Articles from prior issues of The Advocate

May/June 2000

Cirrhosis of the Liver – How and Why It Kills
by Donna Hilton, Publications Director

CIRRHOSIS OF THE LIVER IS a leading cause of death in the middle-aged population, resulting in approximately 25,000 deaths each year. The liver is your body’s largest single organ, weighing as much as four pounds. Essentially, it acts as the body’s chemical factory. The function of the liver is to remove toxins from the blood, regulate blood clotting and cholesterol levels, manufacture proteins, and make immune factors to help fight infection.

Regulation of the composition of the blood – The liver helps control blood levels of sugar, protein, and fat. It also removes bilirubin from your blood, which results from breakdown of red blood cells.

Manufacture of vital nutrients – The liver converts nutrients from the food ingested into forms that can be used by the body. It also manufactures cholesterol, vitamin A and certain proteins, stores nutrients (such as iron and other minerals) and produces bile, which aids digestion. Neutralizing toxic substances — The liver acts as a large filter, clearing your blood of drugs, alcohol and potentially harmful chemicals. Once the liver has removed the harmful substances from your blood, it processes them so they can be eliminated from your blood. When liver cells are injured, they die. The tissue around the injured cells and the response to liver cell death is fibrosis or scar tissue. Fibrosis is often reversible if the cause of liver cell injury is treated in the early stage. Eventually, with continued liver cell injury, cirrhosis occurs. Cirrhosis is an irreversible condition where permanent scarring of the liver has taken place due to liver cell injury. The most common cause of cirrhosis is alcoholism, but viral hepatitis, drugs or toxins, bile duct blockage may also cause the condition, or a variety of inherited diseases.

Symptoms of liver damage include weakness, fatigue, loss of appetite, and weight loss. If bile ducts become blocked, additional symptoms such as jaundice (a yellow color to the skin and eyes) or itching (from bile deposits in the skin) appears. Portal Hypertension can occur when blood is unable to flow through the liver for filtering. Blood is brought to the liver from the intestines through the portal vein. When the blood becomes backed up because of liver damage, the blood pressure becomes elevated in the portal vein. This causes new but weak blood vessels to form in the stomach and lining of the esophagus. If pressure in these weaker vessels becomes too great, they may cause massive bleeding in the esophagus or stomach. As the liver produces less protein, fluid collects in the legs and feet (edema) or in the abdomen (ascites).

Mild liver abnormalities are common. Many people with mild liver abnormalities will never go on to develop serious liver disease. However, significantly abnormal results should never be ignored because the consequences can be deadly. There are no specific drugs for cirrhosis, but symptoms can sometimes be controlled with medication; diuretics and a low-salt diet may control fluid retention, and antihypertensive medication may help control high blood pressure and prevent gastrointestinal bleeding. Any complications of cirrhosis must be treated as they appear. In some cases with end-stage cirrhosis, a liver transplant may be necessary. Always talk to your doctor or pharmacist before taking herbal products or high dose vitamin supplements. Some herbs can damage the liver and some vitamins, such as Vitamin A, can alter liver tests and potentially harm the liver.

Sources: Mayo Health Letter, May 2000 and U.S. Pharmacist