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Showing posts with label Cirrhosis. Show all posts
Showing posts with label Cirrhosis. Show all posts

Thursday, July 26, 2012

THE CAUSES OF CIRRHOSIS

What do you mean by Cirrhosis of the Liver?
Cirrhosis is a complication of numerous liver conditions that is characterised by irregular composition and purpose of the liver. The ailments that lead to cirrhosis do so due to the fact they injure and eliminate liver cells, and the irritation and restore that is linked with the dying liver cells leads to scar tissue to form. The liver cells that do not die multiply in an endeavour to substitute the cells that have died. This final results in clusters of newly-formed liver cells (regenerative nodules) inside the scar tissue. There are numerous triggers of cirrhosis; they incorporate substances (like fat, alcohol, and specified medications), viruses, poisonous metals (like copper and iron that gathers in the liver as an end result of genetic diseases), and autoimmune liver ailment in which the body’s immune program assaults the liver.

Causes of Liver Cirrhosis

The most common causes of liver cirrhosis are fatty liver, alcohol and Hepatitis C. But these are not the only cause there are several other causes as well which have been mentioned below.
    Inherited metabolic and ailments: These are a range of unheard-of problems that enable the accumulation of harmful compounds in the liver. The commonest is haemochromatosis, which brings about excessive deposits of iron in the liver.

  1. Chemicals and Drugs: A range of medication and substances can result in liver injury but a number of result in cirrhosis. Particular specialised medication needs to have to check for their influence on the liver.

  2. Fatty liver linked to weight problems and diabetes.
Prevention Measures of Liver Cirrhosis

  1. Alcoholics must look for help.

  2. Restrict the consumption of alcohol

  3. Prevent get in touch with poisonoussubstances} at work.

What cirrhosis is, characteristically, if you looked at a cirrhotic liver there is widespread fibrosis and nodule formation. The reason it looks so nodular is that of the liver cells trying to overcome the scar tissue. So they wind up with these little nodules because there’s scarring all around and the liver cells are trying to regenerate and grow out of this and at the point where they really can’t do this, that is cirrhosis of the liver you can see there are only a few liver cells and a lot of scar tissue. The whole liver looks like that and then you get that gross appearance of that nodular situation. Once people have cirrhosis of the liver they develop liver cancer. The presence of the virus and the cirrhosis predispose to liver cancer.

Friday, December 2, 2011

No cure for pain: study links excess paracetamol use to fatal liver damage



PAUL ROLAN, THE UNIVERSITY OF ADELAIDE   
"Life-threatening liver damage can occur without the intention of self harm in desperate patients trying to get some relief for pain."



Medicines need not only to be effective but also safe. Now a Scottish study has shown that paracetamol, perhaps the most commonly consumed painkiller in the country, could lead to death if taken in large doses over a period of time.
In the last couple of days, we’ve also heard other adverse information about widely used painkillers, which raises concerns about the dwindling pool of available medicines for pain. And now it seems patients being led to apparently safer alternatives may be risking their lives.
Although the number of individual pain relieving medications on the market is very large, they all come from only a very small number of drug classes. We have the familiar paracetamol and aspirin, another group called the non-steroidal anti-inflammatory drugs (NSAIDS), opioids and adjuvant drugs, which include antidepressants and anti-epileptics.
Earlier this week, the Australian drug regulator, the Therapeutic Goods Administration(TGA), announced it would be removing four products containing dextropropoxyphene – Capadex, Di-Gesic, Doloxene and Paradex – from the market by March 1.
The withdrawal follows adverse assessments from US and European regulators because of concerns about causing ECG changes, which could lead to cardiac arrest.
However, some years ago, when the availability of such drugs was severely restricted in the United Kingdom, patients flooded back to their doctors because they weren’t able to get comparable relief from other products.
Painkiller safety issues

There’s increasing concern over the long-term safety of the opioids. The adverse effects of NSAIDS on the gastrointestinal and cardiovascular systems has been widely reported in the mainstream press. These effects have been the reason for high profile withdrawals, such as that of Merck’s Vioxx.

Aspirin is not used for pain very much given its well-recognised potential to cause ulcers and bleeding the gastrointestinal tract. So doctors like myself frequently advise patients to return to the ubiquitous and everyday paracetamol. At recommended doses paracetamol is remarkably safe although it’s known that even moderate excess can cause fatal hepatotoxicity or overdose death.
As many of these overdoses have traditionally been impulsive, major reductions in mortality in the United Kingdom were brought about by the simple step of reducing pack size.
So doctors are familiar with advising patients not to exceed the recommended dose of 8 tablets a day. But an article published yesterday in the British Journal of Clinical Pharmacologyhas shown that inadvertent “overdoses” from consuming large quantities over a period of time in an attempt to control pain cause also cause life-threatening liver damage.
Paracetamol study

The authors of the paper looked at data from a large university-linked referral unit where patients showing probable or suspected paracetamol hepatotoxicity were treated. They compared patients with a typical “single overdose”, with patients who’d taken large doses of paracetamol over a period of a few days and suffered a “staggered overdose”.

The major reason for the single overdose was attempted suicide. But this was only the motive in one-third of the patients who had a staggered overdose. The majority of these people had simply been seeking pain relief.

Somewhat surprisingly, the average total dose in the staggered group (24 grams) was less than that in the single overdose (27 grams). And of greatest concern is that the minimum dose in the staggered group was 10 grams, which is only 20 tablets.

Clearly, the key message here is that life-threatening liver damage can occur without the intention of self harm in desperate patients trying to get some relief for pain.
Taking care

Although people recognise that the number of pills they can take at any given time may not be safely increased, they may take the drug at more frequent intervals than recommended, losing track of cumulative dose and unintentionally putting themselves at risk.

Unfortunately, it seems therapeutic options are being reduced by safety concerns – perhaps appropriately – but even the drugs thought to be relatively safe may unintentionally be posing a risk.
The key to preventing the problem of staggered paracetamol overdose is education and we are fortunate in Australia to have an organisation such as National Prescribing Service (NPS), which is best placed to do this.
We also need education about how medicines may not produce adequate analgesia and that other approaches are needed. Ideally, a mixed approach will enable doctors to help patients manage their pain in the face of the shrinking number of safe therapeutic options.
Editor's Note: This article was originally published by The Conversationhere, and is licenced as Public Domain under Creative Commons. See Creative Commons - Attribution Licence.

Thursday, April 7, 2011

Cirrhosis - Hepatitis C

Cirrhosis of the liver


Cirrhosis is a late stage of scarring (fibrosis) of the liver caused by long-term liver damage. The liver carries out several necessary functions, including detoxifying harmful substances in your body, cleaning your blood, and making vital nutrients. Cirrhosis can lead to a number of complications, including liver cancer.

Causes of Cirrhosis:

  1. Alcohol Abuse: Excessive and chronic alcohol consumption is one of the most common causes of cirrhosis.

  2. Viral Hepatitis: Hepatitis B and C viruses can lead to cirrhosis over time.

  3. Non-Alcoholic Fatty Liver Disease (NAFLD): Accumulation of fat in the liver can cause inflammation and eventually lead to cirrhosis.

  4. Chronic Bile Duct Disease: Conditions such as primary biliary cirrhosis, primary sclerosing cholangitis, and other chronic bile duct diseases can cause cirrhosis.

  5. Genetic Disorders: Genetic conditions like Wilson's disease, hemochromatosis, and cystic fibrosis can lead to cirrhosis.

  6. Autoimmune Hepatitis: An overactive immune response can attack and damage the liver.

  7. Drug-Induced Liver Injury: Some medications and toxins can cause liver damage that progresses to cirrhosis.

Symptoms of Cirrhosis:

Symptoms of cirrhosis can vary, but they may include:

  • Fatigue
  • Weakness
  • Jaundice (yellowing of the skin and eyes)
  • Itchy skin
  • Abdominal pain and swelling
  • Unexplained weight loss
  • Easy bruising and bleeding
  • Swelling in the legs and ankles
  • Confusion and cognitive impairment (hepatic encephalopathy)

Diagnosis:

Diagnosing cirrhosis typically involves a combination of:

  1. Medical History: The doctor will ask about your medical history, including risk factors like alcohol consumption and viral hepatitis.

  2. Physical Examination: They will look for signs of liver disease, such as jaundice and abdominal swelling.

  3. Blood Tests: These can reveal liver function, the presence of viruses, and other indicators of liver damage.

  4. Imaging: Imaging tests like ultrasound, CT scans, or MRI can show the liver's condition.

  5. Liver Biopsy: A small sample of liver tissue may be taken and examined under a microscope to confirm cirrhosis and its cause.

  6. Fibroscan or Elastography: These non-invasive tests measure liver stiffness to assess fibrosis.

Treatment:

Treatment for cirrhosis primarily focuses on addressing the underlying cause and managing complications. Common interventions include:

  1. Lifestyle Changes: Abstaining from alcohol, losing weight, and managing diabetes can help in cases of alcohol-related or fatty liver cirrhosis.

  2. Medications: Specific medications may be prescribed to manage symptoms and complications.

  3. Hepatitis Treatment: Antiviral medications can be used to treat hepatitis B and C.

  4. Dietary Changes: A low-sodium diet and proper nutrition can help manage fluid retention and malnutrition.

  5. Liver Transplant: In advanced cases, a liver transplant may be necessary if the liver is severely damaged.

Pathology:

The pathology of cirrhosis involves the gradual replacement of normal liver tissue with fibrous scar tissue. This scarring disrupts the liver's structure and function, impeding its ability to process blood and perform essential functions. Over time, this can lead to complications such as portal hypertension (increased pressure in the liver's blood vessels), liver cancer, and other issues.

In summary, cirrhosis is a late-stage liver disease resulting from various causes, characterized by liver scarring and impaired function. Early diagnosis and appropriate treatment are essential in managing the condition and preventing complications.