One of the most common liver conditions in residents of Anguilla is that of cirrhosis. Cirrhosis results from a gradual process that causes scar tissue to gradually replace your healthy liver cells. It usually happens over a long period of time because of infection or alcohol addiction. Most of the time, you cannot fix the damage to your liver but, if you catch it early, there are treatments that can keep problems from getting worse.
What is Cirrhosis?
Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by many forms of liver diseases and conditions such as hepatitis and chronic alcoholism. Each time your liver is injured — whether by disease, excessive alcohol consumption or another cause — it tries to repair itself. As cirrhosis progresses, more and more scar tissue forms, making it difficult for the liver to function (decompensated cirrhosis). Advanced cirrhosis is life-threatening. Cirrhosis is sometimes called end-stage liver disease because it happens after other stages of damage to the liver.
Why do you need a good liver?
Your liver is an organ that is about the size of a football and has very important functions. We cannot live healthily if the liver is severely damaged. The liver filters toxins from your blood, makes enzymes that help you digest food, stores sugar and nutrients, and helps you fight infections. When there is severe scarring, as in cirrhosis, the liver cannot function properly.
What causes cirrhosis?
In Anguilla, many clinicians believe that the most common cause is that of drinking too much alcohol over many years. Other causes include being infected with hepatitis for a long time, particularly hepatitis B or hepatitis C. Another cause of cirrhosis is a severe form of non-alcoholic fatty liver disease (NAFLD), called non-alcoholic steatohepatitis, where the liver becomes inflamed from a build-up of excess fat. Cirrhosis can also be caused by a problem affecting your bile ducts (such as primary biliary cholangitis) or immune system (such as autoimmune hepatitis), some inherited conditions, and the long-term use of certain medicines.
What are some symptoms of cirrhosis?
In the very early stages of cirrhosis, the affected individual might not have any noticeable symptoms. As the disease progresses symptoms might include the following:
• feel very tired and weak
• feel sick (nausea)
• lose your appetite
• lose weight and muscle mass
• get red patches on your palms – and small, spider-like blood vessels on your skin (spider angiomas) above waist level
If cirrhosis gets worse, some of the symptoms and complications include:
• yellowing of the skin and whites of the eyes (jaundice)
• vomiting blood
• itchy skin
• dark urine and tarry-looking stool
• bleeding or bruising easily
• swollen legs (oedema) or abdomen (ascites) from a build-up of fluid
• loss of sex drive (libido)
Diagnosis
If you have any of the above symptoms you should see your doctor. After a detailed history and examination, your doctor will arrange for a number of investigations such as blood tests and various scans. A biopsy of the liver might be needed as well. Once the diagnosis is confirmed you will be referred to a specialist in liver diseases. If you have complications from cirrhosis or a high chance of getting complications, you may be referred to a specialist liver centre.
Treatment
There is no cure for cirrhosis at this time. Your treatment depends on how badly your liver is injured. The goal is to protect the healthy tissue you have left.
The first step is to treat the condition that is causing your cirrhosis to prevent any more damage. This could mean a few different things:
• Stop drinking alcohol right away. Your doctor can suggest a treatment programme for addiction.
• Lose weight if you are obese, especially if your cirrhosis is caused by fat buildup in your liver.
• Take medications if you have hepatitis B or C.
You can also take medications to ease symptoms like itching, fatigue, and pain.
Your doctor will also want to treat any complications that can happen with cirrhosis. In more developed countries, if your cirrhosis is severe, you may need a liver transplant. This is a major operation and the waiting list can be very long.
How to prevent cirrhosis?
There are a number of things you can do to prevent cirrhosis in Anguilla. The number one thing is: Limit alcohol. The best way to prevent alcohol-related cirrhosis is to drink within the recommended limits.
You should stop drinking alcohol immediately if you have alcohol-related cirrhosis. Drinking alcohol speeds up the rate at which cirrhosis progresses, regardless of the cause.
Your doctor, or other healthcare providers, can offer help and advice if you are finding it difficult to cut down the amount you drink.
You should talk to your doctor on how to protect yourself from various infections of the liver. Maintaining your ideal weight would also help to prevent cirrhosis. A healthy lifestyle is a key part of preventing cirrhosis.
Conclusion
Cirrhosis is a liver condition that is closely related to abuse of alcohol over a number of years. More young people in Anguilla are now abusing alcohol so we can expect an increase in cases of cirrhosis in the very near future. Adopting a healthy lifestyle, and avoiding risky sexual activity, can go a long way in preventing cirrhosis of the liver here in Anguilla. If you have symptoms suggestive of cirrhosis, see your doctor as some of the complications can be prevented, despite the fact that there is no cure for this progressive liver disorder.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-eight years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5828).
