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Cirrhosis of Liver Treatment in India

Cirrhosis is a slowly progressing disease in which healthy liver tissue is replaced with scar tissue, eventually preventing the liver from functioning properly. The scar tissue blocks the flow of blood through the liver and slows the processing of nutrients, hormones, drugs, and naturally produced toxins. It also slows the production of proteins and other substances made by the liver. The functions of the liver include –

  • It produces cholesterol and breaks down saturated fat.
  • It also helps in storing glucose in the form of glycogen.
  • It manufactures the substance bile that helps in digestion of the food.
  • It manufactures many blood proteins that help in immune system function, clotting and oxygen transport.
  • It helps in getting rid of many harmful substances in the bloodstream that include alcohol and drugs.
  • It also stores excess nutrients and also returns some of the nutrients to the bloodstream.

Causes of Liver Cirrhosis

Hepatitis C, fatty liver, and alcohol abuse are the most common causes of cirrhosis of the liver, but anything that damages the liver can cause cirrhosis, including:

  • Fatty liver associated with obesity and diabetes
  • Chronic viral infections of the liver (hepatitis types B, C, and D; Hepatitis D is extremely rare)
  • Blockage of the bile duct, which carries bile formed in the liver to the intestines, where it helps in the digestion of fats; in babies, this can be caused by biliary atresia in which bile ducts are absent or damaged, causing bile to back up in the liver. In adults, bile ducts may become inflamed, blocked, or scarred, due to another liver disease called primary biliary cirrhosis.
  • Repeated bouts of heart failure with fluid backing up into the liver
  • Certain inherited diseases such as:
    • Cystic fibrosis
    • Glycogen storage diseases, in which the body is unable to process glycogen, a form of sugar that is converted to glucose and serves as a source of energy for the body
    • Alpha 1 antitrypsin deficiency, an absence of a specific enzyme in the liver
    • Diseases caused by abnormal liver function, such as hemochromatosis, a condition in which excessive iron is absorbed and deposited into the liver and other organs, and Wilson’s disease, caused by the abnormal storage of copper in the liver

Symptoms of Cirrhosis

The symptoms of cirrhosis of the liver vary with the stage of the illness. In the beginning stages, there may not be any symptoms. As the disease worsens, symptoms may include:

Diagnosis and Evaluation of Cirrhosis

Cirrhosis of the liver is diagnosed through several methods:

  • Physical exam. During a physical exam, the doctor can observe changes in how your liver feels or how large it is (a cirrhotic liver is bumpy and irregular instead of smooth).
  • Blood tests. If doctor suspects cirrhosis, you will be given blood tests to find out if liver disease is present.
  • Other tests. In some cases, other tests that take pictures of the liver are performed, such as a computerized tomography (CT scan), ultrasound, or another specialized procedure called a radioisotope liver/spleen scan.
  • Biopsy. The doctor may decide to confirm the diagnosis by taking a sample of tissue (biopsy) from the liver.
  • Surgery. In some cases, cirrhosis is diagnosed during surgery when the doctor is able to see the entire liver. The liver also can be inspected through a laparoscope, a viewing device that is inserted through a tiny incision in the abdomen.

Stages of Cirrhosis

tage 1 : During the initial stage of cirrhosis, a patient may face a few symptoms that include dry mouth, enlargement of the upper stomach area, jaundice and fatigue. The problem of itching can also be seen in some patients. Cirrhosis in its initial stages can be easily eliminated.

Stage 2 : In the absence of appropriate medical care there can be a progression of stage 2. Now the abnormal tissues that were created in stage 1 are now transformed into rigid bands of connective tissue. Fibrosis is the procedure where there is a transformation of tissues. Both fibrosis and the inflammation spread in the periportal and portal veins of the patient.

Stage 3 : Now in this stage, the rigid band of connective tissue merges with each other. There is immense enlargement due to the process of merging. This enlargement hampers the functions of the liver. The liver is unable to digest fat contents, cannot store nutrients or support the blood streaming. Heart problems and kidney problems are due to the condition of cirrhosis.

Stage 4 : This is considered as the most dangerous stage of cirrhosis. The surgery of liver transplant can be opted at this last stage. The liver performs normally after the liver transplant surgery.

Treatment for Cirrhosis

Following are the treatments for the cirrhosis condition –

  • Liver transplantation
  • Preventing further damage to the liver
  • Detecting liver cancer early or preventing it
  • Treating the complications of cirrhosis

In order to control the symptoms of cirrhosis, certain medications can also be given. By decreasing salt in the diet, ascites and edema can be treated. Diuretics is the drug which can prevent edema from occurring again and also removes excess fluid. Changed mental function due to cirrhosis can be treated with the help of drug and diet therapies.

Hepatocellular Carcinoma

Hepatocellular carcinoma (HCC) is a primary malignancy of the liver and occurs predominantly in patients with underlying chronic liver disease and cirrhosis. The cell(s) of origin are believed to be the hepatic stem cells, although this remains the subject of investigation.Tumors progress with local expansion, intrahepatic spread, and distant metastase. Following are the different conditions that can increase the chances of Hepatocellular Carcinoma –

  • Wilson’s disease
  • Hepatitis B
  • Alcoholism
  • Cirrhosis of the liver
  • Aflatoxin consumption
  • Hepatitis C

Secondary Biliary Cirrhosis

Secondary biliary cirrhosis develops due to long-term partial or total obstruction of the large bile ducts outside of the liver. When the ducts are damaged, bile (which is a substance that helps digest fat) builds up in the liver and damages the liver tissue. This condition could result from cystic fibrosis, a congenital defect of the bile ducts or gallstones. Other causes include –

  • Idiopathic sclerosing cholangitis
  • Gallstones
  • Pericholangitis
  • Chronic pancreatitis
  • Cystic fibrosis
  • Congenital biliary atresia
  • Bile duct narrowing after gallbladder surgery

Cost of Cirrhosis Treatment

Compared to the surgical costs in Europe and America, the cost of Cirrhosis treatment is substantially lower in India due to its excellent health care facilities. The cost-effective treatment attracts many patients from across the world.