Cirrhosis

Cirrhosis is an extensive scarring of the liver that is caused by damage to the liver or from a long-term reaction to inflammation over a prolonged time period.  With cirrhosis, the normal tissue of the liver is replaced with fibrotic tissue that has no function, so demands placed on the liver can no longer be met like they once were.  Most often, individuals with cirrhosis will appear with a yellowing of their skin, or jaundice.



There are three types of cirrhosis and their causes/risk factors may include viral hepatitis, use of certain medications or toxic substances, excessive consumption of alcohol, obstruction of the vessels in the liver, other infections, or having an autoimmune disease.  To best promote your health, our team of professionals at Total Home Health will encourage you to remain current on your vaccinations in order to best avoid infections, along with avoiding consumption of alcohol.



Signs and symptoms of cirrhosis may include any of the following:



·      Fatigue, weight loss, abdominal pain.

·      Notably large abdomen from ascites, or the bloating/swelling due to the fluid build-up in the abdomen and legs.

·      Severe itching of the skin.

·      Confusion or difficulty thinking due to the build-up of waste products in the blood stream and brain that the liver is no longer able to get rid of.

·      Personality changes, depression.

·      Altered sleep patterns.

·      Gastrointestinal bleeding, passing of blood in bowel movements.

·      Bruising, nosebleeds, blood noticeable if a person were to vomit.

·      Redness/warmth of the palms of the hands.

·      Spider angiomas (red vascular lesions with branches extending over the nose, cheeks, upper chest and shoulders).

·      Asterixis (coarse tremor characterized by rapid, extension/flexion of the wrists and fingers).

·      Liver breath that will assume a fruity or musty odor.



If you or a loved one notice you are experiencing any of the symptoms as listed above, you may indeed be suffering from cirrhosis and should not hesitate to bring it to the attention of your provider to receive treatment.  There are several laboratory and other diagnostic tests your provider may carry out in order to diagnose you and evaluate how severe your condition has become.



Keep in mind that of the diagnostic procedures, an invasive liver biopsy is the most definitive to diagnose cirrhosis.  A liver biopsy will allow medical professionals to identify the progression and extent of your cirrhosis.  Once diagnosed, your treatment will be composed of anything ranging from lifestyle changes to surgery, including the possibility of a liver transplant.  Complications related to cirrhosis if it is left untreated or if it has progressed to a later stage can be life-threatening.  Complications may include the following:

·      Portal Systemic Encephalopathy (PSE)

-  PSE occurs because those with cirrhosis have a liver that functions poorly and is unable to covert wastes in the body, such as ammonia, to a less toxic form.  Therefore, these wastes build-up and accumulate throughout the bloodstream and even in the brain, which can lead to causing neurological problems.

-  PSE is treated with medications such as the liquid called Lactulose, which if effective will reduce ammonia levels via the bowels when the person has bowel movements.

-  Protein is generally reduced in the diet in the case of PSE because when proteins are broken down in the body, they are turned into ammonia which is what the body needs rid of in this situation.



·      Esophageal Varices

-  These are formed due to portal hypertension, which is elevated blood pressure in the veins that carry blood from the intestines to the liver.

-  Portal hypertension is caused due to impaired blood circulation in the liver, which causes blood to form a new way around to get to where it needs to go (collateral circulation) and the new route of vessels are more fragile and can bleed easily.



·      Acute Graft Rejection after Liver Transplantation

-  Typically will occur 4 to 10 days after surgery.

-  Individuals will experience a fast heart rate, pain in the upper right flank area of the abdomen, and yellowing of the skin.

-  The bone marrow will create cells that will attack the new organ because it does not recognize it.

-  Individuals must expect lifelong therapy with immunosuppressants to avoid rejection and infections.



The professional staff at Total Home Health will make regular visits into your home to continue your care outside of the stressful medical setting.  Our goal in your home will be to promote your health and safety while preventing complications of your cirrhosis by encouraging you to avoid alcohol and follow an appropriate diet…to start.  We will also work in conjunction with all members of your health care team including your physician, dietician, social worker, and more so that you receive the most holistic care as possible for the best outcomes.  Enroll with us today so that we can show you just how much we care about the life you lead!