Cirrhosis Symptoms
Liver Disease Can Manifest In Many Ways. Read On To Learn About Cirrhosis Symptoms.
Some cirrhosis patients may exhibit very few, or no, symptoms of liver disease. However, cirrhosis should be treated as a serious illness and addressed appropriately. Following are some of the most common cirrhosis symptoms.
- Jaundice (yellow skin, due to the buildup of bilirubin in the bloodstream)
- Weakness
- Fatigue
- Diminished appetite
- Bruising easily
- Itchiness
The complications of cirrhosis symptoms may develop as discussed below.
Edema
As damage to the liver worsens, a signal is relayed to the kidneys, to hold onto water and salt in the body. The first stage of this occurrence is that water and salt build up underneath the epidermis (skin) of the legs and ankles, since gravity when standing up, pulls the water and salt down. This is known as “edema”. Typically, this swelling is worst by day’s end, when standing up or sitting has pulled all the water and salt down. Edema is one of the most common cirrhosis symptoms. Lying down overnight may bring some relief because the pull of gravity is reduced. If the liver damage goes unchecked, the edema can result in the accumulation of fluid in the abdominal cavity and the abdominal organs. This results in discomfort/pain, swelling and weight gain.
Spontaneous Bacterial Peritonitis
When fluid accumulates in the abdominal cavity, it creates the ideal environment for bacterial growth. Under normal circumstances, this cavity contains only small amounts of fluid, which are resistant to infection. Any bacteria which may find its way in is killed, or ends up en route to the liver, where it is destroyed. However, when cirrhosis symptoms such as SPB are present, the abdominal fluid which collects can’t resist bacterial infection. Additionally, more and more bacteria can find their way in from the intestines, which can result in spontaneous bacterial peritontis. Though some patients may not experience symptoms, SPB is considered life-threatening and needs to be addressed! Some SPB symptoms include abdominal pain, fever, chills diarrhea, and tenderness in the affected area.
Esophageal and Stomach Varices
In the diseased liver, the presence of scar tissue prevents the normal flow of blood back toward the heart, from the intestines; this raises portal vein pressure, which results in “portal hypertension). If the pressure in this vein becomes exceedingly high, blood flows around the liver, using lower-pressure veins in order to get to the heart. The most frequently used bypass veins in this scenario are the ones which line the lower parts of the esophagus and the higher parts of the stomach. What are the ramifications of this?
With blood flow increasing in veins that would normally not experience such pressure, the veins expand, which is known as esophageal and gastric varices. The greater the blood pressure, the greater the size of these “varices”, and the likelier someone suffering cirrhosis symptoms will be to experience bleeding in the stomach or esophagus. This bleeding is often severe, and again, requires immediate treatment to avoid a fatality. The symptoms can include vomiting blood (which may resemble red-looking blood combined with blood clots that appear as coffee grounds), dizziness or fainting caused by blood pressure changes when standing from a horizontal position, and a black or tarry looking stool.
Hepatic Encephalopathy
When protein in food isn’t assimilated by digestion, bacteria uses absorption in the small intestine to “gather up” and break down what escaped. Normally, the substances excreted and released by the bacteria into the intestine, some of which are toxic, like ammonia, which can harm the brain, are removed from the intestine via the portal vein. They then arrive in the liver, become detoxified”, and are excreted safely via channels of elimination.
However, the underlying cause of cirrhosis symptoms is that the liver simply does not function correctly, on account of damaged liver cells, or a miscommunication between the liver cells and blood. Since portal vein blood passes, to an extent, through the liver, if it is damaged, it cannot detoxify ammonia or other harmful bacterial-digestion byproducts, and the toxins accumulate in the bloodstream. One of the earliest indicators of this scenario is that the patient has a reversal of a normal sleeping pattern, sleeping, instead, during the day and being awake at night. Also present may be fatigue, confusion, inability to concentrate, memory loss, and – in severe cases – coma and death. Because the livers of cirrhosis patients don’t function correctly and are overburdened with further toxins from bacterial processes traveling along the portal vein to the faulty liver, they are highly sensitive to drugs which are normally processed by the liver. ”Normal” doses may need to be avoided, especially sedative drugs; however, some drugs, such as those filtered by the kidneys, instead of the liver, may be used.
Hepatorenal Syndrome
Another one of the cirrhosis symptoms to be aware of, should the condition worsen, is “hepatorenal syndrome”. This complication is serious. Kidney function becomes reduced. Though no physical damage to the kidneys occurs, the way that blood flows through them is altered, and this syndrome carries the definition of a “progressive failure of the kidneys”, to clear substances from the blood and produced normal quantities of urine, despite the fact that some kidney functions, like salt retention, remain intact. Kidneys degrading from this syndrome usually start to work normally again, if the liver becomes healthy or the patient successfully undergoes a liver transplant, which suggests that the functional change in the kidneys under hepatorenal syndrome is indicative of a build up of toxins in the kidneys.
Hepatopulmonary Syndrome
This syndrome is rare, and occurs in those with advances cirrhosis symptoms. It can manifest as trouble breathing, due to the release of particular hormones during late-stage liver disease that cause a malfunction of the lings. The blood which flows through the lungs gets shunted around the alveoli, and consequently can’t pick up sufficent oxygen from the air inside of the alveoli. Shortness of breath, especially when the patient exerts themself, is often experienced.
Hypersplenism
Under normal circumstances, the spleen performs the role of a filter which eliminates old red and white blood cells, along the platelets, which are minuscule particles that allow for blood to clot normally. Drainage blood from the spleen then joins with the blood found in the portal vein from the intestines. Since portal vein pressure rises in cirrhosis, blood flow from the spleen is reduced, then blocked. When this happens, there is a backing up of the blood; it builds up in the spleen, causing the organ to swell and increase in size. In severe cases, the spleen enlarges so much that abdominal pain results.
The result of this process is that blood cell and platelet counts are reduced, due to excessive filtering by the spleen; anemia may occur, causing weakness, and the low white blood cell count can cause infection. Low platelet count may result in an impaired blood clotting, and prolonged bleeding can take place in the event of injury.
Liver Cancer
Cirrhosis symptoms can, as seen above, manifest in many unpredictable ways. However, one unfortunate but unsurprising potential symptom remains: Liver cancer. Cirrhosis, on account of any cause, increases a risk of liver cancer, which may occur in the liver (“primary”), or elsewhere and spread to the affected liver (“secondary”). Common signs of liver cancer are pain in the abdomen, liver enlargement, fever and loss of weight.
Also, a cancerous liver may manufacture and release several substances which could increase red blood cell numbers, hypercalcemia (high blood calcium) and hypoglycemia (low blood sugar).
Cirrhosis due to any cause increases the risk of primary liver cancer (hepatocellular carcinoma). Primary refers to the fact that the tumor originates in the liver. A secondary liver cancer is one that originates elsewhere in the body and spreads (metastasizes) to the liver.
Since there are so many cirrhosis symptoms, anyone experiencing them in any combination is advised to eat and live well, nourish their liver, and see their health care professional to address the problem quickly.