Liver Failure and Cirrhosis: Stages, Causes, Prevention and Treatment

Liver failure and cirrhosis of the liver is a progressive life-threatening condition. So it demands urgent medical attention and care. Cirrhosis of the liver and liver failure are two sides of a coin. In addition when the disease progresses; the irreversible changes increase in liver cells because fibrosis of the liver is developed. This stage is called cirrhosis of the liver.

Our sedentary lifestyle and dietary habits are big contributors to liver failure disease. Because obesity, a high-fat diet, and physical activities lead to low calories consumption. After that, it causes deposits of fat on the liver which causes fatty liver disease and leads to liver failure to cirrhosis of the liver.

Types of Liver Failure:

1. Acute Liver Failure

Firstly acute liver failure is a condition when deterioration of liver function is very rapid. secondly this can happen even days to a week without any preexisting condition or disease.

2. Chronic Liver Failure

Chronic Liver failure is also called chronic liver disease (CLD) which happens gradually over many years. CLD becomes the main culprit of liver failure because this causes deranged liver functions. The disease starts progressing towards cirrhosis of the liver.

The liver is an organ that regenerates and repairs itself but these changes are irreversible when a large part of the liver is affected and damaged beyond repair due to continuous injuries to the liver cells which may lead to cirrhosis of the liver.

Causes of Acute liver failure

The injury to the liver is caused by many reasons which lead to liver failure and cirrhosis. Following are the key causes of liver failure.

1. Large doses of Paracetamol – Over-dose of the paracetamol drug and other non-steroidal anti-inflammatory drugs is a major cause of hepatitis and acute liver. When a person consumes the paracetamol drug more than the prescribed dose can cause liver failure. The reason behind this is the availability of paracetamol drug easily over the counter (OTC)
2. There is a range of viruses that causes inflammation of liver cells (Hepatitis) includes:

• • Hepatitis A
  • Hepatitis B
  • Hepatitis E.
  • Cytomegalovirus
  • Herpes simplex virus

3. Eating Poisonous wild mushrooms (Like Death Cap)
4. Autoimmune hepatitis
5. Wilson’s disease
6. Industrial and chemical toxins

Causes of Chronic liver failure

1. Long term and high quantity of alcohol consumption causes alcoholic liver disease (ALD)
2. Viral infections like Hepatitis A, Hepatitis B, and Hepatitis C are the most common causes of liver failure after alcohol consumption
3. Hemochromatosis can cause cirrhosis of the liver (hemochromatosis means too much iron in your blood)
4. Autoimmune hepatitis is another cause of liver failure
5. Oxalosis is a disease in which kidneys become impaired to remove the calcium oxalate crystals
6. Fatty liver disease is the main culprit of liver failure in the present day.

Stages of Liver Failure

1. Inflammation
2. Fibrosis/Scarring
3. Cirrhosis
4. End-Stage Liver Disease

Symptoms of Liver Failure and cirrhosis of the liver

Symptoms of liver failure increase with the progression of the disease. Symptoms aggravate when the patient moves into the next stage of liver failure. We will discuss here the symptoms of each stage of liver failure.

Inflammation

Inflammation is the first stage of liver failure. Initial symptoms start appearing. This stage is reversible if the diagnosis is made on time and treatment is started. But it is difficult to reverse the disease if the cause of the disease is viral hepatitis. Especially Hepatitis B or hepatitis C. Hepatitis A is curable and reversible.

• Stomach pain and nausea are the most common initial symptoms of hepatitis (Inflammation of liver cells)
• Lack of appetite, tiredness, and dark yellow color of urine
• The yellow color of skin and Eye’s conjunctiva (Jaundice)
• Swollen belly with tenderness in the right hypochondriac region (The are Just below the right ribs)
• Fullness of abdomen
• Fever

Fibrosis/Scarring

If the inflammation stage is prolonged then it leads to scarring and fibrosis of the liver. Health issues are replaced by fibrotic tissues. The level of fibrosis can be checked with a fibro scan which is a type of investigation. Fibrosis is the first stage of cirrhosis of the liver.

• Vomiting
• All the above symptoms continued and aggravated
• Distension of abdomen
• Itching all over the body because of high serum bilirubin levels in the blood
• Skin starts bruising easily
• Increases risk of bleeding because deranged liver function causes low production of blood clotting factors

Cirrhosis of Liver

Most of the liver cells are fibrosed in this stage. Moreover, healthy tissues are replaced by fibrosed tissues, and symptoms are aggravated further. This is the stage when the disease becomes irreversible. Few herbal preparations and medicinal plants have shown good results and help in reversing the changes at this stage.

• All the above symptoms continued
• The abdomen starts distending because of fluid collection in the abdomen
• Ascites developed (Fluid collection in the abdominal cavity)
• Fluid collection in legs and feet (Pedal edema)
• Bleeding tendency increases
• Esophageal varices are developed (more prevalent in alcoholic liver failure)
• Blood in vomiting
• Losing elasticity of skin and bruises on the skin
• Spider Navies start appearing on the abdomen and other body parts. This is the confirmatory sign of cirrhosis of the liver.

End-Stage Liver Disease (ESLD)

End-stage liver disease is the last stage of liver failure and cannot be reversed by any treatment. The only treatment option is a liver transplant at this stage. All the above symptoms aggravated with few additional more dangerous symptoms.

• Fluid collection increases more in the abdomen and legs
• The abdomen becomes more tensed due to ascites (fluid in the abdomen)
• Generalized weakness and heavy blood in stools
• Blood in vomiting due to bleeding varices
• Blood clotting factors and Vitamin K levels decreased which leads to further bleeding
• A low level of clotting factors leads to bleeding in other organs and causes internal bleedings
• Internal bleeding causes kidneys and lung failure
• Kidney and liver failure
• Multi-organ failure
• Even death if transplant of the liver is not done at this stage

Investigations to diagnose the Liver Failure

• Blood tests including Liver function tests, Blood clotting factors, and CBC
• Radiological Tests – Ultrasound abdomen, CT Abdomen, MRI Abdomen
• Fibro Scan
• Biopsy of Liver to confirm if etiology is carcinoma or something else

Prevention of Liver Failure and Cirrhosis of liver

• Limit consumption of alcohol use
• Improve your diet plan and dietary habits.
• Avoid fatty food and packed food materials.
• Do regular exercises to control your weight
• No overdose of drugs or any painkiller medicine even paracetamol without doctors advise
• Do not mix painkillers and alcohol

Treatment options

The treatment options are just to remove the cause of the disease. However, there is no definitive treatment for cirrhosis of the liver except for the corrective measures.

Hepatitis A is a self-limiting disease and does not cause liver failure. However, if there are other predisposing factors like fatty liver disease or alcoholic liver disease it may cause liver failure too. Antiviral treatment options are available for Hepatitis A and B.

The antiviral treatment just helps in reducing the viral load but the risk is always there. If the disease is progressed to 3^rd stage of liver failure then treatment is really difficult and the patient goes into cirrhosis of the liver.

Ayurveda and Unani herbal preparations are available and have very good results. These have a significant role in the treatment of liver failure.

Stage 1 and Stage 2 liver failure symptoms are easily corrected with herbal treatment options.

These herbal medicinal plants are very helpful in the treatment of cirrhosis of the liver even help in reversing the changes of stage 2 and stage 3 changes.

Key herbal and Unani medicinal plants are used in the treatment of liver failure

1. Mako plant (Botanical name – Solanum nigrum)
2. Kasni Plant (Botanical Name – Cichorium intybus)
3. Majoon Dabidulward
4. Jawarish Tamar Hindi
5. Sharbat Jigar
6. Habbe Kabid Noshadri
7. Jawarish Anarain

Disclaimer: Please do not use any medication without Doctor’s valid prescription/Advice