What're the complications of cirrhosis?
Complications of cirrhosis include vomiting of blood, either from ulcers in the stomach or from leaking varicose veins in the lower end of the oesophagus (gullet). This is serious and requires hospital treatment.
The liver is responsible for removing poisonous substances from the blood. In cirrhosis, the blood may bypass the liver and these poisonous substances pass to the brain where they may result in alteration in brain function, causing confusion, drowsiness and finally coma. This is called hepatic encephalopathy. This is also serious and requires hospital treatment.
Some complications of cirrhosis result from the high blood pressure. High blood pressure can cause dilated, twisted veins to form at the lower end of the esophagus. A person may vomit large amounts of blood because of bleeding from esophageal varices. High blood pressure in the portal vein along with poor liver function may also lead to fluid accumulation in the abdomen. Other complications of cirrhosis include kidney failure and a deterioration of brain function due to liver failure.
Liver cancer (hepatoma) is another complication of cirrhosis, particularly when the cirrhosis is due to chronic hepatitis B or hepatitis C infection, iron overload (hemochromatosis), or glycogen storage diseases. Liver cancer may result from cirrhosis due to alcohol abuse.
Gastrointestinal (GI) bleeding can occur from abnormal blood clotting, often caused by deficiencies in vitamin K, low levels of clotting proteins, and low counts of platelets (the blood cells that normally initiate the clotting process).
Bacterial infections are very common in advanced cirrhosis, and may even increase the risk for bleeding. Most bacterial infections, including those in the urinary, respiratory, or gastrointestinal tracts, develop when patients are in the hospital. Abdominal infections are a particular problem in cirrhosis and occur in up to 25% of patients with cirrhosis within a year of diagnosis.
Hepatorenal syndrome occurs if the kidneys drastically reduce their own blood flow in response to the altered blood flow in the liver. It is a life-threatening complication of late-stage liver disease. Symptoms include dark colored urine and a reduction in volume, yellowish skin, abdominal swelling, mental changes (delirium, confusion), jerking or coarse muscle movement, nausea, and vomiting.
Primary biliary cirrhosis is associated with reduced bone growth, partly because of the liver's inability to process vitamin D and calcium and also from some of its treatments. As a result, osteoporosis occurs in 20% to 30% of these patients. Bone loss may also be a complication of liver disease in alcoholics and patients with hepatitis. Treating osteoporosis in patients with cirrhosis can be complicated. One study found that calcitriol (a form of vitamin D) is especially helpful in preventing bone loss in patients with cirrhosis. |
