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Liver Cirrhosis

Liver Cirrhosis

Cirrhosis may be defined as the condition in which the liver functions are seriously affected as a result of the destruction of the liver cells due to cell injury, fatty infiltration and fibrosis. It occurs commonly among chronic alcoholics and also among individuals who have had attacks of hepatitis due to viral infection.
Liver cirrhosis occurs as a gradual process where scar tissues replaces all the healthy liver tissues The slow and gradual process of the destruction of tissues continues which gives rise to cirrhosis which eventually blocks the blood flow through liver.

There are certain major functions performed by the liver namely clotting proteins, important for the blood to clot and removal of substances that can be harmful to the body.
The liver is suppose to perform the task of detoxification and contributing to metabolic activities in blood in order to perform critical functions of the body.

Causes: Cirrhosis may be due to (i)Infectious hepatitis (ii) Chronic alchoholism (iii) malnutrition or due to (iv) metabolic disturbances and (v) Chronic use of Medicines

Symptoms: The onset of cirrhosis may be gradual with gastro-intestinal disturbances such as anorexia, nausea, vomiting, abdominal pain and distension. As the disease progresses, jaundice and other serious changes such as ascites and oesophageal varices occur.
Ascites is an accumulation of fluid in abdomen. It is the term used for an accumulation of fluid in the peritoneal cavity. It can even result due to an increased sodium retention or impaired water excretion.
Oesophagal varices are swollen veins in the oesophagus which tend to bleed by the irritation of fibre in the diet.

Treatment and care:
The principles of treatment are:
Always try to contact a doctor as soon as you begin with the symptoms and be in regular touch with your practitioner.
New and improved treatment techniques have been generated these days to prevent the progression of cirrhosis. Mechanisms for interruption and reversal of scarring is ongoing in the research filed to tackle this problem.
There are vaccination available against hepatitis virus
Treatment usually are done for Ascites:
 1. The fluid accumulated in the belly is removed using stunts and treated with diuretics. Antibiotics are also given to prevent infections.
 2. Variceal bleeding can be prevented using medication like vasocontrictors or by banding the veins. Sometimes stunts are used to move away the blood.

Supportive care to be taken in Liver cirrhitic pateints
1. Consumption of a healthy and balanced diet, preferably a low sodium diet, All kind of alcohol Consumption and drug abuse  should be stopped completely Immunisation is a must against Hepatitis A and hepatitis B and influenza, Try to reduce muscle wasting by exercising and loosing weight.
2. Take medicines as recommended by the doctor.
3. Follow and adhere with the advice imparted by your doctor only.

Dietary Modifications:
Calories: High calorie diet is necessary but due to loss of appetite it becomes difficult for the patient to have more food.
Protein: A high protein diet is helpful for the regeneration of the liver cells (80-120 gms/day).
Fat: Fat is restricted in the diet- 1 gm/kg body weight is allowed.
Carbohydrates: A high carbohydrate diet about 250-400 gm/day is recommended.
Sodium: A low sodium diet is essential to treat the complications, especially ascites and portal hypertension. Salt and sugar intake should be minimal.
Fibre: Fibre in the diet is restricted if oesophagus varices is present. The consistency of the diet should be soft.

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