaca.com [Source type: Academic]

     It may be associated with hydrocele and penile flomation (swelling of the penile shaft)[citation needed] in men.
  • Caput medusa. .In portal hypertension, the umbilical vein may open.^ Increased pressure in the portal vein (portal hypertension).
    • Primary biliary cirrhosis: Complications - MayoClinic.com 12 September 2009 12:21 UTC www.mayoclinic.com [Source type: FILTERED WITH BAYES]
    • Primary biliary cirrhosis 10 February 2010 13:27 UTC www.cnn.com [Source type: General]
    • OhioHealth - Primary biliary cirrhosis 10 February 2010 13:27 UTC www.ohiohealth.com [Source type: General]
    • Primary biliary cirrhosis 10 February 2010 13:27 UTC e.a.cnn.net [Source type: General]
    • Primary biliary cirrhosis - Valley Health System 10 February 2010 13:27 UTC www.valleyhealth.com [Source type: General]
    • georgiahealthinfo.gov 10 February 2010 13:27 UTC georgiahealthinfo.gov [Source type: FILTERED WITH BAYES]

     ^ Obstruction of blood flow can cause the veins that bring blood to the liver to become larger and may lead to high blood pressure in the veins that flow from the intestines to the liver (portal hypertension).
    • Liver damage leading to fatty liver, Cirrhosis & Hepatitis 12 September 2009 12:21 UTC www.herbalprovider.com [Source type: Academic]

     ^ In addition, they may develop a specific type of high blood pressure, called portal hypertension, in the blood vessels that go from the intestine to the liver.

     .Blood from the portal venous system may be shunted through the periumbilical veins into the umbilical vein and ultimately to the abdominal wall veins, manifesting as caput medusa.
  • Cruveilhier-Baumgarten murmur.^ When the liver is scarred and distorted the flow of blood into the liver through the portal vein is impaired.
    • Cirrhosis | Liver Diseases| MUSC Digestive Disease Center 10 February 2010 13:27 UTC www.ddc.musc.edu [Source type: Academic]

     ^ Venodilation on abdominal wall and dilated abdominal wall veins e.
    • Herb for Liver disease, NASH, hepatitis c, fatty liver,liver cirrhosis,liver cancer. 12 September 2009 12:21 UTC www.liver-health.info [Source type: Academic]

     ^ A portal shunt, or portal systemic shunt.
    • Cirrhosis 10 February 2010 13:27 UTC www.hcvets.com [Source type: Academic]
    • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
    • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

     .Venous hum heard in epigastric region (on examination by stethoscope) due to collateral connections between portal system and the remnant of the umbilical vein in portal hypertension.
  • Fetor hepaticus.^ The collaterals are extensively anastomosing with the systemic venous system through the internal epigastric veins.

     ^ Increased pressure in the portal vein (portal hypertension).
    • Primary biliary cirrhosis - Valley Health System 10 February 2010 13:27 UTC www.valleyhealth.com [Source type: General]
    • georgiahealthinfo.gov 10 February 2010 13:27 UTC georgiahealthinfo.gov [Source type: FILTERED WITH BAYES]

     ^ A connection is made between the portal vein,...
    • Cirrhosis | LIVESTRONG.COM 10 February 2010 13:27 UTC www.livestrong.com [Source type: General]

     Musty odor in breath due to increased dimethyl sulfide.
  • Jaundice. .Yellow discoloring of the skin, eye, and mucus membranes due to increased bilirubin (at least 2–3 mg/dL or 30 mmol/L).^ Jaundice is a yellow color in the skin, the mucous membranes, or the eyes.
    • Cirrhosis | LIVESTRONG.COM 10 February 2010 13:27 UTC www.livestrong.com [Source type: General]

     ^ Bilirubin in PBC or PSC (mg/dL) .
    • Cirrhosis: eMedicine Gastroenterology 10 February 2010 13:27 UTC emedicine.medscape.com [Source type: Academic]

     ^ Jaundice is the yellow coloring of the skin and mucus membranes that results from increased serum bilirubin.
    • Cirrhosis 10 February 2010 13:27 UTC janis7hepc.com [Source type: Academic]

     .Urine may also appear dark.
  • Asterixis.^ The whites of the eyes andthe skin may turn yellow (jaundice), and urine may be dark yellow or brown.
    • Cirrhosis, Information about Cirrhosis 10 February 2010 13:27 UTC www.faqs.org [Source type: Academic]

     ^ The whites of the eyes and the skin may turn yellow ( jaundice ), and urine may be dark yellow or brown.
    • Cirrhosis - Definition, Description, Causes and symptoms, Diagnosis, Treatment, Alternative treatment, Prognosis, Prevention 10 February 2010 13:27 UTC health.stateuniversity.com [Source type: Academic]

     ^ Yellow eyes and skin, light-colored stools and dark urine The abdomen may be swollen with a firm, enlarged liver.
    • Billary Diseases, Bile obstruction, Congenital disorder, Primary Biliary Cirrhosis(PBC) 10 February 2010 13:27 UTC livertransplantindia.com [Source type: Academic]

     .Bilateral asynchronous flapping of outstretched, dorsiflexed hands seen in patients with hepatic encephalopathy.
  • Other.^ Effects of L-carnitine in patients with hepatic encephalopathy.
    • Liver Cirrhosis 10 February 2010 13:27 UTC healthlibrary.epnet.com [Source type: Academic]
    • Liver Cirrhosis | ThirdAge Articles 10 February 2010 13:27 UTC www.thirdage.com [Source type: Academic]
    • Saint Francis Breast Health Services - 10 February 2010 13:27 UTC www.saintfrancis.com [Source type: Academic]

     ^ Asterixis is the bilateral but non-uniform flapping motions of outstretched hands.
    • Cirrhosis 10 February 2010 13:27 UTC janis7hepc.com [Source type: Academic]

     ^ Confusion, personality changes, depression, and other mental and cognitive changes and even coma may occur with advanced cirrhosis; this complication is called hepatic encephalopathy.
    • Cirrhosis - New York Presbyterian Hospital 10 February 2010 13:27 UTC nyp.org [Source type: Academic]

     Weakness, fatigue, anorexia, weight loss.

Complications

.As the disease progresses, complications may develop.^ As the disease progresses, complications may develop.
  • Treatment for Cirrhosis of the Liver 12 September 2009 12:21 UTC www.iifar.org [Source type: Academic]
  • Cirrhosis of the Liver 10 February 2010 13:27 UTC www.fbhc.org [Source type: Academic]
  • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]
  • MGC-Cirrhosis of the Liver 10 February 2010 13:27 UTC www.midwestgastro.com [Source type: Academic]
  • HerbChina2000.com - Herbal Remedies - Cirrhosis of the liver 10 February 2010 13:27 UTC www.herbchina2000.com [Source type: FILTERED WITH BAYES]
  • Diabetes Monitor - Cirrhosis Of The Liver 10 February 2010 13:27 UTC www.diabetesmonitor.com [Source type: FILTERED WITH BAYES]
  • Cirrhosis of the Liver 10 February 2010 13:27 UTC drlera.com [Source type: Academic]
  • Cirrhosis of the Liver 12 September 2009 4:14 UTC www.medhelp.org [Source type: Academic]

 ^ Ursodiol may also slow the progression of the disease.
  • CIGNA - Primary Biliary Cirrhosis (PBC) 10 February 2010 13:27 UTC www.cigna.com [Source type: Academic]

 ^ When complications develop, it may be possible to manage them.
  • Texas Liver Coalition - What is cirrhosis? 10 February 2010 13:27 UTC www.texasliver.org [Source type: Academic]

 .In some people, these may be the first signs of the disease.^ In some people,these may be the first signs of the disease.
  • Cirrhosis of the Liver 10 February 2010 13:27 UTC www.fbhc.org [Source type: Academic]

 ^ In some people, these may be the first signs of the disease.  .

 ^ In some people, these may be the first signs of the disease.
  • Treatment for Cirrhosis of the Liver 12 September 2009 12:21 UTC www.iifar.org [Source type: Academic]
  • LIVER CIRRHOSIS 12 September 2009 12:21 UTC www.medic8.com [Source type: Academic]
  • Digestive Disease Center 10 February 2010 13:27 UTC www.ddcyork.com [Source type: Academic]
  • GI Center - Commitment to Excellence 10 February 2010 13:27 UTC www.yourgicenter.com [Source type: FILTERED WITH BAYES]
  • Diabetes Monitor - Cirrhosis Of The Liver 10 February 2010 13:27 UTC www.diabetesmonitor.com [Source type: FILTERED WITH BAYES]
  • Liver Cirrhosis, Liver Cirrhosis Herbal Supplements - Liver Cirrhosis 10 February 2010 13:27 UTC www.herbsmd.com [Source type: Academic]
  • Cirrhosis of the Liver 10 February 2010 13:27 UTC drlera.com [Source type: Academic]
  • Cirrhosis of the Liver-Education - Wake Gastroenterology-[Gastroenterology Services in Raleigh, NC - GI Specialty Practice] 10 February 2010 13:27 UTC www.wakegastro.com [Source type: Academic]
  • Cirrhosis of the Liver Information 12 September 2009 4:14 UTC www.liversociety.org [Source type: Academic]
.
  • Bruising and bleeding due to decreased production of coagulation factors.
  • Jaundice due to decreased processing of bilirubin.
  • Itching (pruritus) due to bile salts products deposited in the skin.
  • Hepatic encephalopathy - the liver does not clear ammonia and related nitrogenous substances from the blood, which are carried to the brain, affecting cerebral functioning: neglect of personal appearance, unresponsiveness, forgetfulness, trouble concentrating, or changes in sleep habits.
  • Sensitivity to medication due to decreased metabolism of the active compounds.
  • Hepatocellular carcinoma is primary liver cancer, a frequent complication of cirrhosis.^ Hepatocellular dysfunction leads to hepatic encephalopathy and liver failure.
    • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]

     ^ Early signs of toxin accumulation in the brain may include neglect of personal appearance, unresponsiveness, forgetfulness, trouble concentrating, or changes in sleeping habits.
    • CIRRHOSIS OF THE LIVER : Edgar Cayce Health Remedies: Cirrhosis of the liver 10 February 2010 13:27 UTC www.edgarcayce.org [Source type: Academic]
    • Cirrhosis of the Liver 10 February 2010 13:27 UTC www.dccc.edu [Source type: FILTERED WITH BAYES]
    • CIRRHOSIS OF THE LIVER 10 February 2010 13:27 UTC www.edgarcayce.org [Source type: Academic]

     ^ Related Searches: carcinoma, hepatocellular , hepatitis b , hepatitis b virus , liver cirrhosis .
    • Search results: cirrhosis: Current Medical Articles and Commentary 10 February 2010 13:27 UTC gastroenterology.jwatch.org [Source type: Academic]

     .It has a high mortality rate.
  • Portal hypertension - blood normally carried from the intestines and spleen through the hepatic portal vein flows more slowly and the pressure increases; this leads to the following complications:
    • Ascites - fluid leaks through the vasculature into the abdominal cavity.
    • Esophageal varices - collateral portal blood flow through vessels in the stomach and esophagus.^ That causes fluid leakage into the abdominal cavity.
      • Cirrhosis of the liver can lead to swollen abdomen | detnews.com | The Detroit News 10 February 2010 13:27 UTC www.detnews.com [Source type: General]

       ^ The main vein that returns blood from the intestines is called the portal vein .
      • Cirrhosis of the Liver Causes, Symptoms, Diagnosis, and Treatment on MedicineNet.com 10 February 2010 13:27 UTC www.medicinenet.com [Source type: Academic]
      • Cirrhosis of the Liver Causes, Symptoms, Diagnosis, and Treatment on MedicineNet.com 12 September 2009 4:14 UTC www.medicinenet.com [Source type: Academic]

       ^ It can cause veins to enlarge in the stomach and in the tube leading from the mouth to the stomach (esophagus).
      • Cirrhosis - Definition, Description, Causes and symptoms, Diagnosis, Treatment, Alternative treatment, Prognosis, Prevention 10 February 2010 13:27 UTC health.stateuniversity.com [Source type: Academic]

       .These blood vessels may become enlarged and are more likely to burst.
  • Problems in other organs.^ Enlarged blood vessels in the esophagus or stomach.
    • Cirrhosis | Causes, Symptoms, Treatment | PDRHealth 10 February 2010 13:27 UTC www.pdrhealth.com [Source type: General]

     ^ This is especially a problem for the blood vessels in the esophagus.
    • HIPUSA.COM - eTools 10 February 2010 13:27 UTC www.hipusa.com [Source type: FILTERED WITH BAYES]

     ^ (Blood vessels in other organs, including the kidney, also narrow.
    • Cirrhosis - MMCI 10 February 2010 13:27 UTC mmci2.adam.com [Source type: Academic]
    • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
    • Cirrhosis 10 February 2010 13:27 UTC www.preventdisease.com [Source type: Academic]
    • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]
    • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

     .
    • Cirrhosis can cause immune system dysfunction, leading to infection.^ Cirrhosis can cause immune system dysfunction, leading to infection .
      • Liver Cirrhosis Remedies, Supplements, Liver Cirrhosis Treatment 10 February 2010 13:27 UTC www.morphemeremedies.com [Source type: FILTERED WITH BAYES]

       ^ Cirrhosis is a leading cause of death worldwide.
      • Cirrhosis: Fibrosis and Cirrhosis: Merck Manual Professional 10 February 2010 13:27 UTC www.merck.com [Source type: Academic]

       ^ Causes: Several processes can lead to cirrhosis.
      • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
      • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]

       .Signs and symptoms of infection may be aspecific are more difficult to recognize (e.g., worsening encephalopathy but no fever).
    • Fluid in the abdomen (ascites) may become infected with bacteria normally present in the intestines (spontaneous bacterial peritonitis).
    • Hepatorenal syndrome - insufficient blood supply to the kidneys, causing acute renal failure.^ Ascites (fluid) in the abdomen may become infected with bacteria normally present in the intestines, and cirrhosis can also lead to kidney dysfunction and failure.  .

       ^ Concentration of ascitic fluid opsonins, which may protect against spontaneous bacterial peritonitis [ 5,6 ].
      • Initial therapy of ascites in patients with cirrhosis 10 February 2010 13:27 UTC www.uptodate.com [Source type: Academic]

       ^ Infection of the fluid in the belly ( spontaneous bacterial peritonitis, or SBP ).
      • WellSpan Health Library 10 February 2010 13:27 UTC www.wellspan.org [Source type: FILTERED WITH BAYES]
      • Cirrhosis - Symptoms - Yahoo! Health 10 February 2010 13:27 UTC health.yahoo.com [Source type: FILTERED WITH BAYES]
      • Cirrhosis-Symptoms 10 February 2010 13:27 UTC www.webmd.com [Source type: FILTERED WITH BAYES]

       .This complication has a very high mortality (over 50%).
    • Hepatopulmonary syndrome - blood bypassing the normal lung circulation (shunting), leading to cyanosis and dyspnea (shortness of breath), characteristically worse on sitting up.^ Medium sized (1.5 to 3 mm), bilateral, basilar, nodular or reticulonodular opacities, with normal lung volumes, are characteristic of HPS and represent dilated subpleural lung vessels.
      • Hepatic Cirrhosis, liver Cirrhosis, Notes on Cyber Gastroenterology, Dr. Julio Murra Saca, El Salvador. 10 February 2010 13:27 UTC www.murrasaca.com [Source type: Academic]

       ^ As compensatory circulation fails, ascites develops, sometimes leading to enormous distention of the abdomen, and crowding of the diaphragm, which, in turn, gives rise to marked dyspnea, the result of pressure upon heart and lungs.
      • Cirrhosis of the Liver. | Henriette's Herbal Homepage 10 February 2010 13:27 UTC www.henriettesherbal.com [Source type: FILTERED WITH BAYES]

       ^ Because of the obstruction to flow and high pressures in the portal vein, blood in the portal vein seeks other veins in which to return to the heart, veins with lower pressures that bypass the liver.
      • Cirrhosis of the Liver Causes, Symptoms, Diagnosis, and Treatment on MedicineNet.com 10 February 2010 13:27 UTC www.medicinenet.com [Source type: Academic]
      • Cirrhosis of the Liver Causes, Symptoms, Diagnosis, and Treatment on MedicineNet.com 12 September 2009 4:14 UTC www.medicinenet.com [Source type: Academic]

       [6]
      • .
    • Portopulmonary hypertension - increased blood pressure over the lungs as a consequence of portal hypertension.^ Blood pressure medicines may help to control portal hypertension.
      • Cirrhosis - Cirrhosis Description - Cirrhosis Symptoms - Cirrhosis Prevention - Cirrhosis Treatment 10 February 2010 13:27 UTC symptomchecker.about.com [Source type: FILTERED WITH BAYES]
      • InteliHealth: 10 February 2010 13:27 UTC www.intelihealth.com [Source type: FILTERED WITH BAYES]

       ^ Portal hypertension : Increased pressure in the blood vessels.
      • Liver Cirrhosis Remedies, Supplements, Liver Cirrhosis Treatment 10 February 2010 13:27 UTC www.morphemeremedies.com [Source type: FILTERED WITH BAYES]

       ^ Increasing pressure in the main vein bringing blood to the liver (portal hypertension).
      • Cirrhosis: Complications - MayoClinic.com 10 February 2010 13:27 UTC www.mayoclinic.com [Source type: Academic]
      • Cirrhosis 10 February 2010 13:27 UTC www.cnn.com [Source type: General]
      • Cirrhosis 10 February 2010 13:27 UTC edition.cnn.com [Source type: General]
      • Cirrhosis 10 February 2010 13:27 UTC quiz.cnn.com [Source type: General]
      • Cirrhosis 10 February 2010 13:27 UTC edition1.cnn.com [Source type: General]

       [6]

Causes

.Cirrhosis has many possible causes; sometimes more than one cause is present in the same patient.^ Cirrhosis has many causes, including .
  • What I need to know about Cirrhosis of the Liver 10 February 2010 13:27 UTC digestive.niddk.nih.gov [Source type: FILTERED WITH BAYES]
  • Liver cirrhosis could be reversed - study 10 February 2010 13:27 UTC foodconsumer.org [Source type: FILTERED WITH BAYES]
  • What I need to know about Cirrhosis of the Liver 10 February 2010 13:27 UTC spotlighthealth.com [Source type: FILTERED WITH BAYES]

 ^ Causes Cirrhosis has many causes.
  • Cirrhosis of the Liver-Education - Wake Gastroenterology-[Gastroenterology Services in Raleigh, NC - GI Specialty Practice] 10 February 2010 13:27 UTC www.wakegastro.com [Source type: Academic]
  • Cirrhosis of the Liver Information 12 September 2009 4:14 UTC www.liversociety.org [Source type: Academic]

 ^ From 5 to 10% of cirrhosis patients respond to this cause.

 .In the Western World, chronic alcoholism and hepatitis C are the most common causes.^ The most common cause of cirrhosis is drinking too much alcohol.
  • Cirrhosis and Portal Hypertension -- familydoctor.org 10 February 2010 13:27 UTC familydoctor.org [Source type: General]
  • Cirrhosis of the Liver - alternative natural treatment choices 10 February 2010 13:27 UTC www.go-symmetry.com [Source type: FILTERED WITH BAYES]

 ^ In the United States, chronic alcoholism and hepatitis C are the most common of its many causes.
  • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]

 ^ Hepatitis B (Read about " Hepatitis B "), which is the most common cause of cirrhosis in many parts of the world.
.
  • Alcoholic liver disease (ALD).^ (See Alcoholic liver disease .

     ^ Alcoholic liver disease.
    • WellSpan Health Library 10 February 2010 13:27 UTC www.wellspan.org [Source type: FILTERED WITH BAYES]
    • MGC-Cirrhosis of the Liver 10 February 2010 13:27 UTC www.midwestgastro.com [Source type: Academic]
    • Cirrhosis of the Liver - alternative natural treatment choices 10 February 2010 13:27 UTC www.go-symmetry.com [Source type: FILTERED WITH BAYES]
    • Liver Cirrhosis, Liver Cirrhosis Herbal Supplements - Liver Cirrhosis 10 February 2010 13:27 UTC www.herbsmd.com [Source type: Academic]
    • Health Information 10 February 2010 13:27 UTC www.mmc.org [Source type: FILTERED WITH BAYES]
    • Cirrhosis of the Liver-Education - Wake Gastroenterology-[Gastroenterology Services in Raleigh, NC - GI Specialty Practice] 10 February 2010 13:27 UTC www.wakegastro.com [Source type: Academic]
    • Cirrhosis of the Liver Information 12 September 2009 4:14 UTC www.liversociety.org [Source type: Academic]
    • MoonDragon's Health & Wellness: Cirrhosis of the Liver 12 September 2009 4:14 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

     ^ Alcoholic liver disease .
    • Treatment for Cirrhosis of the Liver 12 September 2009 12:21 UTC www.iifar.org [Source type: Academic]
    • LIVER CIRRHOSIS 12 September 2009 12:21 UTC www.medic8.com [Source type: Academic]
    • Cirrhosis - MMCI 10 February 2010 13:27 UTC mmci2.adam.com [Source type: Academic]
    • Cirrhosis of the Liver 10 February 2010 13:27 UTC www.fbhc.org [Source type: Academic]
    • Cirrhosis - MMCI 10 February 2010 13:27 UTC mmci2.adam.com [Source type: Academic]
    • Cirrhosis | LIVESTRONG.COM 10 February 2010 13:27 UTC www.livestrong.com [Source type: General]
    • Cirrhosis 10 February 2010 13:27 UTC stfrancishospitals.adam.com [Source type: Academic]
    • GI Center - Commitment to Excellence 10 February 2010 13:27 UTC www.yourgicenter.com [Source type: FILTERED WITH BAYES]
    • Cirrhosis - Health Diseases & Medical Conditions - South Florida Hospital 10 February 2010 13:27 UTC www.mhs.net [Source type: Academic]
    • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]
    • Billary Diseases, Bile obstruction, Congenital disorder, Primary Biliary Cirrhosis(PBC) 10 February 2010 13:27 UTC livertransplantindia.com [Source type: Academic]
    • Renal Dysfunction in Cirrhosis: Introduction 10 February 2010 13:27 UTC www.medscape.com [Source type: Academic]
    • Cirrhosis - Kootenai Health 10 February 2010 13:27 UTC kootenaihealth.adam.com [Source type: Academic]
    • HowStuffWorks "Cirrhosis - Medical Dictionary" 10 February 2010 13:27 UTC healthguide.howstuffworks.com [Source type: Academic]
    • http://www.hiv.va.gov/vahiv?page=pcm-210_liver 10 February 2010 13:27 UTC www.hiv.va.gov [Source type: Academic]
    • HerbChina2000.com - Herbal Remedies - Cirrhosis of the liver 10 February 2010 13:27 UTC www.herbchina2000.com [Source type: FILTERED WITH BAYES]
    • Diabetes Monitor - Cirrhosis Of The Liver 10 February 2010 13:27 UTC www.diabetesmonitor.com [Source type: FILTERED WITH BAYES]
    • Cirrhosis - Shands Healthcare 10 February 2010 13:27 UTC www.shands.org [Source type: Academic]
    • Cirrhosis of the Liver | AloeElite 10 February 2010 13:27 UTC www.aloeelite.com [Source type: FILTERED WITH BAYES]
    • Cirrhosis 10 February 2010 13:27 UTC www.mercksource.com [Source type: Academic]
    • Cirrhosis of the Liver 10 February 2010 13:27 UTC drlera.com [Source type: Academic]
    • U.S. Department of Veterans Affairs 10 February 2010 13:27 UTC www.hiv.va.gov [Source type: Academic]
    • Cirrhosis of the Liver 12 September 2009 4:14 UTC www.medhelp.org [Source type: Academic]

     .Alcoholic cirrhosis develops for between 10% and 20% of individuals who drink heavily for a decade or more.^ What will happen if I have alcoholic cirrhosis and continue to drink?
    • Alcohol-induced cirrhosis 10 February 2010 13:27 UTC hcd2.bupa.co.uk [Source type: General]

     ^ If you have cirrhosis, you should not drink alcohol.
    • MayoClinic.com Health Library - Cirrhosis 10 February 2010 13:27 UTC www.riversideonline.com [Source type: FILTERED WITH BAYES]

     ^ In general, though, the more you drink, the more likely that you will develop cirrhosis.
    • Your Health - Risk Factors for Cirrhosis 10 February 2010 13:27 UTC www.aurorahealthcare.org [Source type: Academic]
    • Risk Factors for Cirrhosis 10 February 2010 13:27 UTC www.svmh.com [Source type: Academic]
    • Tufts Medical Center - Risk Factors for Cirrhosis 10 February 2010 13:27 UTC www.tufts-nemc.org [Source type: Academic]

     [7] .There is great variability in the amount of alcohol needed to cause cirrhosis (as little as 3-4 drinks a day in some men and 2-3 in some women[citation needed]).^ The most common cause of cirrhosis is drinking too much alcohol.
    • Cirrhosis and Portal Hypertension -- familydoctor.org 10 February 2010 13:27 UTC familydoctor.org [Source type: General]
    • Cirrhosis of the Liver - alternative natural treatment choices 10 February 2010 13:27 UTC www.go-symmetry.com [Source type: FILTERED WITH BAYES]

     ^ Not drinking alcohol if alcohol is the cause.
    • Cirrhosis | Health | Patient UK 10 February 2010 13:27 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

     ^ What will happen if I have alcoholic cirrhosis and continue to drink?
    • Alcohol-induced cirrhosis 10 February 2010 13:27 UTC hcd2.bupa.co.uk [Source type: General]

     .Alcohol seems to injure the liver by blocking the normal metabolism of protein, fats, and carbohydrates.^ Alcohol seems to injure the liver by blocking the normal metabolism of protein, fats, and carbohydrates.
    • LIVER CIRRHOSIS 12 September 2009 12:21 UTC www.medic8.com [Source type: Academic]
    • Cirrhosis of the Liver 10 February 2010 13:27 UTC www.fbhc.org [Source type: Academic]
    • Digestive Disease Center 10 February 2010 13:27 UTC www.ddcyork.com [Source type: Academic]
    • GI Center - Commitment to Excellence 10 February 2010 13:27 UTC www.yourgicenter.com [Source type: FILTERED WITH BAYES]
    • Cirrhosis of the Liver 10 February 2010 13:27 UTC catalog.nucleusinc.com [Source type: FILTERED WITH BAYES]
    • Diabetes Monitor - Cirrhosis Of The Liver 10 February 2010 13:27 UTC www.diabetesmonitor.com [Source type: FILTERED WITH BAYES]
    • Cirrhosis of the Liver | AloeElite 10 February 2010 13:27 UTC www.aloeelite.com [Source type: FILTERED WITH BAYES]
    • Cirrhosis of the Liver 10 February 2010 13:27 UTC drlera.com [Source type: Academic]
    • Cirrhosis of the Liver-Education - Wake Gastroenterology-[Gastroenterology Services in Raleigh, NC - GI Specialty Practice] 10 February 2010 13:27 UTC www.wakegastro.com [Source type: Academic]
    • Cirrhosis of the Liver Information 12 September 2009 4:14 UTC www.liversociety.org [Source type: Academic]

     ^ It also damages the liver by altering normal metabolism of proteins, fats, and carbohydrates.
    • Risk Factors for Cirrhosis 10 February 2010 13:27 UTC www.svmh.com [Source type: Academic]
    • Tufts Medical Center - Risk Factors for Cirrhosis 10 February 2010 13:27 UTC www.tufts-nemc.org [Source type: Academic]

     ^ Alcohol appears to damage the person's liver by blocking the normal metabolism of carbohydrates, fats, and proteins.
    • Cirrhosis of the Liver - alternative natural treatment choices 10 February 2010 13:27 UTC www.go-symmetry.com [Source type: FILTERED WITH BAYES]

     .Patients may also have concurrent alcoholic hepatitis with fever, hepatomegaly, jaundice, and anorexia.^ Fever, tender hepatomegaly and jaundice suggest the presence of alcoholic hepatitis.
    • Cirrhosis: Fibrosis and Cirrhosis: Merck Manual Professional 10 February 2010 13:27 UTC www.merck.com [Source type: Academic]

     ^ Patients also may experience fever, jaundice, liver failure, and bleeding.
    • The Epidemiology of Alcoholic Liver Disease 10 February 2010 13:27 UTC pubs.niaaa.nih.gov [Source type: Academic]

     ^ For example, hepatitis C patients who show no significant liver scarring when biopsied may have a low risk for cirrhosis.

     .AST and ALT are both elevated but less than 300 IU/L with a AST:ALT ratio > 2.0, a value rarely seen in other liver diseases.^ Other comorbidities associated with liver disease: .
    • U.S. Department of Veterans Affairs 10 February 2010 13:27 UTC www.hiv.va.gov [Source type: Academic]

     ^ AST and ALT both <500 IU/mL (if no other injurious processes) .
    • U.S. Department of Veterans Affairs 10 February 2010 13:27 UTC www.hiv.va.gov [Source type: Academic]

     ^ Elevated AST, ALT, and ALP common .
    • Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation - September 1, 2006 - American Family Physician 10 February 2010 13:27 UTC www.aafp.org [Source type: Academic]

     .Liver biopsy may show hepatocyte necrosis, Mallory bodies, neutrophilic infiltration with perivenular inflammation.
  • Chronic hepatitis C.^ Chronic hepatitis C causes inflammation of the liver that eventually can lead to cirrhosis.
    • Cirrhosis - Cirrhosis Description - Cirrhosis Symptoms - Cirrhosis Prevention - Cirrhosis Treatment 10 February 2010 13:27 UTC symptomchecker.about.com [Source type: FILTERED WITH BAYES]

     ^ This causes inflammation of the liver, which may be severe and chronic and result in cirrhosis.

     ^ Severe hepatitis may lead to cirrhosis and chronic liver dysfunction.
    • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]

     .Infection with the hepatitis C virus causes inflammation of the liver and a variable grade of damage to the organ that over several decades can lead to cirrhosis.^ Hepatitis C is the second leading cause of cirrhosis.
    • American Liver Foundation - Cirrhosis 10 February 2010 13:27 UTC www.liverfoundation.org [Source type: FILTERED WITH BAYES]

     ^ Chronic viral hepatitis types B, C and D. These hepatitis viruses cause inflammation of the liver and liver damage that after a few decades can cause cirrhosis.
    • Liver cirrhosis - myDr.com.au 10 February 2010 13:27 UTC www.mydr.com.au [Source type: FILTERED WITH BAYES]

     ^ CONDITIONS LEADING TO LIVER TRANSPLANT Cirrhosis: Irreversible damage to liver cells.
    • MoonDragon's Health & Wellness: Cirrhosis of the Liver 12 September 2009 4:14 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

     .Cirrhosis caused by hepatitis C is the most common reason for liver transplant.^ Cirrhosis is most commonly caused by alcoholism, hepatitis B and ...
    • Cirrhosis - Kosmix : Reference, Videos, Images, News, Shopping and more... 10 February 2010 13:27 UTC www.kosmix.com [Source type: Academic]

     ^ The most common cause of cirrhosis is drinking too much alcohol.
    • Cirrhosis of the Liver - alternative natural treatment choices 10 February 2010 13:27 UTC www.go-symmetry.com [Source type: FILTERED WITH BAYES]

     ^ Hepatitis B is a significant cause for cirrhosis.

     .Can be diagnosed with serologic assays that detect hepatitis C antibody or viral RNA. The enzyme immunoassay, EIA-2, is the most commonly used screening test in the US.
  • Chronic hepatitis B.^ Chronic viral hepatitis .
    • WellSpan Health Library 10 February 2010 13:27 UTC www.wellspan.org [Source type: FILTERED WITH BAYES]
    • Cirrhosis - AOL Health 10 February 2010 13:27 UTC www.aolhealth.com [Source type: General]
    • The University of Kansas Hospital - Cirrhosis 10 February 2010 13:27 UTC www.kumed.com [Source type: FILTERED WITH BAYES]
    • Cirrhosis - Quest Diagnostics Patient Health Library 10 February 2010 13:27 UTC www.questdiagnostics.com [Source type: FILTERED WITH BAYES]
    • Cirrhosis 10 February 2010 13:27 UTC www.healthlinkbc.ca [Source type: FILTERED WITH BAYES]
    • Health Information 10 February 2010 13:27 UTC www.mmc.org [Source type: FILTERED WITH BAYES]

     ^ Chronic Viral Hepatitis - the 2 most important are Hepatitis B or C. Non alcoholic fatty liver disease Autoimmune chronic active hepatitis Primary biliary cirrhosis which is uncommon and other conditions that results in the bile ducts becoming blocked.
    • Chronic fatigue syndrome 10 February 2010 13:27 UTC www.homehealth-uk.com [Source type: FILTERED WITH BAYES]

     ^ Anemia (detected on a CBC ) Clotting problems Liver function problems (detected on liver function tests) Low serum albumin The following tests may be used to evaluate the liver: .
    • Cirrhosis - Symptoms, Diagnosis, Treatment of Cirrhosis - NY Times Health Information 10 February 2010 13:27 UTC health.nytimes.com [Source type: FILTERED WITH BAYES]
    • Cirrhosis - Abington Memorial Hospital 10 February 2010 13:27 UTC amh.adam.com [Source type: Academic]

     .The hepatitis B virus causes liver inflammation and injury that over several decades can lead to cirrhosis.^ Related Searches: carcinoma, hepatocellular , hepatitis b , hepatitis b virus , liver cirrhosis .
    • Search results: cirrhosis: Current Medical Articles and Commentary 10 February 2010 13:27 UTC gastroenterology.jwatch.org [Source type: Academic]

     ^ Hepatitis B is a significant cause for cirrhosis.

     ^ Infection with this virus causes inflammation of and low grade damage to the liver that over time can lead to cirrhosis.

     .Hepatitis D is dependent on the presence of hepatitis B, but accelerates cirrhosis in co-infection.^ Chronic infections of hepatitis B can also lead to cirrhosis.
    • Nonalcoholic Cirrhosis | AHealthyMe.com 10 February 2010 13:27 UTC www.ahealthyme.com [Source type: FILTERED WITH BAYES]

     ^ Co-infection with HIV or hepatitis B. .
    • Cirrhosis 10 February 2010 13:27 UTC www.hcvets.com [Source type: Academic]

     ^ Infection with the hepatitis B virus is probably the most common cause of cirrhosis worldwide, although its impact is less pronounced in the US and other western countries.
    • Your Health - Risk Factors for Cirrhosis 10 February 2010 13:27 UTC www.aurorahealthcare.org [Source type: Academic]
    • Tufts Medical Center - Risk Factors for Cirrhosis 10 February 2010 13:27 UTC www.tufts-nemc.org [Source type: Academic]

     .Chronic hepatitis B can be diagnosed with detection of HBsAG > 6 months after initial infection.^ Chronic infection with the hepatitis B virus .
    • Cirrhosis | Health | Patient UK 10 February 2010 13:27 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

     ^ Chronic infections of hepatitis B can also lead to cirrhosis.
    • Nonalcoholic Cirrhosis | AHealthyMe.com 10 February 2010 13:27 UTC www.ahealthyme.com [Source type: FILTERED WITH BAYES]

     ^ CAUSES: Alcoholic liver disease; Chronic Hepatitis B, C, and D; Autoimmune Hepatitis; Inherited diseases; Blocked bile ducts; Nonalcoholic steatohepatitis (NASH); Drugs, toxins, and infections.
    • Liver damage leading to fatty liver, Cirrhosis & Hepatitis 12 September 2009 12:21 UTC www.herbalprovider.com [Source type: Academic]
    • Liver damage leading to fatty liver, Cirrhosis & Hepatitis 10 February 2010 13:27 UTC www.herbalprovider.com [Source type: Academic]

     .HBeAG and HBV DNA are determined to assess whether patient will need antiviral therapy.
  • Non-alcoholic steatohepatitis (NASH).^ CAUSES: Alcoholic liver disease; Chronic Hepatitis B, C, and D; Autoimmune Hepatitis; Inherited diseases; Blocked bile ducts; Nonalcoholic steatohepatitis (NASH); Drugs, toxins, and infections.
    • Liver damage leading to fatty liver, Cirrhosis & Hepatitis 12 September 2009 12:21 UTC www.herbalprovider.com [Source type: Academic]
    • Liver damage leading to fatty liver, Cirrhosis & Hepatitis 10 February 2010 13:27 UTC www.herbalprovider.com [Source type: Academic]

     ^ Patients with liver cirrhosis and non-cirrhotic alcoholic liver disease have a clearly increased risk for ICH. .
    • BioMed Central | Full text | Liver cirrhosis, other liver diseases, and risk of hospitalisation for intracerebral haemorrhage: A Danish population-based case-control study 10 February 2010 13:27 UTC www.biomedcentral.com [Source type: Academic]

     ^ Therefore, before resection is performed for HCC, the non-tumor portion of the liver should be biopsied to determine whether there is associated cirrhosis.
    • Cirrhosis | Oncology and Neuroscience Blog from Elekta 10 February 2010 13:27 UTC blog.elekta.com [Source type: Academic]

     .In NASH, fat builds up in the liver and eventually causes scar tissue.^ If the bile ducts are blocked, the back up of bile can also cause the build up of scar tissue.
    • Cirrhosis of the liver - Medical Look 12 September 2009 4:14 UTC www.medical-look.com [Source type: FILTERED WITH BAYES]

     ^ Another cause is a condition called nonalcoholic steatohepatitis (NASH), which causes fat to build up in the liver and produces scarring.
    • Cirrhosis - Cirrhosis Description - Cirrhosis Symptoms - Cirrhosis Prevention - Cirrhosis Treatment 10 February 2010 13:27 UTC symptomchecker.about.com [Source type: FILTERED WITH BAYES]

     ^ Eventually, PSC can cause liver failure.
    • Billary Diseases, Bile obstruction, Congenital disorder, Primary Biliary Cirrhosis(PBC) 10 February 2010 13:27 UTC livertransplantindia.com [Source type: Academic]

     .This type of hepatitis appears to be associated with diabetes, protein malnutrition, obesity, coronary artery disease, and treatment with corticosteroid medications.^ This type of hepatitis appears to be associated with diabetes, protein malnutrition, obesity, coronary artery disease, and corticosteroid treatment.
    • Cirrhosis of the Liver 10 February 2010 13:27 UTC www.fbhc.org [Source type: Academic]
    • Liver Cirrhosis, Liver Cirrhosis Herbal Supplements - Liver Cirrhosis 10 February 2010 13:27 UTC www.herbsmd.com [Source type: Academic]
    • Cirrhosis of the Liver | AloeElite 10 February 2010 13:27 UTC www.aloeelite.com [Source type: FILTERED WITH BAYES]
    • Cirrhosis of the Liver 10 February 2010 13:27 UTC drlera.com [Source type: Academic]
    • Cirrhosis of the Liver-Education - Wake Gastroenterology-[Gastroenterology Services in Raleigh, NC - GI Specialty Practice] 10 February 2010 13:27 UTC www.wakegastro.com [Source type: Academic]
    • Cirrhosis of the Liver 12 September 2009 4:14 UTC www.medhelp.org [Source type: Academic]

     ^ NASH is often linked to diabetes, obesity, coronary artery disease and protein malnutrition.
    • American Liver Foundation - Cirrhosis 10 February 2010 13:27 UTC www.liverfoundation.org [Source type: FILTERED WITH BAYES]

     ^ This type of hepatitis appears to be associated with diabetes, protein malnutrition, obesity, coronary artery disease, and corticosteroid treatment.  Blocked bile ducts.

     .This disorder is similar to that of alcoholic liver disease but patient does not have an alcohol history.^ Alcoholic liver disease.
    • WellSpan Health Library 10 February 2010 13:27 UTC www.wellspan.org [Source type: FILTERED WITH BAYES]
    • MGC-Cirrhosis of the Liver 10 February 2010 13:27 UTC www.midwestgastro.com [Source type: Academic]
    • Cirrhosis of the Liver 10 February 2010 13:27 UTC catalog.nucleusinc.com [Source type: FILTERED WITH BAYES]
    • Cirrhosis of the Liver - alternative natural treatment choices 10 February 2010 13:27 UTC www.go-symmetry.com [Source type: FILTERED WITH BAYES]
    • Liver Cirrhosis, Liver Cirrhosis Herbal Supplements - Liver Cirrhosis 10 February 2010 13:27 UTC www.herbsmd.com [Source type: Academic]
    • Health Information 10 February 2010 13:27 UTC www.mmc.org [Source type: FILTERED WITH BAYES]
    • Cirrhosis of the Liver-Education - Wake Gastroenterology-[Gastroenterology Services in Raleigh, NC - GI Specialty Practice] 10 February 2010 13:27 UTC www.wakegastro.com [Source type: Academic]
    • Cirrhosis of the Liver Information 12 September 2009 4:14 UTC www.liversociety.org [Source type: Academic]
    • MoonDragon's Health & Wellness: Cirrhosis of the Liver 12 September 2009 4:14 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

     ^ Alcohol and liver Disease .
    • Last stages of cirrhosis of the liver - Healthcare.com 12 September 2009 12:21 UTC www.healthcare.com [Source type: FILTERED WITH BAYES]

     ^ Alcoholism and alcoholic liver disease are higher in minorities.

     .Biopsy is needed for diagnosis.
  • Primary biliary cirrhosis.^ Methotrexate therapy for primary biliary cirrhosis.
    • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

     ^ Primary biliary cirrhosis.
    • Cirrhosis - MMCI 10 February 2010 13:27 UTC mmci2.adam.com [Source type: Academic]
    • WellSpan Health Library 10 February 2010 13:27 UTC www.wellspan.org [Source type: FILTERED WITH BAYES]
    • Primary Biliary Cirrhosis - a comprehensive view - Wellsphere 10 February 2010 13:27 UTC www.wellsphere.com [Source type: Academic]
    • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]
    • Health Information 10 February 2010 13:27 UTC www.mmc.org [Source type: FILTERED WITH BAYES]

     ^ Recurrent primary biliary cirrhosis.
    • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

     .May be asymptomatic or complain of fatigue, pruritus, and non-jaundice skin hyperpigmentation with hepatomegaly.^ Symptoms of primary biliary cirrhosis include pruritus, fatigue, jaundice, melanosis, malabsorption of lipids and vitamins, and eventually hepatocellular failure and development of portal hypertension.
    • Primary Biliary Cirrhosis: MR Imaging Findings and Description of MR Imaging Periportal Halo Sign -- Wenzel et al. 176 (4): 885 -- American Journal of Roentgenology 10 February 2010 13:27 UTC www.ajronline.org [Source type: Academic]

     ^ As cirrhosis progresses, your skin and the whites of your eyes may turn yellow, a condition called jaundice (JON-diss).
    • Liver Cirrhosis Treatment Cure Malaysia Alternative Acupuncture Chinese Herbal Medical Cure Centre Liver Harden 12 September 2009 12:21 UTC www.geocities.com [Source type: FILTERED WITH BAYES]
    • What I need to know about Cirrhosis of the Liver 10 February 2010 13:27 UTC digestive.niddk.nih.gov [Source type: FILTERED WITH BAYES]
    • Liver cirrhosis could be reversed - study 10 February 2010 13:27 UTC foodconsumer.org [Source type: FILTERED WITH BAYES]

     ^ The whites of the eyes and the skin may turn yellow ( jaundice ), and urine may be dark yellow or brown.
    • Cirrhosis - Definition, Description, Causes and symptoms, Diagnosis, Treatment, Alternative treatment, Prognosis, Prevention 10 February 2010 13:27 UTC health.stateuniversity.com [Source type: Academic]

     .There is prominent alkaline phosphatase elevation as well as elevations in cholesterol and bilirubin.^ Elevated bilirubin (without increase in alkaline phosphatase) .
    • http://www.hiv.va.gov/vahiv?page=pcm-210_liver 10 February 2010 13:27 UTC www.hiv.va.gov [Source type: Academic]

     ^ Elevated alkaline phosphatase (with or without bilirubin elevation) .
    • http://www.hiv.va.gov/vahiv?page=pcm-210_liver 10 February 2010 13:27 UTC www.hiv.va.gov [Source type: Academic]

     ^ Alkaline phosphatase elevation was common.

     .Gold standard diagnosis is antimitochondrial antibodies with liver biopsy as confirmation if showing florid bile duct lesions.^ A liver biopsy confirms cirrhosis.
    • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]

     ^ Liver biopsy , the only test that can directly confirm a diagnosis of cirrhosis.
    • WellSpan Health Library 10 February 2010 13:27 UTC www.wellspan.org [Source type: FILTERED WITH BAYES]
    • Health Information 10 February 2010 13:27 UTC www.mmc.org [Source type: FILTERED WITH BAYES]

     ^ A liver biopsy can confirm the diagnosis but is not always necessary.

     .It is more common in women.
  • Primary sclerosing cholangitis.^ (PBC) and primary sclerosing cholangitis.
    • Primary Biliary Cirrhosis - a comprehensive view - Wellsphere 10 February 2010 13:27 UTC www.wellsphere.com [Source type: Academic]

     ^ Primary biliary cirrhosis and primary sclerosing cholangitis .
    • Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation - September 1, 2006 - American Family Physician 10 February 2010 13:27 UTC www.aafp.org [Source type: Academic]

     ^ Primary sclerosing cholangitis .
    • Renal Dysfunction in Cirrhosis: Introduction 10 February 2010 13:27 UTC www.medscape.com [Source type: Academic]

     .PSC is a progressive cholestatic disorder presenting with pruritus, steatorrhea, fat soluble vitamin deficiencies, and metabolic bone disease.^ Pruritus (in cholestatic liver diseases) .
    • U.S. Department of Veterans Affairs 10 February 2010 13:27 UTC www.hiv.va.gov [Source type: Academic]

     ^ Once jaundice is present, fat-soluble vitamin deficiency and malabsorption ( e.g.

     ^ Avoid artificial sweeteners - see www.dorway.com Vitamin A, Vitamin K and Vitamin D replacement therapy adds fat-soluble vitamins lost in fatty stools.
    • Dr Sandra Cabot's Liver Doctor - Love your Liver and Live Longer 10 February 2010 13:27 UTC www.liverdoctor.com [Source type: Academic]

     .There is a strong association with inflammatory bowel disease (IBD), especially ulcerative colitis.^ History of inflammatory bowel disease .
    • U.S. Department of Veterans Affairs 10 February 2010 13:27 UTC www.hiv.va.gov [Source type: Academic]

     ^ Cholangiocarcinoma may occur in 7 to 15% of patients with PSC. Patients with a long history of inflammatory bowel disease and smokers are at the highest risk.
    • Primary Sclerosing Cholangitis and Primary Biliary Cirrhosis - Patients - American College of Gastroenterology 10 February 2010 13:27 UTC www.acg.gi.org [Source type: Academic]

     ^ Many people with autoimmune hepatitis also have other autoimmune problems such as thyroiditis, Graves' disease or ulcerative colitis.
    • Stages of cirrhosis? - Yahoo! Answers 10 February 2010 13:27 UTC answers.yahoo.com [Source type: General]
    • MayoClinic.com Health Library - Cirrhosis 10 February 2010 13:27 UTC www.riversideonline.com [Source type: FILTERED WITH BAYES]

     .Diagnosis is best with contrast cholangiography showing diffuse, multifocal strictures and focal dilation of bile ducts, leading to a beaded appearance.^ Primary biliary cirrhosis is an autoimmune liver disorder characterized by the progressive destruction of intrahepatic bile ducts, leading to cholestasis, cirrhosi...
    • Last stages of cirrhosis of the liver - Healthcare.com 12 September 2009 12:21 UTC www.healthcare.com [Source type: FILTERED WITH BAYES]

     ^ HLA-DR was expressed focally on bile ducts and CoH in PBC, but was absent in normal controls.

     ^ This can lead to jaundice (yellowish discoloration of the eyes and skin), stone formation in the bile ducts and infection in the bile ducts known as cholangitis.
    • Primary Sclerosing Cholangitis and Primary Biliary Cirrhosis - Patients - American College of Gastroenterology 10 February 2010 13:27 UTC www.acg.gi.org [Source type: Academic]

     .Non-specific serum immunoglobulins may also be elevated.
  • Autoimmune hepatitis.^ Non-invasive serum markers of liver fibrosis may help identify patients with cirrhosis.
    • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]

     ^ Autoimmune hepatitis (AIH) is another disease that may develop subsequently [ 46 ], thus, it also should be considered in the differential diagnosis, particularly with a transaminitis.

     ^ ANA testing and anti-smooth-muscle antibody (ASMA) testing may help find autoimmune chronic hepatitis .
    • Cirrhosis - Exams and Tests - Health.com 10 February 2010 13:27 UTC www.health.com [Source type: FILTERED WITH BAYES]
    • Health Information 10 February 2010 13:27 UTC www.mmc.org [Source type: FILTERED WITH BAYES]

     .This disease is caused by the immunologic damage to the liver causing inflammation and eventually scarring and cirrhosis.^ Too much iron can cause damage to the liver.
    • Cirrhosis - Erewhon Natural Foods 10 February 2010 13:27 UTC www.erewhonmarket.com [Source type: Academic]
    • Statesman Health : Integrative Medicine  :  Conditions   :  Cirrhosis 12 September 2009 4:14 UTC www.statesman.com [Source type: Academic]

     ^ Liver inflammation over a long period of time may cause scarring which leads to cirrhosis.
    • Primary Sclerosing Cholangitis and Primary Biliary Cirrhosis - Patients - American College of Gastroenterology 10 February 2010 13:27 UTC www.acg.gi.org [Source type: Academic]

     ^ Cirrhosis is caused by long-term liver diseases that damage liver tissue.
    • American Liver Foundation - Cirrhosis 10 February 2010 13:27 UTC www.liverfoundation.org [Source type: FILTERED WITH BAYES]

     .Findings include elevations in serum globulins, especially gamma globulins.^ Hepatic Encephalopathy Blood ammonia will be checked because an elevated serum ammonia level is a classic laboratory finding in hepatic encephalopathy.
    • Cirrhosis 10 February 2010 13:27 UTC janis7hepc.com [Source type: Academic]

     ^ They are generally identified by finding of an elevation of only serum alkaline phosphatase (ALP) or/and total serum cholesterol, often by chance through routine check up.

     ^ Laboratory findings include a serum ALP increase, but some may have mild increases in serum ALT and AST concentrations as well.

     .Therapy with prednisone +/- azathioprine is beneficial.^ In the case of auto-immune hepatitis, prednisone therapy, with or without azathioprine, can improve quality of life and halt progression to cirrhosis.
    • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

     .Cirrhosis due to autoimmune hepatitis still has 10-year survival of 90%+.^ Many things can cause cirrhosis including various liver diseases such as hemochromatosis, Wilson's disease, alpha-1 antitrypsin deficiency, autoimmune hepatitis, and biliary atresia.
    • How to Live with Hepatitis - Hepatitis Foundation International (Health Travel, Hep B, Hep C, Chronic Hep and Cirrhosis) 10 February 2010 13:27 UTC www.hepfi.org [Source type: FILTERED WITH BAYES]

     ^ Treatment for hepatitis -related cirrhosis involves medications used to treat the different types of hepatitis, such as interferon for viral hepatitis and corticosteroids for autoimmune hepatitis.

     ^ Alcoholic liver disease damaging the liver cells Alcoholism damaging the entire organ Viral hepatitis Chronic hepatitis C Chronic hepatitis B Chronic hepatitis D Autoimmune hepatitis Hemochromatosis Wilson's disease Glycogen storage diseases Home Remedies For Cirrhosis of Liver .
    • Home Remedies for Cirrhosis of liver - Treatment & Cure - Natural Remedy for Cirrhosis of liver – Cirrhosis of liver Diet 10 February 2010 13:27 UTC www.natural-homeremedies.com [Source type: FILTERED WITH BAYES]

     .There is no specific tool to diagnose autoimmune but it can be beneficial to initiate a trial of corticosteroids.
  • Hereditary hemochromatosis.^ There is no specific therapy.

     ^ It is not useful for an initial bleeding episode, however, since it poses a much higher risk for encephalopathy than with endoscopic sclerotherapy and there is no survival advantage.
    • Cirrhosis 10 February 2010 13:27 UTC www.hcvets.com [Source type: Academic]

     ^ However, there is no specific dermatological feature in PBC patients with pruritus other than diffuse pigmentation and scratch marks.

     .Usually presents with family history of cirrhosis, skin hyperpigmentation, diabetes mellitus, pseudogout, and/or cardiomyopathy, all due to signs of iron overload.^ Signs of cirrhosis of the liver are possible glossitis, cheilosis and paresthesias due to vitamin metabolism alteration, increase in collateral venous circulation and palpable, firm smooth liver.
    • http://www.healself.org/Liver%20Problems.html 12 September 2009 4:14 UTC www.healself.org [Source type: Original source]

     ^ A classic triad of skin hyperpigmentation (bronzing), type 2 diabetes, and hepatic cirrhosis has long been recognized as evidence of advanced iron overload.
    • Cirrhosis Information and Courses from MediaLab, Inc. 10 February 2010 13:27 UTC www.medialabinc.net [Source type: FILTERED WITH BAYES]

     ^ Prognostic significance of glycaemic control in patients with HBV- and HCV-related cirrhosis and diabetes mellitus.
    • Assessment of Prognosis of Cirrhosis: Abstract 10 February 2010 13:27 UTC www.medscape.com [Source type: Academic]

     .Labs will show fasting transferrin saturation of > 60% and ferritin > 300 ng/mL. Genetic testing may be used to identify HFE mutations.^ Fasting transferrin saturation and HFE (haemochromatosis C282Y) mutation: along with a raised ferritin these tests can screen for haemochromatosis.
    • Cirrhosis | Doctor | Patient UK 10 February 2010 13:27 UTC www.patient.co.uk [Source type: Academic]

     ^ Blood tests may be used to measure: .
    • WellSpan Health Library 10 February 2010 13:27 UTC www.wellspan.org [Source type: FILTERED WITH BAYES]
    • Cirrhosis - Exams and Tests - Health.com 10 February 2010 13:27 UTC www.health.com [Source type: FILTERED WITH BAYES]
    • Health Information 10 February 2010 13:27 UTC www.mmc.org [Source type: FILTERED WITH BAYES]

     ^ Anemia (detected on a CBC ) Clotting problems Liver function problems (detected on liver function tests) Low serum albumin The following tests may be used to evaluate the liver: .
    • Cirrhosis - Abington Memorial Hospital 10 February 2010 13:27 UTC amh.adam.com [Source type: Academic]

     .If these are present, biopsy may not need to be performed.^ Although it may be confirmed by an ultrasound examination , it may be necessary to perform a liver biopsy to obtain tissue samples from the liver.
    • Cirrhosis of the liver 10 February 2010 13:27 UTC www.netdoctor.co.uk [Source type: FILTERED WITH BAYES]
    • Cirrhosis of the liver 12 September 2009 4:14 UTC www.tiscali.co.uk [Source type: FILTERED WITH BAYES]

     ^ To confirm the diagnosis, your doctor may need to do a liver biopsy, in which a small sample of liver tissue is removed with a needle and examined in a laboratory.
    • American Liver Foundation - Cirrhosis 10 February 2010 13:27 UTC www.liverfoundation.org [Source type: FILTERED WITH BAYES]

     ^ The diagnosis may be confirmed by performing a liver biopsy, in which a long hollow needle is used to obtain a small tissue sample for examination under a microscope.
    • Liver damage leading to fatty liver, Cirrhosis & Hepatitis 10 February 2010 13:27 UTC www.herbalprovider.com [Source type: Academic]

     .Treatment is with phlebotomy to lower total body iron levels.
  • Wilson's disease.^ You also will be treated for underlying diseases for example, interferon and other medications for viral hepatitis, corticosteroids or other immunosuppressant medications for autoimmune hepatitis, and phlebotomy, which is the periodic removal of a pint of blood to reduce iron levels in hemochromatosis.
    • Cirrhosis - Cirrhosis Description - Cirrhosis Symptoms - Cirrhosis Prevention - Cirrhosis Treatment 10 February 2010 13:27 UTC symptomchecker.about.com [Source type: FILTERED WITH BAYES]

     ^ Autoimmune inflammation of the liver Disorders of the drainage system of the liver (the biliary system) Hepatitis B Medications Metabolic disorders of iron and copper ( hemochromatosis and Wilson's disease ) Symptoms .
    • Cirrhosis - Shands Healthcare 10 February 2010 13:27 UTC www.shands.org [Source type: Academic]

     ^ Wilson's disease, a hereditary disease which causes the body to retain copper.
    • Symptoms of Liver Disease, Problems 12 September 2009 12:21 UTC www.y2khealthanddetox.com [Source type: FILTERED WITH BAYES]

     .Autosomal recessive disorder characterized by low serum ceruloplasmin and increased hepatic copper content on liver biopsy.^ Hepatitis C is now the most common reason for liver transplantation in the US. Other causes of cirrhosis include hepatitis B, medications, autoimmune inflammation of the liver, disorders of the drainage system of the liver (the biliary system), and metabolic disorders of iron and copper (hemochromatosis and Wilson's disease).
    • AllRefer Health - Cirrhosis (Liver Cirrhosis) 12 September 2009 12:21 UTC health.allrefer.com [Source type: Academic]

     ^ For example, hepatitis C patients who show no significant liver scarring when biopsied may have a low risk for cirrhosis.

     ^ Anemia (detected on a CBC ) Clotting problems Liver function problems (detected on liver function tests) Low serum albumin The following tests may be used to evaluate the liver: .
    • Cirrhosis - Abington Memorial Hospital 10 February 2010 13:27 UTC amh.adam.com [Source type: Academic]

     .May also have Kayser-Fleischer rings in the cornea and altered mental status.
  • Alpha 1-antitrypsin deficiency (AAT).^ Alpha-1 antitrypsin deficiency.

     ^ Alpha-1 antitrypsin deficiency .
    • Cirrhosis | LIVESTRONG.COM 10 February 2010 13:27 UTC www.livestrong.com [Source type: General]
    • Renal Dysfunction in Cirrhosis: Introduction 10 February 2010 13:27 UTC www.medscape.com [Source type: Academic]

     ^ On rare occasions, the absence of certain specific enzymes can lead to liver as well as lung injury, as in alpha 1 antitrypsin deficiency.

     Autosomal recessive disorder. .Patients may also have COPD, especially if they have a history of tobacco smoking.^ Cholangiocarcinoma may occur in 7 to 15% of patients with PSC. Patients with a long history of inflammatory bowel disease and smokers are at the highest risk.
    • Primary Sclerosing Cholangitis and Primary Biliary Cirrhosis - Patients - American College of Gastroenterology 10 February 2010 13:27 UTC www.acg.gi.org [Source type: Academic]

     ^ High-quality dietary protein may be especially helpful for patients with ascites and for repairing muscle mass, but excessive protein loads may trigger encephalopathy.
    • Cirrhosis 10 February 2010 13:27 UTC www.hcvets.com [Source type: Academic]
    • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
    • Cirrhosis 10 February 2010 13:27 UTC www.preventdisease.com [Source type: Academic]
    • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

     ^ Although, these tests are not specific (or sensitive) by themselves for a diagnosis of cirrhosis, when used in the context of the history and physical findings, they may be helpful diagnostically.
    • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]

     .Serum AAT levels are low.^ Serum albumin measures protein in the blood (low levels indicate poor liver function).
    • Cirrhosis - MMCI 10 February 2010 13:27 UTC mmci2.adam.com [Source type: Academic]
    • Cirrhosis 10 February 2010 13:27 UTC www.hcvets.com [Source type: Academic]
    • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
    • Cirrhosis 10 February 2010 13:27 UTC www.preventdisease.com [Source type: Academic]
    • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]
    • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]
    • Cirrhosis - Diagnosis 10 February 2010 13:27 UTC health.shorehealth.org [Source type: Academic]

     ^ Serum albumin measure protein in the blood with low levels indicating poor liver function.

     ^ This phenomenon is associated with the presence of ascites, pleural effusions, subcutaneous edema, and low mean serum albumin levels, butnot with splenomegaly or varices.

     .Recombinant AAT is used to prevent lung disease due to AAT deficiency.
  • Cardiac cirrhosis.^ Some causes of cirrhosis are due to infectious diseases which can often be prevented.
    • Cirrhosis | Health | Patient UK 10 February 2010 13:27 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

     ^ Many things can cause cirrhosis including various liver diseases such as hemochromatosis, Wilson's disease, alpha-1 antitrypsin deficiency, autoimmune hepatitis, and biliary atresia.
    • How to Live with Hepatitis - Hepatitis Foundation International (Health Travel, Hep B, Hep C, Chronic Hep and Cirrhosis) 10 February 2010 13:27 UTC www.hepfi.org [Source type: FILTERED WITH BAYES]

     ^ Alcoholic fibrosis and cirrhosis Cardiac fibrosis Venous outflow obstruction such as Budd-Chiari syndrome and veno-occlusive disease .

     Due to chronic right sided heart failure which leads to liver congestion.
  • Galactosemia
  • Glycogen storage disease type IV
  • Cystic fibrosis
  • Hepatotoxic drugs or toxins
  • Certain parasitic infections (such as schistosomiasis)

Pathophysiology

.The liver plays a vital role in synthesis of proteins (e.g.^ AcH is particularly being researched because it plays a role in most actions of alcohol, including damaging effects on the liver that may lead to cirrhosis.
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.preventdisease.com [Source type: Academic]
  • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]

 ^ Drugs that block factors in the immune system, called thromboxanes, may play an important role in the inflammatory process that kills liver cells in alcoholic cirrhoses.

 ^ Genetic factors that regulate the immune responses in the intestine also play role in increasing the risk for liver injury from alcoholism.

 , albumin, clotting factors and complement), detoxification and storage (e.g., vitamin A). In addition, it participates in the metabolism of lipids and carbohydrates.
.Cirrhosis is often preceded by hepatitis and fatty liver (steatosis), independent of the cause.^ Hepatitis C is the second leading cause of cirrhosis.
  • American Liver Foundation - Cirrhosis 10 February 2010 13:27 UTC www.liverfoundation.org [Source type: FILTERED WITH BAYES]

 ^ Cirrhosis is caused by irreversible scarring of the liver.
  • Cirrhosis - Kosmix : Reference, Videos, Images, News, Shopping and more... 10 February 2010 13:27 UTC www.kosmix.com [Source type: Academic]
  • Cirrhosis | LIVESTRONG.COM 10 February 2010 13:27 UTC www.livestrong.com [Source type: General]
  • Cirrhosis - Abington Memorial Hospital 10 February 2010 13:27 UTC amh.adam.com [Source type: Academic]
  • Cirrhosis - Shands Healthcare 10 February 2010 13:27 UTC www.shands.org [Source type: Academic]

 ^ Fatty liver causes scarring of the liver.

 .If the cause is removed at this stage, the changes are still fully reversible.^ Phosphatidylcholine (PC) breaks down scar tissue in the liver and may be able to reverse tissue changes that cause cirrhosis.
  • Liver_Cirrhosis - Health Information on Vitamins & Nutritional Supplements - Mitamins 12 September 2009 12:21 UTC www.mitamins.com [Source type: Academic]
  • Liver Cirrhosis 10 February 2010 13:27 UTC www.puritan.com [Source type: Academic]
  • Delicious Living - for the organic, green and healthy lifestyle 10 February 2010 13:27 UTC healthnotes.deliciouslivingmag.com [Source type: Academic]
  • Hypoallergenic Nutritional Supplements from Pure Encapsulations 10 February 2010 13:27 UTC www.purecaps.com [Source type: Academic]
  • Liver Cirrhosis 10 February 2010 13:27 UTC www.nutritionfocus.org [Source type: Academic]
  • Liver Cirrhosis 10 February 2010 13:27 UTC www.gnc.co.uk [Source type: Academic]
  • Citizens Health Information 10 February 2010 13:27 UTC www.citizensmemorial.com [Source type: Academic]

 ^ In clinical trials [Natural Remedy] has been shown to break down scar tissue in the liver and may be able to reverse tissue changes that cause cirrhosis.

 ^ Stopping or reversing the process requires removal of the cause.
  • Hepatitis C, Cirrhosis, Current Information On Hepatitis C & treatments for the medical professional and patient. 10 February 2010 13:27 UTC www.hepatitis-central.com [Source type: Academic]
.The pathological hallmark of cirrhosis is the development of scar tissue that replaces normal parenchyma, blocking the portal flow of blood through the organ and disturbing normal function.^ The scar tissue also blocks blood flow through the portal vein (which carries blood from the intestines to the liver).
  • Cirrhosis: Fatty Liver, Cirrhosis, and Related Disorders: Merck Manual Home Edition 12 September 2009 12:21 UTC www.merck.com [Source type: Academic]

 ^ Cirrhosis harms the structure of the liver and blocks the flow of blood.

 ^ Cirrhosis occurs when substantial amounts of scar tissue replace normal tissue in the liver.
  • WellSpan Health Library 10 February 2010 13:27 UTC www.wellspan.org [Source type: FILTERED WITH BAYES]
  • Health Information 10 February 2010 13:27 UTC www.mmc.org [Source type: FILTERED WITH BAYES]

 .Recent research shows the pivotal role of stellate cell, a cell type that normally stores vitamin A, in the development of cirrhosis.^ Research also suggests that the hepatic stellate cell might play an important role in the development of cirrhosis.

 ^ 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.
  • CIRRHOSIS 10 February 2010 13:27 UTC www.gastro.com [Source type: Academic]
  • Hepatitis C, Cirrhosis, Current Information On Hepatitis C & treatments for the medical professional and patient. 10 February 2010 13:27 UTC www.hepatitis-central.com [Source type: Academic]

 ^ Symptoms of primary biliary cirrhosis include pruritus, fatigue, jaundice, melanosis, malabsorption of lipids and vitamins, and eventually hepatocellular failure and development of portal hypertension.
  • Primary Biliary Cirrhosis: MR Imaging Findings and Description of MR Imaging Periportal Halo Sign -- Wenzel et al. 176 (4): 885 -- American Journal of Roentgenology 10 February 2010 13:27 UTC www.ajronline.org [Source type: Academic]

 .Damage to the hepatic parenchyma leads to activation of the stellate cell, which becomes contractile (called myofibroblast) and obstructs blood flow in the circulation.^ Stellate cells serve as contractile cells for adjacent hepatic endothelial cells.
  • Cirrhosis: eMedicine Gastroenterology 10 February 2010 13:27 UTC emedicine.medscape.com [Source type: Academic]

 ^ Activated stellate cells also have contractile properties.
  • Cirrhosis: eMedicine Gastroenterology 10 February 2010 13:27 UTC emedicine.medscape.com [Source type: Academic]

 ^ In cirrhosis, liver cell damage slows down blood flow.
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.preventdisease.com [Source type: Academic]
  • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

 .In addition, it secretes TGF-β1, which leads to a fibrotic response and proliferation of connective tissue.^ Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function.
  • Symptoms of Liver Disease, Problems 12 September 2009 12:21 UTC www.y2khealthanddetox.com [Source type: FILTERED WITH BAYES]
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

 ^ This immune system disorder is a subset of scleroderma, a disease that leads to thickening, tightening and hardening of connective tissue.
  • OhioHealth - Primary biliary cirrhosis 10 February 2010 13:27 UTC www.ohiohealth.com [Source type: General]
  • Primary biliary cirrhosis - Valley Health System 10 February 2010 13:27 UTC www.valleyhealth.com [Source type: General]
  • georgiahealthinfo.gov 10 February 2010 13:27 UTC georgiahealthinfo.gov [Source type: FILTERED WITH BAYES]

 ^ If these changes continue to be stimulated, a proliferation of fibrosis continues in hepatic stellate cells and normal tissue is replaced with abnormal, fibrotic liver tissue (Wolf 2001).

 .Furthermore, it disturbs the balance between matrix metalloproteinases and the naturally occurring inhibitors (TIMP 1 and 2), leading to matrix breakdown and replacement by connective tissue-secreted matrix.^ Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrous scar tissue as well as regenerative nodules (lumps that occur as a result of a process in which damaged tissue is regenerated), leading to progressive loss of liver function.
  • Cirrhosis - Kosmix : Reference, Videos, Images, News, Shopping and more... 10 February 2010 13:27 UTC www.kosmix.com [Source type: Academic]

 ^ Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function.
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

 ^ This immune system disorder is a subset of scleroderma, a disease that leads to thickening, tightening and hardening of connective tissue.
  • Primary biliary cirrhosis 10 February 2010 13:27 UTC www.cnn.com [Source type: General]
  • Primary biliary cirrhosis 10 February 2010 13:27 UTC e.a.cnn.net [Source type: General]
  • Primary biliary cirrhosis - Valley Health System 10 February 2010 13:27 UTC www.valleyhealth.com [Source type: General]
  • georgiahealthinfo.gov 10 February 2010 13:27 UTC georgiahealthinfo.gov [Source type: FILTERED WITH BAYES]

 [8]
.The fibrous tissue bands (septa) separate hepatocyte nodules, which eventually replace the entire liver architecture, leading to decreased blood flow throughout.^ Scar tissue also may block blood flow through the liver.
  • Liver damage leading to fatty liver, Cirrhosis & Hepatitis 12 September 2009 12:21 UTC www.herbalprovider.com [Source type: Academic]

 ^ Scar tissue also blocks the normal flow of blood through the liver.
  • Liver cirrhosis could be reversed - study 10 February 2010 13:27 UTC foodconsumer.org [Source type: FILTERED WITH BAYES]

 ^ Scar tissue replaces healthy liver tissue, partially blocking the flow of blood through the liver.

 .The spleen becomes congested, which leads to hypersplenism and increased sequestration of platelets.^ Hepatic dysfunction affecting clotting factors and functional hypersplenism impacting platelet life increase the risk of massive GI hemorrhage.

 ^ For example, portal hypertension leads to splenomegaly, and thus, low platelet counts caused by sequestration of platelets in the spleen.
  • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]

 ^ The bones become soft and fragile, leading to increased risk of fractures.
  • Primary Biliary Cirrhosis Treatments, Diagnosis, Symptoms- Primary Biliary Cirrhosis 10 February 2010 13:27 UTC www.gicare.com [Source type: Academic]

 .Portal hypertension is responsible for most severe complications of cirrhosis.^ Rikkers LF: Surgical complications of cirrhosis and portal hypertension.
  • CIRRHOSIS: advanced liver disease 10 February 2010 13:27 UTC www.natap.org [Source type: Academic]

 ^ Cirrhosis is the most common cause of portal hypertension in the United States.
  • CIRRHOSIS: advanced liver disease 10 February 2010 13:27 UTC www.natap.org [Source type: Academic]

 ^ Portal hypertension is one of the major complications of cirrhosis.
  • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]

Diagnosis

.The gold standard for diagnosis of cirrhosis is a liver biopsy, through a percutaneous, transjugular, laparoscopic, or fine-needle approach.^ Liver biopsy through a transjugular, percutaneous, fine-needle or laparoscopic approach is the best way to diagnose cirrhosis.

 ^ A liver biopsy confirms cirrhosis.
  • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]

 ^ In situations where there is question about the diagnosis of cirrhosis, a definitive diagnosis can usually be made with liver biopsy, through a percutaneous, transjugular, or laparoscopic approach.
  • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]

 .Histologically cirrhosis can be classified as micronodular, macronodular, or mixed, but this classification has been abandoned since it is non-specific to the aetiology, it may change as the disease progresses, and serological markers are much more specific.^ As the disease progresses, complications may develop.
  • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]
  • Cirrhosis of the Liver | AloeElite 10 February 2010 13:27 UTC www.aloeelite.com [Source type: FILTERED WITH BAYES]

 ^ On the basis of the results obtained from the histological studies cirrhosis can be divided into macronodular, micronodular, or mixed, but it is unfocused to the etiology and these may loss with the progress of the disease and serological sign are greatly specific.

 ^ As cirrhosis progresses you may .
  • Liver cirrhosis could be reversed - study 10 February 2010 13:27 UTC foodconsumer.org [Source type: FILTERED WITH BAYES]

 [citation needed]. .However, a biopsy is not necessary if the clinical, laboratory, and radiologic data suggests cirrhosis.^ If the laboratory, clinical, and radiological records suggests cirrhosis them there is no requirement of going for liver biopsy.

 ^ The diagnosis of cirrhosis requires integration of clinical, laboratory, radiological and pathological data.
  • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]

 ^ This article reviews the data on the epidemiology and clinical manifestations of chronic HCV infection in older adults (age > 60 years) and suggests an approach to management of this infection in this population.
  • Hepatitis C Virus Infection in the Elderly: Epidemiology, Na... : Drugs & Aging 10 February 2010 13:27 UTC adisonline.com [Source type: Academic]

 .Furthermore, there is a small but significant risk to liver biopsy, and cirrhosis itself predisposes for complications due to liver biopsy.^ There is a small but significant risk to liver biopsy, and thus it is reserved for specific cases.
  • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]

 ^ Patients with cirrhosis of the liver are at high risk of a large variety of complications.
  • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

 ^ A liver biopsy confirms cirrhosis.
  • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]

 [9]

Lab findings

The following findings are typical in cirrhosis:
.
  • Aminotransferases - AST and ALT are moderately elevated, with AST > ALT. However, normal aminotransferases do not preclude cirrhosis.
  • Alkaline phosphatase - usually slightly elevated.
  • GGT – correlates with AP levels.^ AST, ALT usually ↑; may be normal .
    • U.S. Department of Veterans Affairs 10 February 2010 13:27 UTC www.hiv.va.gov [Source type: Academic]

     ^ Elevated alkaline phosphatase (with or without bilirubin elevation) .
    • U.S. Department of Veterans Affairs 10 February 2010 13:27 UTC www.hiv.va.gov [Source type: Academic]

     ^ AST and ALT levels may be normal in advanced disease .
    • Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation - September 1, 2006 - American Family Physician 10 February 2010 13:27 UTC www.aafp.org [Source type: Academic]

     .Typically much higher in chronic liver disease from alcohol.
  • Bilirubin - may elevate as cirrhosis progresses.
  • Albumin - levels fall as the synthetic function of the liver declines with worsening cirrhosis since albumin is exclusively synthesized in the liver
  • Prothrombin time - increases since the liver synthesizes clotting factors.
  • Globulins - increased due to shunting of bacterial antigens away from the liver to lymphoid tissue.
  • Serum sodium - hyponatremia due to inability to excrete free water resulting from high levels of ADH and aldosterone.
  • Thrombocytopenia - due to both congestive splenomegaly as well as decreased thrombopoietin from the liver.^ (See Alcoholic liver disease .
    • AllRefer Health - Cirrhosis (Liver Cirrhosis) 12 September 2009 12:21 UTC health.allrefer.com [Source type: Academic]

     ^ Albumin is synthesized exclusively in the liver.
    • Cirrhosis 10 February 2010 13:27 UTC janis7hepc.com [Source type: Academic]

     ^ Alcoholic liver disease.
    • WellSpan Health Library 10 February 2010 13:27 UTC www.wellspan.org [Source type: FILTERED WITH BAYES]
    • Cirrhosis of the Liver 10 February 2010 13:27 UTC catalog.nucleusinc.com [Source type: FILTERED WITH BAYES]
    • Health Information 10 February 2010 13:27 UTC www.mmc.org [Source type: FILTERED WITH BAYES]
    • MoonDragon's Health & Wellness: Cirrhosis of the Liver 12 September 2009 4:14 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

     However, this rarely results in platelet count < 50,000/mL.
  • Leukopenia and neutropenia - due to splenomegaly with splenic margination.
  • Coagulation defects - the liver produces most of the coagulation factors and thus coagulopathy correlates with worsening liver disease.
.There is now a validated and patented combination of 6 of these markers as non-invasive biomarker of fibrosis (and so of cirrhosis) : FibroTest [10].^ Non-invasive serum markers of liver fibrosis may help identify patients with cirrhosis.
  • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]

 ^ Therefore, non-invasive methods for the assessment of liver fibrosis and inflammation have been proposed.
  • Hepatitis C Virus Infection in the Elderly: Epidemiology, Na... : Drugs & Aging 10 February 2010 13:27 UTC adisonline.com [Source type: Academic]

 ^ If there is good clinical documentation of the duration of the cirrhosis of progression of the fibrosis, the term early cirrhosis has sometimes been used.
Other laboratory studies performed in newly diagnosed cirrhosis may include:

Imaging

Liver cirrhosis as seen on an axial CT of the abdomen.
.Ultrasound is routinely used in the evaluation of cirrhosis, where it may show a small and nodular liver in advanced cirrhosis along with increased echogenicity with irregular appearing areas.^ Signs of advanced cirrhosis may include: .
  • Dr Sandra Cabot's Liver Doctor - Love your Liver and Live Longer 10 February 2010 13:27 UTC www.liverdoctor.com [Source type: Academic]

 ^ Routine tests of liver function may be quite normal in cirrhosis.
  • Hepatic Cirrhosis, liver Cirrhosis, Notes on Cyber Gastroenterology, Dr. Julio Murra Saca, El Salvador. 10 February 2010 13:27 UTC www.murrasaca.com [Source type: Academic]

 ^ Ultrasound technique is being used now to evaluate cirrhosis.
  • Liver Cirrhosis Symptoms, Stages, Treatment & Causes 10 February 2010 13:27 UTC www.ayushveda.com [Source type: FILTERED WITH BAYES]

 .Ultrasound may also screen for hepatocellular carcinoma, portal hypertension and Budd-Chiari syndrome (by assessing flow in the hepatic vein).^ CLOSE WINDOW ] Screening for hepatocellular carcinoma.

 ^ Screening for hepatocellular carcinoma.

 ^ Hepatic vein obstruction (ie, Budd-Chiari syndrome) Congestive heart failure .
  • Cirrhosis: eMedicine Gastroenterology 10 February 2010 13:27 UTC emedicine.medscape.com [Source type: Academic]
.A new type of device, the FibroScan (transient elastography), uses elastic waves to determine liver stiffness which theoretically can be converted into a liver score based on the METAVIR scale.^ The stiffness of the liver is determined by using elastic waves.
  • Liver Cirrhosis Symptoms, Stages, Treatment & Causes 10 February 2010 13:27 UTC www.ayushveda.com [Source type: FILTERED WITH BAYES]

 ^ Another method for assessing fibrosis is transient elastography (FibroScan ® ), which measures liver stiffness using pulse-echo ultrasonography.
  • Hepatitis C Virus Infection in the Elderly: Epidemiology, Na... : Drugs & Aging 10 February 2010 13:27 UTC adisonline.com [Source type: Academic]

 ^ A liver biopsy is used to determine the progression of PBC. The biopsy involves a thin needle that removes a small sample of liver tissue under local anesthetic (numbing medicine).
  • Primary Biliary Cirrhosis - Medpedia 10 February 2010 13:27 UTC wiki.medpedia.com [Source type: Academic]

 .The FibroScan produces an ultrasound image of the liver (from 20–80 mm) along with a pressure reading (in kPa.^ X rays, magnetic resonance imaging, or ultrasound images, which are pictures developed from sound waves, may show an enlarged or shrunken liver.
  • Liver cirrhosis could be reversed - study 10 February 2010 13:27 UTC foodconsumer.org [Source type: FILTERED WITH BAYES]

 ^ Ultrasound exam of the liver Images of the liver and bile ducts are taken to assess for liver abnormalities.
  • Primary Sclerosing Cholangitis and Primary Biliary Cirrhosis - Patients - American College of Gastroenterology 10 February 2010 13:27 UTC www.acg.gi.org [Source type: Academic]

 ^ Ultrasound Ultrasound testing uses sound waves projected into the body to produce an image of internal organs, structures, tumors, etc.
  • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]

 ) .The test is much faster than a biopsy (usually last 2.5–5 minutes) and is completely painless.^ Ultrasound is painless and usually takes less than 30 minutes.

 ^ Radiation treatments are painless and usually last a few minutes.
  • Cancer Types - Biliary Cirrhosis / Bile Duct Cancer 10 February 2010 13:27 UTC www.montefiore.org [Source type: Academic]

 ^ Usually if cirrhosis is suspected, other tests such as blood tests, ultrasounds or a liver biopsy are done to confirm the diagnosis, assess the severity and identify the cause.
  • Liver cirrhosis - myDr.com.au 10 February 2010 13:27 UTC www.mydr.com.au [Source type: FILTERED WITH BAYES]

 .It shows reasonable correlation with the severity of cirrhosis.^ A common symptom of primary biliary cirrhosis is fatigue, but doctors haven't found any correlation between the degree of exhaustion and the severity of the illness.
  • Primary biliary cirrhosis 10 February 2010 13:27 UTC www.cnn.com [Source type: General]
  • OhioHealth - Primary biliary cirrhosis 10 February 2010 13:27 UTC www.ohiohealth.com [Source type: General]
  • Primary biliary cirrhosis 10 February 2010 13:27 UTC e.a.cnn.net [Source type: General]
  • Primary biliary cirrhosis - Valley Health System 10 February 2010 13:27 UTC www.valleyhealth.com [Source type: General]

 ^ Blood testing for other reasons may reveal abnormal liver function and prompt further investigation which shows cirrhosis.
  • Cirrhosis | Doctor | Patient UK 10 February 2010 13:27 UTC www.patient.co.uk [Source type: Academic]

 ^ One study reported that MRI can accurately diagnose cirrhosis and provide correlation with its severity.
  • Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation - September 1, 2006 - American Family Physician 10 February 2010 13:27 UTC www.aafp.org [Source type: Academic]

 [11]
.Other tests performed in particular circumstances include abdominal CT and liver/bile duct MRI (MRCP).^ Other tests (blood tests, imaging tests, liver biopsy) may also be performed.
  • Cirrhosis - MMCI 10 February 2010 13:27 UTC mmci2.adam.com [Source type: Academic]

 ^ Other inherited conditions that may cause cirrhosis include cystic fibrosis and alpha-1-antitrypsin deficiency a disorder in which abnormal protein damages liver cells.
  • dreddyclinic.com - Cirrhosis 10 February 2010 13:27 UTC www.dreddyclinic.com [Source type: Academic]

 ^ Other tests may include: Inserting a catheter into the liver vein and measuring the pressure within that vein; rarely necessary Removing fluid from the abdomen and examining it Other tests to determine what has caused the cirrhosis and what complications may occur .

Endoscopy

.Gastroscopy (endoscopic examination of the esophagus, stomach and duodenum) is performed in patients with established cirrhosis to exclude the possibility of esophageal varices.^ Small esophageal varices in cirrhotic patients .
  • Hepatitis C Cirrhosis and Treatment 10 February 2010 13:27 UTC janis7hepc.com [Source type: Academic]

 ^ Cirrhosis has many possible causes; sometimes more than one cause are present in the same patient.
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

 ^ If the patient bleeds from the varices of the stomach or esophagus, the doctor can band these veins through a flexible tube (upper endoscopy).

 .If these are found, prophylactic local therapy may be applied (sclerotherapy or banding) and beta blocker treatment may be commenced.^ Gastroenterologists varied in the use of prophylactic antibiotics for acute EVB. More gastroenterologists used combination secondary prophylaxis in the form of band ligation eradication and beta-blocker therapy rather than either treatment alone.
  • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

 ^ If you have had an episode of variceal bleeding, you may need more frequent screening and beta-blocker medicine, or your doctor may recommend variceal banding to help prevent future bleeding.
  • Health Information 10 February 2010 13:27 UTC www.mmc.org [Source type: FILTERED WITH BAYES]

 ^ Fortunately, improved therapies may significantly reduce these discouraging estimates.
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
  • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]
.Rarely diseases of the bile ducts, such as primary sclerosing cholangitis, can be causes of cirrhosis.^ Primary biliary cirrhosis is a disease of adults where the bile ducts become damaged.
  • Liver cirrhosis - myDr.com.au 10 February 2010 13:27 UTC www.mydr.com.au [Source type: FILTERED WITH BAYES]

 ^ These diseases include primary biliary cirrhosis and primary sclerosing chlorangitis.
  • Cirrhosis - MMCI 10 February 2010 13:27 UTC mmci2.adam.com [Source type: Academic]

 ^ For example, primary biliary cirrhosis, sclerosing cholangitis, and congenital problems of the bile ducts.
  • Cirrhosis | Health | Patient UK 10 February 2010 13:27 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

 .Imaging of the bile ducts, such as ERCP or MRCP (MRI of biliary tract and pancreas) can show abnormalities in these patients, and may aid in the diagnosis.^ Colchicine may be tried in such patients.
  • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

 ^ If there are clear signs of cirrhosis such as ascites, coagulopathy, and a shrunken nodular-appearing liver, then confirmation of diagnosis by biopsy may not be necessary.
  • Cirrhosis | Doctor | Patient UK 10 February 2010 13:27 UTC www.patient.co.uk [Source type: Academic]

 ^ Imaging methods such as CT scan, MRI and Ultrasound help assessing the structural effects of the disease on the liver and are particularly useful in identifying complications.
  • Liver Cirrhosis Treatment | Cirhosis of liver Cure | Natural Medication, diet, prognosis for symptoms of Cirrhosis causes 10 February 2010 13:27 UTC www.biogetica.com [Source type: FILTERED WITH BAYES]

Pathology

Cirrhosis leading to hepatocellular carcinoma (autopsy specimen).
.Macroscopically, the liver is initially enlarged, but with progression of the disease, it becomes smaller.^ The liver becomes very enlarged.

 ^ Progress in liver diseases.

 ^ Slowing or reversing the progression of liver disease.
  • Hepatic Cirrhosis, liver Cirrhosis, Notes on Cyber Gastroenterology, Dr. Julio Murra Saca, El Salvador. 10 February 2010 13:27 UTC www.murrasaca.com [Source type: Academic]

 .Its surface is irregular, the consistency is firm and the color is often yellow (if associates steatosis).^ The color of the liver tends to be yellow and it develops a firm consistency.
  • Liver Cirrhosis Symptoms, Stages, Treatment & Causes 10 February 2010 13:27 UTC www.ayushveda.com [Source type: FILTERED WITH BAYES]

 .Depending on the size of the nodules there are three macroscopic types: micronodular, macronodular and mixed cirrhosis.^ The mixed cirrhosis type where the nodules are of different sizes.
  • Liver Cirrhosis Symptoms, Stages, Treatment & Causes 10 February 2010 13:27 UTC www.ayushveda.com [Source type: FILTERED WITH BAYES]

 ^ Cirrhosis is characterized by diffuse interlacing bands of fibrous tissue dividing the hepatic parenchyma into micronodular or macronodular areas.
  • http://www.hiv.va.gov/vahiv?page=pcm-210_liver 10 February 2010 13:27 UTC www.hiv.va.gov [Source type: Academic]

 ^ The sensitivity and specificity for an accurate diagnosis of cirrhosis and its etiology range from 80 to 100 percent, depending on the number and size of the histologic samples and on the sampling method.
  • Cirrhosis and Chronic Liver Failure: Part I. Diagnosis and Evaluation - September 1, 2006 - American Family Physician 10 February 2010 13:27 UTC www.aafp.org [Source type: Academic]

 .In micronodular form (Laennec's cirrhosis or portal cirrhosis) regenerating nodules are under 3 mm.^ Alcoholic cirrhosis (also sometimes referred to as portal, Laennecs, nutritional, or micronodular cirrhosis) is the primary cause of cirrhosis in the US. It is estimated to be responsible for 44% of deaths from cirrhosis in North America.
  • Cirrhosis 10 February 2010 13:27 UTC www.hcvets.com [Source type: Academic]

 ^ Micronodular cirrhosis is characterized by uniformly small nodules ( < 3 mm in diameter) and thick regular bands of connective tissue.
  • Cirrhosis: Fibrosis and Cirrhosis: Merck Manual Professional 10 February 2010 13:27 UTC www.merck.com [Source type: Academic]

 ^ Often, this process is accompanied by random clusters of regenerated liver cells that develop throughout the liver, usually forming nodules around the fibrosis.

 .In macronodular cirrhosis (post-necrotic cirrhosis), the nodules are larger than 3 mm.^ The macro nodular type where the nodules are larger than 3 mm .
  • Liver Cirrhosis Symptoms, Stages, Treatment & Causes 10 February 2010 13:27 UTC www.ayushveda.com [Source type: FILTERED WITH BAYES]

 ^ Micronodular cirrhosis is characterized by uniformly small nodules ( < 3 mm in diameter) and thick regular bands of connective tissue.
  • Cirrhosis: Fibrosis and Cirrhosis: Merck Manual Professional 10 February 2010 13:27 UTC www.merck.com [Source type: Academic]

 ^ Portal pressures higher than 12 mm Hg are generally required for the accumulation of fluid in cirrhosis.

 .The mixed cirrhosis consists in a variety of nodules with different sizes.^ The mixed cirrhosis type where the nodules are of different sizes.
  • Liver Cirrhosis Symptoms, Stages, Treatment & Causes 10 February 2010 13:27 UTC www.ayushveda.com [Source type: FILTERED WITH BAYES]

 ^ A. — Pathologic difference was consistent throughout primary biliary cirrhosis cohort in regard to visibility of MR imaging periportal halo sign.
  • Primary Biliary Cirrhosis: MR Imaging Findings and Description of MR Imaging Periportal Halo Sign -- Wenzel et al. 176 (4): 885 -- American Journal of Roentgenology 10 February 2010 13:27 UTC www.ajronline.org [Source type: Academic]

 ^ Indeed, cirrhosis is defined as a histologic lesion consisting of bridging fibrosis with regenerative nodules ( Figure 1 ) in the setting of clinical evidence chronic liver disease.
  • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]
.However, cirrhosis is defined by its pathological features on microscopy: (1) the presence of regenerating nodules of hepatocytes and (2) the presence of fibrosis, or the deposition of connective tissue between these nodules.^ Histopathology: Cirrhosis is characterized by regenerating nodules and fibrosis.
  • Cirrhosis: Fibrosis and Cirrhosis: Merck Manual Professional 10 February 2010 13:27 UTC www.merck.com [Source type: Academic]

 ^ Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrous scar tissue as well as regenerative nodules (lumps that occur as a result of a process in which damaged tissue is regenerated), leading to progressive loss of liver function.
  • Cirrhosis - Kosmix : Reference, Videos, Images, News, Shopping and more... 10 February 2010 13:27 UTC www.kosmix.com [Source type: Academic]

 ^ The disease progresses through four stages of increasing fibrosis and hepatocyte depletion (hepatocellular parenchymal extinction), resulting in a network of connecting scars, reduction of bile ducts, and macroor micronodular cirrhosis [ 1 ].
  • Primary Biliary Cirrhosis: MR Imaging Findings and Description of MR Imaging Periportal Halo Sign -- Wenzel et al. 176 (4): 885 -- American Journal of Roentgenology 10 February 2010 13:27 UTC www.ajronline.org [Source type: Academic]

 .The pattern of fibrosis seen can depend upon the underlying insult that led to cirrhosis; fibrosis can also proliferate even if the underlying process that caused it has resolved or ceased.^ The treatment used depends on the underlying cause of the cirrhosis.
  • MayoClinic.com Health Library - Cirrhosis 10 February 2010 13:27 UTC www.riversideonline.com [Source type: FILTERED WITH BAYES]

 ^ Specific treatment for cirrhosis depends on the underlying cause.
  • dreddyclinic.com - Cirrhosis 10 February 2010 13:27 UTC www.dreddyclinic.com [Source type: Academic]

 ^ Treatment depends on the underlying cause.
  • Cirrhosis - Alternative Medicine Report 10 February 2010 13:27 UTC www.qualityhealth.com [Source type: Academic]

 .The fibrosis in cirrhosis can lead to destruction of other normal tissues in the liver: including the sinusoids, the space of Disse, and other vascular structures, which leads to altered resistance to blood flow in the liver and portal hypertension.^ Cirrhosis can also lead to other problems.
  • Liver cirrhosis could be reversed - study 10 February 2010 13:27 UTC foodconsumer.org [Source type: FILTERED WITH BAYES]

 ^ Cirrhosis of the Liver can lead to: .
  • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]

 ^ Cirrhosis is a condition where normal liver tissue is replaced by scar tissue (fibrosis).
  • Cirrhosis | Health | Patient UK 10 February 2010 13:27 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

 [12]
.As cirrhosis can be caused by many different entities which injure the liver in different ways, different cause-specific patterns of cirrhosis, and other cause-specific abnormalities can be seen in cirrhosis.^ Other causes of liver cirrhosis are diseases of metabolic origin.
  • Hepatic Cirrhosis, liver Cirrhosis, Notes on Cyber Gastroenterology, Dr. Julio Murra Saca, El Salvador. 10 February 2010 13:27 UTC www.murrasaca.com [Source type: Academic]

 ^ Causes Cirrhosis has many causes.

 ^ Cirrhosis has many causes.
  • Cirrhosis of the Liver | AloeElite 10 February 2010 13:27 UTC www.aloeelite.com [Source type: FILTERED WITH BAYES]

 .For example, in chronic hepatitis B, there is infiltration of the liver parenchyma with lymphocytes;[12] in cardiac cirrhosis there are erythrocytes and a greater amount of fibrosis in the tissue surrounding the hepatic veins;[13] in primary biliary cirrhosis, there is fibrosis around the bile duct, the presence of granulomas and pooling of bile;[14] and in alcoholic cirrhosis, there is infiltration of the liver with neutrophils.^ Optimal timing of liver transplantation for primary biliary cirrhosis.
  • Assessment of Prognosis of Cirrhosis: Abstract 10 February 2010 13:27 UTC www.medscape.com [Source type: Academic]

 ^ Methotrexate therapy for primary biliary cirrhosis.
  • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

 ^ Autoimmune liver diseases include autoimmune hepatitis and primary biliary cirrhosis .
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.preventdisease.com [Source type: Academic]
  • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

 [12]

Grading

.The severity of cirrhosis is commonly classified with the Child-Pugh score.^ Therefore, TIPS is generally not recommended for patients with preexisting encephalopathy, an ejection fraction lower than 55%, or a Child-Pugh Score higher than 12 ( Table 5 ).

 ^ However, Child-Pugh score has important limitations among which is subjective interpretation of some of its variables, making it difficult to categorize patients according to their own disease severity.
  • Assessment of Prognosis of Cirrhosis: Abstract 10 February 2010 13:27 UTC www.medscape.com [Source type: Academic]

 ^ These tests are important components of a classification scheme known as the Child–Pugh score or Child–Pugh classification Childs-Pugh classification (Table 3) and therefore are also used to help assess the severity of the liver disease.
  • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]

 .This score uses bilirubin, albumin, INR, presence and severity of ascites and encephalopathy to classify patients in class A, B or C; class A has a favourable prognosis, while class C is at high risk of death.^ This procedure is risky but may be used for patients with severe ascites.
  • Cirrhosis - MMCI 10 February 2010 13:27 UTC mmci2.adam.com [Source type: Academic]
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.preventdisease.com [Source type: Academic]
  • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

 ^ The results of these tests along with the presence of specific complications (ascites and encephalopathy) are used for calculating the Child-Pugh Classification.
  • Cirrhosis - MMCI 10 February 2010 13:27 UTC mmci2.adam.com [Source type: Academic]
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
  • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

 ^ The most predictive indicators for eventual outcome are willingness of the patient to not drink alcohol, the severity of any encephalopathy, levels of serum bilirubin and albumin, prothrombin time; the patient's age, and existing kidney function (Mihas et al.

 .It was devised in 1964 by Child and Turcotte and modified in 1973 by Pugh et al..^ The Child-Turcotte-Pugh (CTP) scoring classification, originally devised to risk-stratify patients undergoing shunt surgery for portal decompression, is a useful system to assess liver disease severity in patients with established cirrhosis ( Table 4 ) .
  • Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment - September 1, 2006 - American Family Physician 10 February 2010 13:27 UTC www.aafp.org [Source type: Academic]

 ^ Update Child-Turcotte-Pugh and MELD scores regularly.
  • http://www.hiv.va.gov/vahiv?page=pcm-210_liver 10 February 2010 13:27 UTC www.hiv.va.gov [Source type: Academic]

 ^ The most common tool for gauging prognosis in cirrhosis is the Child-Turcotte-Pugh (CTP) system.
  • Cirrhosis: eMedicine Gastroenterology 10 February 2010 13:27 UTC emedicine.medscape.com [Source type: Academic]

 [15]
.More modern scores, used in the allocation of liver transplants but also in other contexts, are the Model for End-Stage Liver Disease (MELD) score and its pediatric counterpart, the Pediatric End-Stage Liver Disease (PELD) score.^ Wiesner R, Edwards E, Freeman R, et al ; Model for end-stage liver disease (MELD) and allocation of donor livers.
  • Cirrhosis | Doctor | Patient UK 10 February 2010 13:27 UTC www.patient.co.uk [Source type: Academic]

 ^ Liver transplantation is only therapeutic option for patients who have end-stage disease.
  • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

 ^ MELD and PELD: application of survival models to liver allocation.
  • Liver Transplantation: Cirrhosis 10 February 2010 13:27 UTC www.medscape.com [Source type: Academic]
.The hepatic venous pressure gradient, i.e., the difference in venous pressure between afferent and efferent blood to the liver, also determines severity of cirrhosis, although hard to measure.^ The blood pressure in the veins of the liver is then measured.
  • Cirrhosis 10 February 2010 13:27 UTC www.hcvets.com [Source type: Academic]
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.preventdisease.com [Source type: Academic]
  • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

 ^ Severe hepatitis may lead to cirrhosis and chronic liver dysfunction.
  • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]

 ^ Hepatic venous pressure gradient predicts clinical decompensation in patients with compensated cirrhosis.
  • Assessment of Prognosis of Cirrhosis: Abstract 10 February 2010 13:27 UTC www.medscape.com [Source type: Academic]

 .A value of 16 mm or more means a greatly increased risk of dying.^ The destruction of healthy liver tissue that occurs in cirrhosis greatly increases the risk of liver cancer, primarily hepatocellular carcinoma, which affects the hepatocytes, the main type of liver cell.
  • georgiahealthinfo.gov 10 February 2010 13:27 UTC georgiahealthinfo.gov [Source type: FILTERED WITH BAYES]

 ^ Indeed, the presence of a mean pulmonary pressure of greater than 35 mm Hg significantly increases the risks of liver transplant surgery.
  • Cirrhosis: eMedicine Gastroenterology 10 February 2010 13:27 UTC emedicine.medscape.com [Source type: Academic]

 ^ Cirrhosis greatly increases the risk for liver cancer, regardless of the cause of cirrhosis.

 [16]

Management

.Generally, liver damage from cirrhosis cannot be reversed, but treatment could stop or delay further progression and reduce complications.^ Treatment Liver damage from cirrhosis cannot be reversed, but treatment can stop or delay further progression and reduce complications.

 ^ Liver damage from cirrhosis cannot be reversed, but treatment can stop or delay further progression and reduce complications.
  • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

 ^ Treatment of cirrhosis is designed to limit any further damage to the liver as well as complications.

 .A healthy diet is encouraged, as cirrhosis may be an energy-consuming process.^ A healthy diet is encouraged, as cirrhosis may be an energy-consuming process.
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

 ^ The relationship between cirrhosis mortality and alcohol consumption may vary depending on the type of alcoholic beverage—beer, wine, or spirits—consumed.
  • The Epidemiology of Alcoholic Liver Disease 10 February 2010 13:27 UTC pubs.niaaa.nih.gov [Source type: Academic]

 ^ In all cases of cirrhosis of the liver a healthy balanced diet and avoidance of alcohol are essential.
  • Liver cirrhosis - myDr.com.au 10 February 2010 13:27 UTC www.mydr.com.au [Source type: FILTERED WITH BAYES]

 .Close follow-up is often necessary.^ Close follow-up is often necessary.
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

 ^ This is a complicated medical procedure with a significant risk of organ rejection, and even in successful cases, lifelong follow-up therapy with immunosuppressant drugs will be necessary.
  • Cirrhosis and Liver Disease: Online References For Health Concerns 10 February 2010 13:27 UTC www.lef.org [Source type: Academic]

 ^ Therefore, you should understand that primary biliary cirrhosis is often considered a synonym or a condition closely related to the following: .

 .Antibiotics will be prescribed for infections, and various medications can help with itching.^ Antibiotics will be prescribed for infections, and various medications can help with itching.
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]
  • Cirrhosis of the Liver 10 February 2010 13:27 UTC catalog.nucleusinc.com [Source type: FILTERED WITH BAYES]

 ^ Doctors often prescribe antihistamines or other medications such as cholestyramine (Questran) and rifampin (Rifadin, Rimactane) to reduce itching caused by metabolites in the blood.
  • MayoClinic.com Health Library - Cirrhosis 10 February 2010 13:27 UTC www.riversideonline.com [Source type: FILTERED WITH BAYES]

 ^ Because immunosuppressants make your body more vulnerable to infection, your health care provider may also prescribe antibacterial, antiviral and antifungal medications.
  • MoonDragon's Health & Wellness: Cirrhosis of the Liver 12 September 2009 4:14 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

 .Laxatives, such as lactulose, decrease risk of constipation; their role in preventing encephalopathy is limited.^ Laxatives, such as lactulose, decrease risk of constipation; their role in preventing encephalopathy is limited.
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

 ^ It is not useful as the first choice for stopping an initial bleeding episode or for preventing rebleeding, however, since it poses a high risk for encephalopathy.
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

 ^ Laxatives such as lactulose may be given to help absorb toxins and speed their removal from the intestines.

Treating underlying causes

.Alcoholic cirrhosis caused by alcohol abuse is treated by abstaining from alcohol.^ Treating alcoholic cirrhosis Abstaining from alcohol is the main treatment for alcoholic cirrhosis.
  • MayoClinic.com Health Library - Cirrhosis 10 February 2010 13:27 UTC www.riversideonline.com [Source type: FILTERED WITH BAYES]

 ^ Some of the underlying causes of cirrhosis can be treated.
  • Cirrhosis | Health | Patient UK 10 February 2010 13:27 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

 ^ Treatment exists of elimination of the causes and preventing complications: Elimination of causes: alcoholic cirrhosis caused by alcohol abuse is treated by abstaining from alcohol.
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

 .Treatment for hepatitis-related cirrhosis involves medications used to treat the different types of hepatitis, such as interferon for viral hepatitis and corticosteroids for autoimmune hepatitis.^ Reversibility of hepatitis C virus-related cirrhosis.

 ^ Medications can help treat hepatic encephalopathy.
  • Cirrhosis 10 February 2010 13:27 UTC www.cnn.com [Source type: General]
  • OhioHealth - Cirrhosis 10 February 2010 13:27 UTC www.ohiohealth.com [Source type: General]
  • Cirrhosis 10 February 2010 13:27 UTC edition.cnn.com [Source type: General]
  • Cirrhosis 10 February 2010 13:27 UTC quiz.cnn.com [Source type: General]
  • Cirrhosis 10 February 2010 13:27 UTC edition1.cnn.com [Source type: General]
  • Cirrhosis - Valley Health System 10 February 2010 13:27 UTC www.valleyhealth.com [Source type: General]

 ^ Autoimmune disorders are treated by giving corticosteroids.
  • Liver Cirrhosis Treatment | Cirhosis of liver Cure | Natural Medication, diet, prognosis for symptoms of Cirrhosis causes 10 February 2010 13:27 UTC www.biogetica.com [Source type: FILTERED WITH BAYES]

 .Cirrhosis caused by Wilson's disease, in which copper builds up in organs, is treated with chelation therapy (e.g., penicillamine) to remove the copper.^ Some of the underlying causes of cirrhosis can be treated.
  • Cirrhosis | Health | Patient UK 10 February 2010 13:27 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

 ^ Cirrhosis caused by Wilson’s disease is treated with medications to remove the excess copper from the body.
  • Liver cirrhosis - myDr.com.au 10 February 2010 13:27 UTC www.mydr.com.au [Source type: FILTERED WITH BAYES]

 ^ Cirrhosis caused by Wilson's disease, in which copper builds up in organs, is treated with chelation therapy (e.g.
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

Preventing further liver damage

.Regardless of underlying cause of cirrhosis, alcohol and paracetamol, as well as other potentially damaging substances, are discouraged.^ Alcohol and acetaminophen, as well as other potentially damaging substances, are discouraged.
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

 ^ Cirrhosis can cause other cardiovascular complications.
  • Cirrhosis: Fibrosis and Cirrhosis: Merck Manual Professional 10 February 2010 13:27 UTC www.merck.com [Source type: Academic]

 ^ Avoid alcohol no matter what the underlying cause of cirrhosis is.
  • Repair Liver Damage and Scarring - Treatments to Prevent Cirrhosis 10 February 2010 13:27 UTC www.nativeremedies.com [Source type: FILTERED WITH BAYES]

 .Vaccination of susceptible patients should be considered for Hepatitis A and Hepatitis B.^ Vaccinations for hepatitis A and B should be administered.
  • Primary Sclerosing Cholangitis and Primary Biliary Cirrhosis - Patients - American College of Gastroenterology 10 February 2010 13:27 UTC www.acg.gi.org [Source type: Academic]

 ^ Patients should be referred for consideration of liver transplantation after the first signs of hepatic decompensation.
  • Cirrhosis: eMedicine Gastroenterology 10 February 2010 13:27 UTC emedicine.medscape.com [Source type: Academic]

 ^ Aminoglycoside antibiotics are considered obligate nephrotoxins in patients with cirrhosis and should be avoided.
  • Cirrhosis: eMedicine Gastroenterology 10 February 2010 13:27 UTC emedicine.medscape.com [Source type: Academic]

Preventing complications

Ascites

Main article: Ascites
.Salt restriction is often necessary, as cirrhosis leads to accumulation of salt (sodium retention).^ Once cirrhosis has been diagnosed, sodium and fluids should be restricted and all alcohol consumption must cease.

 ^ Patients with cirrhosis experience sodium retention, impaired free water excretion, and intravascular volume overload.
  • Cirrhosis: eMedicine Gastroenterology 10 February 2010 13:27 UTC emedicine.medscape.com [Source type: Academic]

 ^ Cirrhosis often leads to other ailments such as high blood pressure, cancer of the liver and complete failure of the functioning of the liver.
  • Liver Cirrhosis Symptoms, Stages, Treatment & Causes 10 February 2010 13:27 UTC www.ayushveda.com [Source type: FILTERED WITH BAYES]

 .Diuretics may be necessary to suppress ascites.^ If there are clear signs of cirrhosis such as ascites, coagulopathy, and a shrunken nodular-appearing liver, then confirmation of diagnosis by biopsy may not be necessary.
  • Cirrhosis | Doctor | Patient UK 10 February 2010 13:27 UTC www.patient.co.uk [Source type: Academic]

 ^ For example, for ascites and edema, the doctor may recommend a low-sodium diet or the use of diuretics, which are drugs that remove fluid from the body.

 ^ The diuretic spironolactone may be helpful in combination with a beta-blocker for reducing both ascites and rebleeding after an initial episode.
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]

Esophageal variceal bleeding

Main article: Esophageal varices
.For portal hypertension, propranolol is a commonly used agent to lower blood pressure over the portal system.^ For portal hypertension, propranolol is a commonly used agent to lower blood pressure over the portal system.
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

 ^ Hypertension High blood pressure.
  • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]

 ^ The portal system is normally a low-pressure system.
  • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]

 .In severe complications from portal hypertension, transjugular intrahepatic portosystemic shunting is occasionally indicated to relieve pressure on the portal vein.^ TIPS = transjugular intrahepatic portosystemic shunt .
  • Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment - September 1, 2006 - American Family Physician 10 February 2010 13:27 UTC www.aafp.org [Source type: Academic]

 ^ The transjugular intrahepatic portosystemic stent shunt procedure for refractory ascites.
  • Renal Dysfunction in Cirrhosis: Introduction 10 February 2010 13:27 UTC www.medscape.com [Source type: Academic]

 ^ The mechanism of the initial natriuresis after transjugular intrahepatic portosystemic shunt.
  • Renal Dysfunction in Cirrhosis: Introduction 10 February 2010 13:27 UTC www.medscape.com [Source type: Academic]

 .As this can worsen encephalopathy, it is reserved for those at low risk of encephalopathy, and is generally regarded only as a bridge to liver transplantation or as a palliative measure.^ In this situation the only option is to have a liver transplant.
  • Chronic fatigue syndrome 10 February 2010 13:27 UTC www.homehealth-uk.com [Source type: FILTERED WITH BAYES]

 ^ Only a liver transplant can help.
  • Liver Cirrhosis | ThirdAge Articles 10 February 2010 13:27 UTC www.thirdage.com [Source type: Academic]

 ^ Liver transplantation is only therapeutic option for patients who have end-stage disease.
  • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

Hepatic encephalopathy

Main article: Hepatic encephalopathy
.High-protein food increases the nitrogen balance, and would theoretically increase encephalopathy; in the past, this was therefore eliminated as much as possible from the diet.^ High-protein food increases the nitrogen balance, and would theoretically increase encephalopathy; in the past, this was therefore eliminated as much as possible from the diet.
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

 ^ Recent studies show that this assumption was incorrect, and high-protein foods are even encouraged to maintain adequate nutrition.
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

 ^ High-quality dietary protein may be especially helpful for patients with ascites and for repairing muscle mass, but excessive protein loads may trigger encephalopathy.
  • Cirrhosis 10 February 2010 13:27 UTC www.hcvets.com [Source type: Academic]
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.preventdisease.com [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

 .Recent studies show that this assumption was incorrect, and high-protein foods are even encouraged to maintain adequate nutrition.^ Recent studies show that this assumption was incorrect, and high-protein foods are even encouraged to maintain adequate nutrition.
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

 ^ High-protein food increases the nitrogen balance, and would theoretically increase encephalopathy; in the past, this was therefore eliminated as much as possible from the diet.
  • Cirrhosis Support Group - DailyStrength 10 February 2010 13:27 UTC www.dailystrength.org [Source type: General]

 ^ At high risk are patients whose tests results show very low protein levels and very high bilirubin levels.

Hepatorenal syndrome

Main article: Hepatorenal syndrome
.The hepatorenal syndrome is defined as a urine sodium less than 10 mmol/L and a serum creatinine > 1.5 mg/dl (or 24 hour creatinine clearance less than 40 ml/min) after a trial of volume expansion without diuretics.^ Hepatorenal syndrome is diagnosed when a creatinine clearance less than 40 mL/min is present or when a serum creatinine greater than 1.5 mg/dL, urine volume less than 500 mL/d, and urine sodium less than 10 mEq/L are present.
  • Cirrhosis: eMedicine Gastroenterology 10 February 2010 13:27 UTC emedicine.medscape.com [Source type: Academic]

 ^ Urine sodium < 10 mEq per L (10 mmol per L) .
  • Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment - September 1, 2006 - American Family Physician 10 February 2010 13:27 UTC www.aafp.org [Source type: Academic]

 ^ Recommended if serum sodium is less than 120 to 125 mEq per L (120 to 125 mmol per L) 3 .
  • Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment - September 1, 2006 - American Family Physician 10 February 2010 13:27 UTC www.aafp.org [Source type: Academic]

 [17]

Spontaneous bacterial peritonitis

Main article: Spontaneous bacterial peritonitis
.Cirrhotic patients with ascites are at risk of spontaneous bacterial peritonitis.^ Runyon BA. Ascites and spontaneous bacterial peritonitis.
  • Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment - September 1, 2006 - American Family Physician 10 February 2010 13:27 UTC www.aafp.org [Source type: Academic]

 ^ Adapted with permission from Runyon BA. Ascites and spontaneous bacterial peritonitis.
  • Cirrhosis and Chronic Liver Failure: Part II. Complications and Treatment - September 1, 2006 - American Family Physician 10 February 2010 13:27 UTC www.aafp.org [Source type: Academic]

 ^ Spontaneous arteriovenous shunt in cirrhotic patient.

Transplantation

Main article: Liver transplantation
.If complications cannot be controlled or when the liver ceases functioning, liver transplantation is necessary.^ In certain cases liver transplant will be necessary.
  • Cirrhosis 10 February 2010 13:27 UTC www.umm.edu [Source type: Academic]
  • Cirrhosis - Alternative Medicine Report 10 February 2010 13:27 UTC www.qualityhealth.com [Source type: Academic]
  • Cirrhosis - Erewhon Natural Foods 10 February 2010 13:27 UTC www.erewhonmarket.com [Source type: Academic]
  • Statesman Health : Integrative Medicine  :  Conditions   :  Cirrhosis 12 September 2009 4:14 UTC www.statesman.com [Source type: Academic]

 ^ If the liver stops functioning or complications are beyond control, liver transplant is recommended.
  • Liver Cirrhosis Treatment | Cirhosis of liver Cure | Natural Medication, diet, prognosis for symptoms of Cirrhosis causes 10 February 2010 13:27 UTC www.biogetica.com [Source type: FILTERED WITH BAYES]

 ^ When complications cannot be controlled or when the liver becomes so damaged from scarring that it completely stops functioning, a liver transplant is necessary.
  • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]
  • Cirrhosis of the Liver 10 February 2010 13:27 UTC catalog.nucleusinc.com [Source type: FILTERED WITH BAYES]

 .Survival from liver transplantation has been improving over the 1990s, and the five-year survival rate is now around 80%, depending largely on the severity of disease and other medical problems in the recipient.^ Survival rates after transplantation are excellent.
  • Cirrhosis - MMCI 10 February 2010 13:27 UTC mmci2.adam.com [Source type: Academic]
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]

 ^ There is an 80% 5-year survival rate for liver transplantation cases.
  • Liver Cirrhosis Treatment | Cirhosis of liver Cure | Natural Medication, diet, prognosis for symptoms of Cirrhosis causes 10 February 2010 13:27 UTC www.biogetica.com [Source type: FILTERED WITH BAYES]

 ^ Five-year survival rates are about 85% and can be lower or higher depending on severity.
  • Cirrhosis 10 February 2010 13:27 UTC www.hcvets.com [Source type: Academic]
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.preventdisease.com [Source type: Academic]
  • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

 [18] .In the United States, the MELD score is used to prioritize patients for transplantation.^ Your MELD score may go up or down while you wait for a transplant.
  • MoonDragon's Health & Wellness: Cirrhosis of the Liver 12 September 2009 4:14 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

 ^ In contrast to these negative assumptions on the use of liver transplants in ALD patients, many clinicians contend that ALD is, in fact, an excellent reason for liver transplantation.

 ^ MELD score and clinical type predict prognosis in hepatorenal syndrome: relevance to liver transplantation.
  • Assessment of Prognosis of Cirrhosis: Abstract 10 February 2010 13:27 UTC www.medscape.com [Source type: Academic]

 [19] .Transplantation necessitates the use of immune suppressants (cyclosporine or tacrolimus).^ Experiments using monthly infusions of hepatitis B immune globulin (HBIg) after transplantation show great promise in preventing recurrence in these patient.

 ^ Optimal immunosuppression needs to be provided to prevent recurrence of PBC. It is still controversial as to whether to use cyclosporine or tacrolimus [ 131 , 132 ].

 ^ Antibiotics for infections in the bile ducts and drugs that quiet the immune system (prednisone, azathioprine, cyclosporine, methotrexate) may also be used.
  • Cirrhosis - MMCI 10 February 2010 13:27 UTC mmci2.adam.com [Source type: Academic]

Decompensated cirrhosis

.In patients with previously stable cirrhosis, decompensation may occur due to various causes, such as constipation, infection (of any source), increased alcohol intake, medication, bleeding from esophageal varices or dehydration.^ Drinking alcohol will increase the rate of progression of cirrhosis from whatever cause.
  • Cirrhosis | Health | Patient UK 10 February 2010 13:27 UTC www.patient.co.uk [Source type: FILTERED WITH BAYES]

 ^ Internal bleeding from these varices (variceal bleeding) occurs in 20% to 30% of cirrhosis patients.

 ^ Patients with cirrhosis may present with ascites, hepatic encephalopathy and/or esophageal variceal hemorrhage.

 .It may take the form of any of the complications of cirrhosis listed above.^ Cirrhosis may entail other complications: .
  • Cirrhosis and Liver Disease: Online References For Health Concerns 10 February 2010 13:27 UTC www.lef.org [Source type: Academic]

 ^ Symptoms of cirrhosis and its complications may include: .
  • WellSpan Health Library 10 February 2010 13:27 UTC www.wellspan.org [Source type: FILTERED WITH BAYES]
  • Health Information 10 February 2010 13:27 UTC www.mmc.org [Source type: FILTERED WITH BAYES]

 ^ Other autoimmune diseases, such as scleroderma or Sjgrens syndrome, may also accompany this form of cirrhosis.
  • Cirrhosis 10 February 2010 13:27 UTC www.hcvets.com [Source type: Academic]
.Patients with decompensated cirrhosis generally require admission to hospital, with close monitoring of the fluid balance, mental status, and emphasis on adequate nutrition and medical treatment - often with diuretics, antibiotics, laxatives and/or enemas, thiamine and occasionally steroids, acetylcysteine and pentoxifylline.^ Monitoring the patient with cirrhosis .
  • Cirrhosis: eMedicine Gastroenterology 10 February 2010 13:27 UTC emedicine.medscape.com [Source type: Academic]

 ^ This is also serious and requires hospital treatment.
  • Liver Cirrhosis Treatment Cure Alternative Acupuncture Medicine Herbs Herbal Treatment Kuala Lumpur KL Medical Centre, Malaysia Liver Cirrhosis Chinese Herbal Medicine Centre Treatment Herbal Cure Malaysia Herbs Cure Diseases Chinese KL Centre 12 September 2009 12:21 UTC www.geocities.com [Source type: Academic]
  • Liver Cirrhosis Herbs Herbal Acupuncture, Liver Cirrhosis Treatment, Liver Cirrhosis Alternative Medicine, Liver Cirrhosis Alternative Treatment, Liver Cirrhosis Neuro Acupuncture Alternative Treatment, Liver Cirrhosis Alternative Treatment, Chinese Master's Liver Cirrhosis Herbal Medicine Treatment, Liver Cirrhosis Remedies Treatment, Liver Cirrhosis Medical Centre 12 September 2009 12:21 UTC www.thetole.org [Source type: Academic]

 ^ Good nutrition often plays a vital role in the treatment of cirrhosis.
  • GHI Your Health: Cirrhosis Detection & Treatment 10 February 2010 13:27 UTC www.ghi.com [Source type: Academic]

 .Administration of saline is generally avoided as it would add to the already high total body sodium content that typically occurs in cirrhosis.^ If, however, cirrhosis has already developed, patients have a high risk for developing liver cancer even if iron levels are normalized.
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
  • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]

 ^ Persistent ascites and low serum sodium identify patients with cirrhosis and low MELD scores who are at high risk for early death.
  • Assessment of Prognosis of Cirrhosis: Abstract 10 February 2010 13:27 UTC www.medscape.com [Source type: Academic]

 ^ Post-TIPS ascites-free patients with cirrhosis and previous refractory ascites demonstrate subtle sodium retention when challenged with a high sodium load.
  • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

Epidemiology

Disability-adjusted life year for cirrhosis of the liver per 100,000 inhabitants in 2004.[20]
     no data      less than 50      50-100      100-200      200-300      300-400      400-500      500-600      600-700      700-800      800-900      900-1000      more than 1000
.Cirrhosis and chronic liver disease were the 10th leading cause of death for men and the 12th for women in the United States in 2001, killing about 27,000 people each year.^ Over 25,000 deaths have occurred due to cirrhosis of the liver.
  • Home Remedies for Cirrhosis of the Liver - Natural Cure and Treatment 10 February 2010 13:27 UTC www.natural-homeremedies.org [Source type: FILTERED WITH BAYES]

 ^ Cirrhosis is the eleventh leading cause of death by disease in the United States, killing more than 25,000 people each year.
  • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

 ^ Liver Cirrhosis Mortality in the United States, 1970–99.

 [21] .Also, the cost of cirrhosis in terms of human suffering, hospital costs, and lost productivity is high.^ Cirrhosis is the eighth leading cause of death by disease and the cost of cirrhosis in terms of human suffering, hospital costs and lost productivity is high because loss of liver function affects the body in many ways.
  • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]

 ^ Long-term or high level exposure to certain chemicals and drugs can cause cirrhosis, including arsenic, methotrexate, and toxic doses of vitamin A. Changes That Resemble Cirrhosis .
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
  • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

 ^ Key search terms included furosemide, albumin, human albumin solution, nephrotic syndrome, and cirrhosis.
  • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]
.Established cirrhosis has a 10-year mortality of 34-66%, largely dependent on the cause of the cirrhosis; alcoholic cirrhosis has a worse prognosis than primary biliary cirrhosis and cirrhosis due to hepatitis.^ Cirrhosis is most commonly caused by alcoholism, hepatitis B and ...
  • Cirrhosis - Kosmix : Reference, Videos, Images, News, Shopping and more... 10 February 2010 13:27 UTC www.kosmix.com [Source type: Academic]

 ^ Autoimmune liver diseases include autoimmune hepatitis and primary biliary cirrhosis .
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.preventdisease.com [Source type: Academic]
  • Cirrhosis - Edward Hospital, Naperville IL Area 10 February 2010 13:27 UTC www.edward.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

 ^ Fatigue in primary biliary cirrhosis.

 .The risk of death due to all causes is increased twelvefold; if one excludes the direct consequences of the liver disease, there is still a fivefold increased risk of death in all disease categories.^ Ten deaths were due to liver disease.
  • Cirrhosis: Free Medical and Health Information on Cirrhosis Treatment and Research 10 February 2010 13:27 UTC www.lifestages.com [Source type: Academic]

 ^ There is also an increased risk for liver cancer.

 ^ Liver Cancer Cirrhosis greatly increases the risk for liver cancer, regardless of the cause of cirrhosis.
  • Cirrhosis 10 February 2010 13:27 UTC www.hcvets.com [Source type: Academic]

 [22]
.Little is known on modulators of cirrhosis risk, apart from other diseases that cause liver injury (such as the combination of alcoholic liver disease and chronic viral hepatitis, which may act synergistically in leading to cirrhosis).^ Chronic liver injury leads to the clinical-pathologic entity known as cirrhosis.
  • Cirrhosis - a knol by Don 10 February 2010 13:27 UTC knol.google.com [Source type: Academic]

 ^ Cirrhosis of the Liver can lead to: .
  • Diagnose-Me: Condition: Cirrhosis of the Liver 10 February 2010 13:27 UTC www.diagnose-me.com [Source type: Academic]

 ^ Conditions that may cause cirrhosis and the need for a liver transplant include: Chronic hepatitis B and C. Diseases of the bile ducts.
  • MoonDragon's Health & Wellness: Cirrhosis of the Liver 12 September 2009 4:14 UTC www.moondragon.org [Source type: FILTERED WITH BAYES]

 .Studies have recently suggested that coffee consumption may protect against cirrhosis, especially alcoholic cirrhosis.^ Edema is especially common in alcoholic cirrhosis.
  • MayoClinic.com Health Library - Cirrhosis 10 February 2010 13:27 UTC www.riversideonline.com [Source type: FILTERED WITH BAYES]

 ^ Once cirrhosis has been diagnosed, sodium and fluids should be restricted and all alcohol consumption must cease.

 ^ Some preliminary studies suggest it may provide some protection against liver damage and scarring and may improve survival rates in alcoholic patients with cirrhosis.
  • Cirrhosis: the causes, diagnosis, treatment, and prevention of cirrhosis. Drug ... 10 February 2010 13:27 UTC www.henryfordhealth.org [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.preventdisease.com [Source type: Academic]
  • Cirrhosis 10 February 2010 13:27 UTC www.bcbswny.com [Source type: Academic]

 [23]

References

  1. ^ "Cirrhosis – MayoClinic.com". http://www.mayoclinic.com/print/cirrhosis/DS00373/DSECTION=all&METHOD=print. 
  2. ^ "Liver Cirrhosis". Review of Pathology of the Liver. http://www.meddean.luc.edu/lumen/MedEd/orfpath/cirhosis.htm. 
  3. ^ "Pathology Education: Gastrointestinal". http://www.pathology.vcu.edu/education/gi/lab3.h.html. 
  4. ^ Roguin A (2006). "Rene Theophile Hyacinthe Laënnec (1781-1826): the man behind the stethoscope". Clinical medicine & research 4 (3): 230–5. PMID 17048358. 
  5. ^ Li CP, Lee FY, Hwang SJ, et al. (1999). "Spider angiomas in patients with liver cirrhosis: role of alcoholism and impaired liver function". Scand. J. Gastroenterol. 34 (5): 520–3. doi:10.1080/003655299750026272. PMID 10423070. 
  6. ^ a b Rodríguez-Roisin R, Krowka MJ, Hervé P, Fallon MB (2004). "Pulmonary-Hepatic vascular Disorders (PHD)". Eur. Respir. J. 24 (5): 861–80. doi:10.1183/09031936.04.00010904. PMID 15516683. 
  7. ^ Alcohol-Induced Liver Disease; http://www.liverfoundation.org/education/info/alcohol/
  8. ^ Iredale JP (2003). "Cirrhosis: new research provides a basis for rational and targeted treatments". BMJ 327 (7407): 143–7. doi:10.1136/bmj.327.7407.143. PMID 12869458. PMC 1126509. http://bmj.bmjjournals.com/cgi/content/full/327/7407/143. 
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External links

.
  • Cirrhosis of the Liver at the National Digestive Diseases Information Clearinghouse (NDDIC).^ Primary biliary cirrhosis — Comprehensive overview covers symptoms, diagnosis, treatment of this chronic liver disease.
    • Primary biliary cirrhosis - Valley Health System 10 February 2010 13:27 UTC www.valleyhealth.com [Source type: General]

     ^ If it's determined that you may have cirrhosis, you may be referred to a doctor who specializes in the digestive system (gastroenterologist) or the liver (hepatologist).
    • Cirrhosis - Valley Health System 10 February 2010 13:27 UTC www.valleyhealth.com [Source type: General]

     ^ Note: Current information on VHA policy, guidelines, and tools related to liver disease can be found on the VA Hepatitis C website .
    • http://www.hiv.va.gov/vahiv?page=pcm-210_liver 10 February 2010 13:27 UTC www.hiv.va.gov [Source type: Academic]

     .NIH Publication No.^ NIH Publication No.
    • Cirrhosis 10 February 2010 13:27 UTC www.umm.edu [Source type: Academic]
    • Cirrhosis - Alternative Medicine Report 10 February 2010 13:27 UTC www.qualityhealth.com [Source type: Academic]
    • Cirrhosis - Erewhon Natural Foods 10 February 2010 13:27 UTC www.erewhonmarket.com [Source type: Academic]
    • Statesman Health : Integrative Medicine  :  Conditions   :  Cirrhosis 12 September 2009 4:14 UTC www.statesman.com [Source type: Academic]

     04-1134, December 2003.

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