Liver Cirrhosis Overview

Cirrhosis is a prognosis of various liver diseases and it is the final stage of liver fibrosis. However, not all chronic liver diseases will advance to cirrhosis. For example, only about 20 to 25% of chronic hepatitis C patients will advance to the cirrhosis stage and it usually takes many years to do so. This article will provide a general overview of what happens when a liver disease does develop into the cirrhosis stage.

Cirrhosis results in liver cell necrosis and fiber (scar) tissue overgrowth. A healthy, normal functioning liver is made up of trillions of liver cells, aligned in liver cell plates, which form the functional lobes. In a normal cell’s life cycle, apoptosis (normal cell death) occurs at a certain point and new cells replace the dead cells. This cycle maintains the structure and functionality of the liver. However, if cell death is caused by viral hepatitis, alcohol, or any other pathological causes, the normal cell replacement cycle is disrupted and can compromise the structure of the liver itself. Pathological disorders like hepatitis cause continuous and abnormally large numbers of cells to die, which eventually results in collapses of the liver’s reticular-fiber framework. As this happens, newly regenerated cells lose their normal alignment and form abnormal lobes. These lobes are non-functional. At the same time, scarring (fibrosis) occurs to repair the damaged structure of the liver and the amount of fiber tissue increases greatly. Over time, the culmination of these changes in the liver eventually leads to cirrhosis.

When liver cirrhosis progresses, the liver itself becomes hardened and it will shrink in size while the surface becomes uneven. Liver function deterioration and portal vein hypertension are the main causes of pathogenesis. Clinically, there are two stages in liver cirrhosis, compensated and de-compensated. In the compensated stage, disease progression is stealthy and shows very few noticeable symptoms. Liver function tests may show normal enzyme readings and without a biopsy, it is difficult to identify clinically. During this stage, the most common symptoms could be fatigue, anorexia, over-frequent thirst, thick coating on the tongue, nausea, stomach broadness, and dull pains in the liver area.  As liver functions further deteriorates and the portal vein pressure increases, these symptoms may worsen. New symptoms and physical signs such as spider moles, liver palms, liver shrinkage, jaundice, edema, ascites, and low grad fever could start to show and at this point, the cirrhosis starts to enter the de-compensated stage.

The de-compensated stage of cirrhosis is the late stage of the chronic liver diseases and many complications may arise. The most serious complications are ascites, gastric bleeding, spontaneous peritonitis, hepatic-renal dysfunction, encephalopathy, and hepatocellular carcinoma

For patients with cirrhosis, the purpose of Chinese medicinal herbal treatment is to sustain the stability of the compensated condition and prevent progression into the de-compensated stage. For those already in the de-compensated condition, herbal treatment can deal with the various complications and try to reverse the de-compensated stage back to the compensated stage. Many patients with cirrhosis are also candidates for a liver transplant. The waiting period can be long and Chinese herbal treatment can ensure that the patient is in the best condition possible before undergoing this major surgical procedure. Patients who are not suitable for a transplant can maximize their quality of life with an herbal protocol. In the de-compensated stage, the patient needs many different types of medical care and we are going to discuss specific areas of these complications in the coming articles.