Cirrhosis – Sign, symptoms and treatment
The word cirrhosis is used for advanced stage of liver disease. Among all digestive diseases, cirrhosis of the liver caused by chronic alcohol abuse is the leading cause of death in the world.
The French physician Rene Laennec first used the word cirrhosis. It is a Greek word Kirrhos meaning yellow orange. It describe the normal color and rough surface of the diseased liver. The cirrhotic liver is a firm, dull yellowish mass with orange nodules projecting from its surface.
It is usually irreversible. It is the end stage of liver disease. When liver cells are injured , they come together and form regenerative nodules. This is why cirrhotic liver is more bumpy as compared to healthy liver.
Causes of Cirrhosis
Most commonly, it occur due to excessive alcohol intake, fatty liver disease and hepatitis C infection.
Other causes may include:
- Biliary obstruction
- Liver necrosis
- Metabolic diseases
Symptoms of Cirrhosis Link Assistant
- GI disturbance
- Loss of appetite
- Nausea
- Vomiting
- Distention
- Epigastric pain
- Jaundice
- Iron deficiency
- Weakness
- Macrocytic anemia
Nutrition therapy of cirrhosis
When alcoholism is an added underlying problem, treatment is difficult. Each patient require supportive care. Therapy is usually aimed at correcting fluid and electrolyte problems and providing as much nutrition support as possible for hepatic repair.
Guidelines for nutrition therapy for cirrhosis of the liver should include following principles:
Energy
50 kcal/kg body weight.
Fluid retention, if present will affect the accuracy of estimating kcalorie needs.
As muscle tissue is wasted, it is replaced by fluid weight.
An estimated dry weight should be used when feasible to estimate kcalorie needs.
Protein intake
1.5g/kg body weight
Intake should be adequate to regenerate liver cells and prevent infections.
Protein estimation should be based on dry weight whenever possible.
Sodium
Intake less than 2000 mg/day
It help reduce fluid retention.
A sodium intake level of less than 2000 mg/day is restrictive.
Carbohydrate
Adequate intake is needed to prevent catabolism of body protein for energy which increase blood ammonia.
Intestinal bacteria make ammonia from undigested protein.
Fat
Fat restriction should be less than 30% of calories in patients with steatorrhea.
Vitamins and minerals
The central role of the liver is to metabolize vitamins and minerals.
All people with advanced liver disease require vitamins and minerals supplementations. Nutrient supplementation is determined by monitoring serum levels
Diagnosis
A biopsy is a method of choice for confirming the diagnosis.
Other tests include:
Liver function test
Ultrasound
Anti body test
Elastography test
Treatment of cirrhosis
Management consist of treatment of underlying disease, adequate calorie intake and medications for treating complications.
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