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Alcoholic Hepatitis & Cirrhosis

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alcoholic hepatitus

Alcoholic hepatitis versus Cirrhosis of the liver

The pathology behind Cirrhosis of the Liver is the increasing formation of fibrous tissues which slowly prevents the liver performing it’s vital intrinsic  function within our body. Often we hear about the term “hepatitis” due to overuse of alcohol and link it to cirrhosis. The main difference between these two liver diseases is that alcoholic hepatitis is reversible while cirrhosis can’t be reversed. However, alcoholic hepatitis can lead to cirrhosis of the liver. Let’s find out how this occurs  and how both of them are diverse in nature.

What is alcoholic hepatitis?

Hepatitis is defined as inflammation of the liver. The etiology behind this type of liver injury is chronic heavy alcohol intake and abuse over years. Less commonly, heavy alcohol intake over a short period of time called binge drinking, may also induce hepatitis. However this relationship between alcohol and hepatitis is complex. Not all heavy drinkers develop hepatitis and not all hepatitis patients are heavy alcohol drinkers. Only 35% percent of heavy drinkers develop alcoholic hepatitis. Hence it may be linked to many other conditions such as:

• Genetic differences in the processing of alcohol by the body. This is the reason why alcohol damages women more than men.
• Coexisting liver disorders like hepatitis C
• Malnutrition

However a continued alcohol intake may result in cirrhosis of the liver. This progression occurs in 10-20% of the heavy drinkers.

Types of Alcohol-related liver disease

Liver  disease due to alcohol intake can be divided into three types:

1. Fatty liver disease
This is the condition in which the liver cells called hepatocytes accumulate excess fat. It is usually an asymptomatic condition or may have mild symptoms like fatigue, weakness and weight loss. This disease is present in almost all heavy drinkers (90-100%) and is reversible after a short period of around two weeks when the individuals stop drinking.

2. Alcoholic hepatitis
This is the condition in which hepatocytes swell up due to inflammation and become damaged. It may produce these symptoms,  nausea, vomiting, abdominal pain, loss of appetite, fever and jaundice. Mild cases of hepatitis may be reversible but you may need to stop drinking for months or even years. On the other hand, severe hepatitis may have serious complications like liver failure or death.

3. Alcoholic cirrhosis
This is the condition where the liver cells become irreversibly scarred. This damage leads to loss of function of the liver. It is the most serious type of liver disease due to alcohol. The symptoms may be similar to alcoholic hepatitis. The damage in this condition cannot be reversed and eventually leads to liver failure.Removing  alcohol  may halt the progression of  liver damage, but the most severe cases may need strict treatment measures including a transplant.
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Progression to Cirrhosis of the Liveralcoholoic hepatitus,liver disease,cirrhosis

A majority of heavy alcohol drinkers may progress  from fatty liver disease to alcoholic hepatitis and eventually to cirrhosis of the liver. Some may skip the fatty liver stage and directly develop hepatitis. Other may have an asymptomatic form of alcoholic hepatitis. One in four drinkers with fatty liver will progress to alcoholic hepatitis. One in five drinkers with fatty liver develop cirrhosis. The risk of developing cirrhosis of the liver is strongly linked to coexisting hepatitis C in the individual.

Complications of alcoholic liver disease

These complications may occur after years or decades of heavy drinking habits. Many of them can be very serious in nature. These include:

• Ascites ( fluid buildup in the abdomen)
• Variceal bleeding ( from veins in esophagus or stomach)
• Spleen enlargement
• High blood pressure within the organ
• Hepatic encephalopathy ( brain disorders or coma)
• Kidney failure
• Liver cancer

Diagnosis

Alcohol abuse over many years may raise suspicions of an alcoholic liver disease in the individual. Tests for Liver function  may be required to rule out other conditions and to determine the condition of the liver. A liver biopsy is the most definitive  standard test. It may reveal the degree of liver inflammation or help determine the onset of cirrhosis.

Treatment of Alcoholic Hepatitis and Cirrhosis of the Liver

Here are a few lifestyle and medical measures you might take to treat alcoholic liver disease or prevent a progression to the irreversible state of cirrhosis:

  • Take a healthy balanced diet
  • Avoid drinking alcohol: You may join alcohol recovery programs which may help you with the process.
  • Medications to manage the complications that arise.
  • A liver transplant may be required if cirrhosis of the liver progresses to an advanced stage
  • Acupuncture
  • Traditional Chinese medicine
  • Health supplements
  • Look at the dietary intake

The Centers For Disease and Control and Prevention (CDC) reports that that are about 3.5 million people in the United States of America who have chronic hepatitis C. The CDC also estimates that 20 percent of the people suffering from chronic hepatitis C virus will go on to develop cirrhosis of the liver. The complication with this scenario is that most of the people infected have no idea that they are. This means they have never taken the time required to consider the link between hepatitis C and Cirrhosis of the liver.


The Link between Cirrhosis of the Liver and Hepatitis C

The key link between Cirrhosis of the Liver Hepatitis C is that they both attack the liver. They are dangerous because they both do not sure any symptoms in the early stages. This is the reason why most people with these conditions may be oblivious to their presence. In most cases, the diagnosis comes too late to save the liver, and sometimes life.

Hepatitis C Virus Starts Attacking the Liver

Initially, the hepatitis C virus attacks the liver and, in most cases, later develops into a chronic infection. This chronic infection results in inflammation of the liver which causes damage. According to the Healthline Newsletter , it can take up to 30 years of damage to the liver before the problem is eventually identified.

Development into Cirrhosis

There are a number of factors which can lead to liver damage, including prolonged alcohol abuse, hepatitis, and parasites.

As the inflammation of the liver continues over time, the result is permanent damage and wounds that no longer heal. This is called cirrhosis. When the liver arrives at the point of cirrhosis, it is no longer able to heal itself. The result of cirrhosis can be a collapse of the liver, cancer, and end-stage liver disease. The only solution at this stage is a liver transplant.

The Stages Of Cirrhosis

Cirrhosis of the liver can happen in two main stages. In the first stage, Compensated cirrhosis, the body continues to function even though there is damage in the liver. In the second stage, Decompensated cirrhosis, you may start to experience pronounced symptoms. Healthline identifies some of this symptoms as variceal haemorrhage, hepatic encephalopathy, and kidney failure.

Symptoms of Cirrhosis Caused By Hepatitis C

Cirrhosis related to hepatitis C can show no symptoms in the beginning until the condition is at an advanced stage.

The leading symptoms of this condition include feeling fatigued.  If you experience a lack of appetite, nausea, and weight loss that is not intended, you may also be developing the condition.

Other symptoms include itchiness, bruising and bleeding easily, yellow eyes and skin, swelling legs, fluid in the abdomen, and veins that are enlarged in the upper stomach and the esophagus.

This condition can also result in impaired mental function. This is caused by an excessive build-up of toxins and an infection in the lining of the abdomen. When the kidney and liver fail at the same time, it’s time to get help.


Difference between Liver Cirrhosis and Liver Cancer

When talking about liver cirrhosis, it is easy for people to confuse this with liver cancer. These two are different.

Liver Cancer

Liver cancer manifests as a malignant parasitic tumor which grows slowly in the liver. It has potential, just like other malignant tumors to spread to other organs in the body. It can have no causes or sometimes result from other diseases of the liver which can include cirrhosis.

Some of the common symptoms of this type of cancer include pain in the abdominal area. Other signs include yellowish skin, dysfunction of the liver, abdominal mass, and nausea.

Liver Cirrhosis

On the other hand, cirrhosis of the liver is a result of healthy tissues slowly turning into scar tissue which becomes dysfunctional. Unlike liver cancer, cirrhosis is more dangerous as it does not usually show any symptoms when it’s in the early stages.

Some of the common signs of this condition include loss of appetite, fatigue, jaundice, bruises, and fever. If you notice blood in the stool, a build-up of fluid in the abdomen, an orange brownish color in the urine, personality changes and injury to the kidney which is acute, you may be a potential victim.

Do Most People With Hepatitis C Develop Liver Cancer?

Before concluding this article, let’s look at some common questions that naturally come up when a person hears about the link between Hepatitis C and Cirrhosis of the Liver. Do most people who have liver cirrhosis end up with liver cancer? According to WebMD, an online resource that provides information about health issues, the answer is no, as only about 5 percent of the 3 million Americans who have hepatitis C will end up with liver cancer.


Hepatitis C and Cirrhosis Treatment

medication priceA good prognosis of cirrhosis depends on identifying the condition while it is still in its early stages. Treating a patient with hepatitis C using interferon and ribavirin can help slow down the development of cirrhosis. Once the condition has reached the advanced stages, the only treatment which remains effective is a liver transplant.

While interferon and ribavirin are good treament methods, the latest cure for Hepatitis C consists of Sofosbuvir. However, a 12 week treatment costs $84,000, while a 24 week treatment costs over $164,000 for Sofosbuvir in the US. Countries like India, Egypt, etc. sell the generic treatment for these crucial drugs at 90% discounts.

Even though treatment does not always result in a total eradication of the hepatitis virus, it can help to delay complications caused by cirrhosis. Starting treatment late will reduce the choices you have.


Conclusion

Patients diagnosed with both hepatitis C and cirrhosis of the liver can lead healthy and productive lives. The answer lies in an early diagnosis. An early diagnosis depends on you being able to identify the symptoms. When you start to suspect that this may be a condition you have, consulting your doctor will help you to eliminate the guessing game.

In order to ensure that you preserve your health, you may want to avoid alcohol and get proper medical care on a regular basis. Treating the underlying hepatitis C virus infection can help slow down the progression of cirrhosis. Above all, the right information about the link between these two conditions can help you make informed decisions.

If you have just found yourself on the receiving end of a diagnosis of cirrhosis, the chances are that you have several questions and worries about the matter at hand. This is entirely normal, and to be expected. A diagnosis of cirrhosis will change your life, but the important thing to remember is that provided you take action now, and recognise the seriousness of the condition, you can manage it and turn it around for a long time to come.

Your doctor will have explained to you what cirrhosis is, and probably given you a lot of reading material to take home. To simplify matters, cirrhosis is the medical terms of scarring of the liver. Cirrhosis is a condition which has taken years to build up, and can be due to several issues, including excessive alcohol intake over many years, a long-standing hepatitis issue, or it can also be down to non-alcoholic fatty liver disease. Whichever option has caused your cirrhosis, the important thing is the here and now.

The liver is a hardy organ, it can continue to work despite a severe amount of scarring, and when the right management options are put into place, it can even work to heal itself to a large degree.


It’s Good to Talk About Cirrhosis

The diagnosis you have received has sent your world into a spin, and that’s totally understandable. The emotions which come attached to a diagnosis such as this need to be spoken about, to get the out in the open, and to prevent a negative frame of mind from developing. It is okay to feel scared, it is okay to have many questions, and the best course of action is to speak to your doctor, nurse, or other healthcare professional, to air your concerns, get reassurance, and to help you develop a positive, kick ass frame of mind.

Cirrhosis is not a death sentence, despite the worrying nature of the world. When we are told we have a complicated-sounded medical condition, the word along can be enough to cause anxiety and stress, but the important thing to remember is that provided you take the right steps to slow down any progression, then you are doing everything you can.

So, what are the treatment options available to you? Keep reading.


How to Manage Cirrhosis of the Liver

The important thing to remember is that there is no cure for cirrhosis, this is a condition you now have, and one which needs to be managed for the rest of your life. The main ways to do this really depend on the cause of your cirrhosis in the first place, i.e. excessive alcohol. If it was alcohol which caused your cirrhosis then you will be advised to stop your alcohol intake completely. Regardless of whether alcohol has been a factor in your diagnosis, lowering your intake dramatically is the number one step forward.

Alcohol is damaging to the whole body in many ways, but the liver really take the brunt of the damage. Over time, usually around 10 years of consumption to a high level, the liver becomes excessively scarred and cannot process alcohol within it, as it would otherwise do. Make the work easier on your liver, to help it start repairing itself, by cutting it out completely.

There is also the chance that a hepatitis, usually hep C, diagnosis has had some bearing on your diagnosis. If this is the case, you will be advised to take anti-viral medication to help treat the underlying cause of your cirrhosis diagnosis. This should be complied with, as per your doctor’s instructions.

If you have done any research on the Internet (proceed with caution), then you will have seen the word ‘transplant bandied’ about. Now, this is only in the most severe cases of cirrhosis, an at this stage you would know that you needed this course of action. A liver transplant is the last course of action, and there are countless options that come before it, so it is best to put that option to the back of your mind, to help you focus on the positives.

So, the main management options available to you now are:

  • Stop, or at least drastically reduce, your alcohol intake immediately
  • If you are advised to take antiviral medications, then do so as per instructions
  • Live a healthy lifestyle, lose weight if you need to, and maintain a healthy weight otherwise. Check out this article on preventing cirrhosis of the liver
  • Look at what you eat, and make sure you get plenty of vitamins and minerals – be kind to yourself!
  • Try a low salt diet, as this will help your liver work more effectively, and take the pressure off whilst it is trying to right itself
  • You may be advised to take blood pressure tablets if your readings are high

Treat Your Body Like a Temple

And that’s it! Nothing terrifying, nothing scary, simply moderate lifestyle changes that will give you an infinite amount of energy, and boost your overall health ten fold. Managing cirrhosis is about looking after yourself as if your body was a temple – which it is! If you have spent years upsetting your body, perhaps with too much alcohol over a long period of time, then it’s important to realize that you can’t turn back the clock. What is done is done. Now is the time to do what you can, and that means taking control of your health and not going back to your old ways.

We are in no way trying to belittle cirrhosis, because it is a serious condition, but you should treat it as a warning sign, a way of your body shouting at you to change. If you listen to your body, and if you make sure that you don’t veer off course, there is no reason you cannot reverse some of the damage, and slow down any further progression of your condition.

Unless extremely sever, cirrhosis is not a death sentence, it is a warning, a serious one which should be listened to immediately, and one which should take precedence in your mind and actions.