Liver cirrhosis is the late stage of fibrosis that attacks the liver. It is a prevalent condition caused by chronic alcoholism. Other than alcoholic addiction, liver cirrhosis is caused by other diseases that attack the liver for instance hepatitis. Liver cirrhosis attacks the liver. The liver is a primary organ in the human body that is associated with numerous critical functions. Examples of such roles include cleaning blood in the body, detoxifying harmful substances in the body, and making essential nutrients in the body ( Singbartl, 2018). Cirrhosis occurs in response to any damage that happens to the liver. The liver has a habit of undergoing an automatic repair when it is injured. During the repair process, scars occur, and this is where cirrhosis stems. As the process continues, numerous injuries arise and eventually inhibit the normal function of the liver.
Anatomy and Physiology of the Liver
The liver is the principal organ in the human body that is affected by cirrhosis. The liver is an organ located in the upper right-hand side of the human abdominal cavity. Its position is beneath the diaphragm, above the right kidney, the stomach, and the intestines. The organ is dark reddish-brown and is cone shaped. It is approximated to weigh about three pounds. The blood flowing to the liver originates from two different sources ( Liakoni et al., 2014). The first source is the hepatic artery. This blood vessel supplies the liver with oxygenated blood. The second is the hepatic portal vein. This type of blood vessel supplies the liver with blood rich in different kinds of nutrients.
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The liver, at any specific time in the human body, holds nearly 13 percent of total amount of blood supplied in the entire human body. The organ is a composition of two different and vital lobes. Each lobe is made up of eight segments that are composed of 1000 lobules. The lobes form a connection with small ducts that further creates a more extensive connection with larger ducts that ends up forming hepatic duct. It is the hepatic duct that is charged with transporting the bile to the duodenum and the gallbladder via bile duct ( Przybyłkowski et al., 2014).
It is estimated that the liver receives 30% of the resting cardiac output. It makes the liver a giant chemical processing plant in the human body. The chemical produced and regulated by the liver plays vital roles in regulating the body's internal environment or homeostasis. The liver has different liver cells known as the hepatocytes; these contain enzymes that are critical to metabolic functions in the body. The metabolic processes involved in the liver are crucial as well as harmful to the body ( Qin et al., 2014). For instance, the liver acts as a nutrients' store in the body. Furthermore, it is involved in detoxifying compounds that pose a danger to the body. Such compounds are made safe to be excreted via the kidney and other specific organs.
Liver Cirrhosis and Homeostasis in the Liver
The liver plays a critical role in maintaining homeostasis. Homeostasis is defined as the process of keeping the internal environment at a constant rate. The liver is involved in ensuring that the chemical and physical factors are kept at a constant rate ( Primignani, 2010). In a situation where there is a high glucose level in the bloodstream, it is the mandate of the liver to ensure that the glucose is converted to glycogen through insulin hormone and stored. In case there is less glucose, the liver converts the stored glycogen to glucose and through this reversible process, homeostasis is maintained. The same situation applies to temperature control mechanism in the body.
Cirrhosis thus affects homeostasis in the body by inhibiting or altering the liver’s normal functions ( Bergl &Truwit 2018). First, cirrhosis jeopardizes the blood supply to the liver and thus, can bring about possible high blood pressure. It affects blood vessels that transport blood from the liver to the intestines. As a result, it disturbs the normal environment of such structure by creating positive feedback on them where there is a need for negative feedback ( Rehm et al., 2010). Other than this, while affected by cirrhosis, the body organs such the liver may work reversely. For instance, in a situation where the liver needs to reduce the temperature, it will increase the temperature when affected by cirrhosis. Such are the situations where the liver is not in a position to trigger the necessary cells that lower the temperature. This means that the body temperature will remain to be in an imbalance situation as long as the liver is unable to balance it. This will affect other organs such as the kidney and skin that may try to perform the role of the liver. This will further disrupt the homeostasis process in the body.
Signs and symptoms of liver cirrhosis
The liver cirrhosis’ symptoms are difficult to spot at its early stage of development. However, this is not the case when the scars pile up, and the condition worsens off. The liver's function is generally interrupted with more scars, and at this time, different signs and symptoms become apparent ( Biecker, 2011). Various signs and symptoms manifest, the typical signs include the following. Such individuals will feel fatigue coupled with the loss of appetite, loss of weight, and itchy skin. Further, the blood capillaries in such individual appear typically at the upper side of the abdomen ( Tsochatzis, Bosch & Burroughs, 2014). Other than the mentioned signs, others are nausea, weaknesses, red palm, and pain mostly in the position where the liver is located. However, there are specific signs that develop and become apparent when the liver cirrhosis progresses. Examples include bleeding gums, dizziness, confusion, personality changes, and loss of mass. A person experiencing such signs and symptoms needs to ensure that he or she seeks medical consultation.
Differential diagnosis issue related to liver cirrhosis
A differential diagnosis of liver cirrhosis takes into consideration different conditions that affected that liver that might later manifest to liver cirrhosis. For instance, there are critical liver conditions that have signs and symptoms similar to cirrhosis. However, there are specific diagnosis factors that distinguish liver cirrhosis from such disease. Examples include abdominal extensions, jaundice, and pruritus ( Biecker 2011). Others include hand and nail features. These include leukonychia and others. Other specific diagnostic factors for the condition include coffee-ground vomitus as well as a black stool, or disease refers to as Melena.
Treatments options
Liver cirrhosis can be treated in a situation where it is diagnosed early. The damages caused by this disease can be minimized by treating the causes or any other complication that arises. Different treatment approaches can be adopted. The first is the treating the alcohol dependency. This reduces the chances of more scars and thus can have an impact in control of liver cirrhosis. Another option is medication. The patient may be advised to take medicine that ensures that the liver cells damages are controlled ( Wiest, Lawson & Geuking, 2014). The next is monitoring the pressure in the portal vein. This is the point where high blood pressure potentially develops. In case the blood pressure is controlled at this point, it can reduce the severity of cirrhosis. Banding is another option to reduce bleeding, while others are injections sclerotherapy, Trans-jugular intrahepatic portosystemic stent shunt (TIPSS), screening for liver cancer, and the liver transplant .
References
Bergl, P., & Truwit, J. D. (2018). Respiratory Physiology in Liver Disease. In Hepatic Critical Care (pp. 31-44). Springer, Cham.
Biecker, E. (2011). Diagnosis and therapy of ascites in liver cirrhosis. World journal of gastroenterology: WJG , 17 (10), 1237.
Liakoni, E., Bravo, A. E. R., Terracciano, L., Heim, M., & Krähenbühl, S. (2014). Symptomatic hepatocellular liver injury with hyperbilirubinemia in two patients treated with rivaroxaban. JAMA internal medicine , 174 (10), 1683-1686.
Primignani, M. (2010). Portal vein thrombosis revisited. Digestive and Liver Disease , 42 (3), 163-170.
Przybyłkowski, A., Gromadzka, G., Chabik, G., Wierzchowska, A., Litwin, T., & Członkowska, A. (2014). Liver cirrhosis in patients newly diagnosed with the neurological phenotype of Wilson's disease. Functional Neurology , 29 (1), 23.
Qin, N., Yang, F., Li, A., Prifti, E., Chen, Y., Shao, L., ... & Zhou, J. (2014). Alterations of the human gut microbiome in liver cirrhosis. Nature , 513 (7516), 59.
Rehm, J., Taylor, B., Mohapatra, S., Irving, H., Baliunas, D., Patra, J., & Roerecke, M. (2010). Alcohol as a risk factor for liver cirrhosis: a systematic review and meta ‐ analysis. Drug and alcohol review , 29 (4), 437-445.
Singbartl, K. (2018). Renal Physiology in Liver Disease. In Hepatic Critical Care (pp. 53-58). Springer, Cham.
Tsochatzis, E. A., Bosch, J., & Burroughs, A. K. (2014). Liver cirrhosis. The Lancet , 383 (9930), 1749-1761.
Wiest, R., Lawson, M., & Geuking, M. (2014). Pathological bacterial translocation in liver cirrhosis. Journal of Hepatology , 60 (1), 197-209.
