What is cirrhosis of the liver? Can cirrhosis be reversed? Does cirrhosis of the liver go away? Discover the key facts about this chronic liver disease.

Understanding Cirrhosis of the Liver

Cirrhosis is a chronic and progressive liver disease characterized by the replacement of healthy liver tissue with scar tissue. This scarring impairs the liver’s ability to function properly, leading to a range of serious health complications.

Causes of Cirrhosis

The most common causes of cirrhosis include long-term alcohol abuse, viral hepatitis (particularly hepatitis C), and nonalcoholic fatty liver disease. Other less common causes include bile duct disorders, genetic and metabolic disorders, and autoimmune diseases.

Stages of Cirrhosis

Cirrhosis progresses through several stages, starting with inflammation and cell death, followed by the formation of scar tissue, and eventually, the development of nodules and advanced liver damage.

Symptoms of Cirrhosis

Cirrhosis often doesn’t cause symptoms in the early stages, but as the disease progresses, common symptoms include fatigue, loss of appetite, weight loss, abdominal pain, and swelling in the legs or abdomen.

Diagnosing Cirrhosis

Cirrhosis is typically diagnosed through a combination of medical history, physical examination, blood tests, imaging studies, and in some cases, liver biopsy.

Treating Cirrhosis

Treatment for cirrhosis focuses on addressing the underlying cause, managing symptoms, and preventing complications. This may involve medication, dietary changes, alcohol cessation, and in severe cases, liver transplantation.

Can Cirrhosis be Reversed?

Generally, no. Once cirrhosis has developed, the liver damage is considered irreversible. However, early intervention and treatment can sometimes slow the progression of the disease and prevent further damage.

Preventing Cirrhosis

Maintaining a healthy lifestyle, avoiding excessive alcohol consumption, and managing underlying medical conditions that can lead to cirrhosis, such as viral hepatitis and nonalcoholic fatty liver disease, can help prevent the development of this chronic liver disease.

Cirrhosis and Liver Cancer

People with cirrhosis have an increased risk of developing liver cancer, also known as hepatocellular carcinoma. Regular monitoring and screening for liver cancer are essential for individuals with cirrhosis.

Living with Cirrhosis

Managing cirrhosis requires a multifaceted approach, including ongoing medical care, lifestyle modifications, and careful monitoring for complications. With proper management, many people with cirrhosis can maintain a good quality of life.

Cirrhosis Complications

Cirrhosis can lead to a range of serious complications, including portal hypertension, esophageal varices, ascites, hepatic encephalopathy, and an increased risk of liver cancer. Prompt treatment and management of these complications are essential.

Cirrhosis and Liver Transplantation

In severe cases of cirrhosis, a liver transplant may be the only viable treatment option. Transplantation can significantly improve the prognosis for individuals with end-stage liver disease.

The Importance of Early Diagnosis and Treatment

Early detection and treatment of the underlying causes of cirrhosis can help slow the progression of the disease and prevent or manage complications. Regular check-ups and monitoring are crucial for individuals at risk of developing cirrhosis.

Cirrhosis and Lifestyle Factors

Lifestyle factors, such as alcohol consumption, diet, and physical activity, can play a significant role in the development and progression of cirrhosis. Making healthy lifestyle choices is an essential part of managing this chronic liver disease.

Cirrhosis and Comorbidities

Individuals with cirrhosis often have other underlying health conditions, such as diabetes, cardiovascular disease, or kidney disease. Addressing these comorbidities is crucial for effective management of cirrhosis and overall health outcomes.

Cirrhosis Research and Advancements

Ongoing research into the causes, prevention, and treatment of cirrhosis is leading to new insights and advancements in this field. Collaboration between healthcare providers, researchers, and patients is essential for driving progress in the management of this chronic liver disease.

Symptoms, Causes, Stages, Diagnosis, and Treatment

SOURCES:

American Liver Foundation: “The Progression of Liver Disease,” “Cirrhosis,” “How is Hepatitis C Transmitted or Spread?” “How can I prevent getting Hepatitis C?” “Who is at risk for Hepatitis C?” “Hepatitis B,” “25 Ways to Love Your Liver.”

Athena Health: “Cirrhosis.”

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Cleveland Clinic: “Cirrhosis of the Liver,” “What is portal hypertension?”

Hepatitis C Online: “Evaluation and Prognosis of Patients with Cirrhosis.”

Mayo Clinic: “Cirrhosis, “Cirrhosis: Diagnosis,” “Esophageal varices: Symptoms,” “Cirrhosis: Causes,” “Hepatitis B.”

Merck Manual: “Alcoholic Liver Disease.”

National Institute of Diabetes and Digestive and Kidney Diseases: “Diagnosis of Cirrhosis,” “What is Cirrhosis?” “Nonalcoholic Fatty Liver Disease (NAFLD) & Nonalcoholic Steatohepatitis (NASH),” “Eating, Diet, & Nutrition for NAFLD & NASH: How can my diet help prevent or treat NAFLD and NASH?”

University of Pittsburgh Medical Center: “Can You Live Without Your Liver?”

UpToDate: “Cirrhosis (Beyond the Basics). “

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CDC: “Alcohol and Public Health: Frequently Asked Questions.”

HCV Advocate: “What is Cirrhosis?”

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Medlineplus.gov: “Cirrhosis.”

U.S. Department of Veterans Affairs: “Viral Hepatitis — Cirrhosis: A Patient’s Guide.”

NIH.gov: “Management options in decompensated cirrhosis.”

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Hepatic Medicine: “Management options in decompensated cirrhosis.”

Ucsf.edu: “When is a liver transplant indicated for cirrhosis?”

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American Family Physician: “Cirrhosis: Diagnosis, Management, and Prevention.”

Deutsches Arzteblatt International: “The Etiology, Diagnosis and Prevention of Liver Cirrhosis.”

Alimentary Pharmacology and Therapeutics: “Systematic Review with Meta-analysis: Coffee Consumption and the Risk of Cirrhosis. ”

American Journal of Gastroenterology: “Statins Reduce the Risk of Cirrhosis and Its Decompensation in Chronic Hepatitis B Patients: A Nationwide Cohort Study.”

Journal of Hepatology: “Statin Use and Risk of Cirrhosis Development in Patients With Hepatitis C Virus Infection.”

What is It, Symptoms, Causes & Stages

Overview

Cirrhosis causes scaring and nodules to form throughout the liver.

What is cirrhosis of the liver?

Cirrhosis is a late-stage liver disease in which healthy liver tissue is replaced with scar tissue and the liver is permanently damaged. Scar tissue keeps your liver from working properly.

Many types of liver diseases and conditions injure healthy liver cells, causing cell death and inflammation. This is followed by cell repair and finally tissue scarring as a result of the repair process.

The scar tissue blocks the flow of blood through the liver and slows the liver’s ability to process nutrients, hormones, drugs and natural toxins (poisons). It also reduces the production of proteins and other substances made by the liver. Cirrhosis eventually keeps the liver from working properly. Late-stage cirrhosis is life-threatening.

How common is cirrhosis?

Scientists estimate that cirrhosis of the liver affects about one in 400 adults in the U.S. It affects about 1 in 200 adults age 45 to 54, the age group most commonly affected by cirrhosis. Cirrhosis causes about 26,000 deaths each year in the U.S. and is the seventh leading cause of death in the U.S. among adults 25 to 64 years of age.

Who gets cirrhosis, who is most at risk?

You are more likely to get cirrhosis of the liver if you:

• Abuse alcohol for many years.
• Have viral hepatitis.
• Have diabetes.
• Are obese.
• Inject drugs using shared needles.
• Have a history of liver disease.
• Have unprotected sex.

Is cirrhosis cancer?

No, cirrhosis of the liver isn’t cancer. However, most people who have liver cancer have cirrhosis. If you have cirrhosis, you have an increased risk of liver cancer. If you have hepatitis B or hepatitis C, you have an increased risk of liver cancer because these diseases often lead to cirrhosis. Any cause of liver disease can lead to cirrhosis, which increases your chance of liver cancer. (Even if you have hepatitis B or fatty liver disease without cirrhosis, you are at increased risk of liver cancer.)

Is cirrhosis a hereditary disease?

Cirrhosis itself is not an inherited (passed from parent to child) disease. However, some of the diseases that can cause liver damage that lead to cirrhosis are inherited diseases.

Can cirrhosis be reversed?

Generally no. If you have been told you have cirrhosis, you have a late-stage liver disease and the damage that is already done is permanent. There are many liver diseases and complications of liver diseases that can lead to cirrhosis. If your liver disease or complication is caught early and successfully managed, it may be possible to slow or stop the progression of disease.

Is cirrhosis fatal?

Having a diagnosis of cirrhosis of the liver doesn’t mean you have an immediately fatal condition. However, as cirrhosis continues, more scarring occurs and liver function continues to decline. Eventually, your failing liver may become a life-threatening condition. Yet there’s still hope. You and your medical team will discuss if you are a candidate for a liver transplant. If so, you will begin the process of being placed on a national liver transplant recipient list.

Symptoms and Causes

What are the symptoms of cirrhosis?

The symptoms of cirrhosis depend on the stage of your disease. In the beginning stages, you may not have any symptoms. If you do have symptoms, some are general and could easily be mistaken for symptoms of many other diseases and illnesses.

Early symptoms and signs of cirrhosis include:

As liver function gets worse, other more commonly recognized symptoms of cirrhosis appear including:

• Easy bruising and bleeding.
• Yellow tint to your skin or the whites of your eyes (jaundice).
• Itchy skin.
• Swelling (edema) in your legs, feet and ankles.
• Fluid buildup in your belly/abdomen (ascites).
• Brownish or orange color to your urine.
• Light-colored stools.
• Confusion, difficulty thinking, memory loss, personality changes.
• Blood in your stool.
• Redness in the palms of your hands.
• Spider-like blood vessels that surround small, red spots on your skin (telangiectasias).
• In men: loss of sex drive, enlarged breasts (gynecomastia), shrunken testicles.
• In women: premature menopause (no longer having your menstrual period).

Is cirrhosis painful?

Yes, cirrhosis can be painful, especially as the disease worsens. Pain is reported by up to 82% of people who have cirrhosis and more than half of these individuals say their pain is long-lasting (chronic).

Most people with liver disease report abdominal pain. Pain in your liver itself can feel like a dull throbbing pain or a stabbing sensation in your right upper abdomen just under your ribs. General abdominal pain and discomfort can also be related to swelling from fluid retention and enlargement of your spleen and liver caused by cirrhosis.

Pain can come both from the diseases that lead to cirrhosis and/or cirrhosis can make the pain from existing diseases worse. For instance, if you have non-alcoholic fatty liver disease and are obese, you may also have osteoarthritis and cirrhosis makes your bone and joint pain worse. Cirrhosis also causes an inflammatory state in your entire body. Inflammation and your body’s reaction to inflammation can cause general pain.

What causes cirrhosis?

The most common causes of cirrhosis of the liver are:

• Alcohol abuse (alcohol-related liver disease caused by long-term [chronic] use of alcohol).
• Chronic viral infections of the liver (hepatitis B and hepatitis C).
• Fatty liver associated with obesity and diabetes and not alcohol. This condition is called non-alcoholic steatohepatitis.

Anything that damages the liver can lead to cirrhosis. Other causes include:

• Inherited diseases:
• Autoimmune hepatitis (your body’s own immune system attacks healthy liver tissue causing damage).
• Diseases that damage or block bile ducts in the liver (tubes that carry bile from the liver to other parts of digestive system; bile helps digest fats):
  • Primary biliary cholangitis (bile ducts become injured, then inflamed, then permanently damaged).
  • Primary sclerosing cholangitis (inflammation of the bile ducts leads to scarring and narrowing of the ducts and buildup of bile in the liver).
  • Blocked bile duct (can cause infections, backup of products in the liver).
  • Biliary atresia (infants are born with poorly formed or blocked bile ducts, causing damage, scarring, loss of liver tissue and cirrhosis).
• Chronic heart failure (causes fluid to back up in your liver, swelling in other areas of your body and other symptoms).
• Rare diseases, such as amyloidosis, in which abnormal deposits in the liver of an abnormal protein called amyloid disrupts normal liver function.

Changes from liver diseases that lead to cirrhosis are gradual. Liver cells are injured and if injury – from whatever cause – continues, liver cells start to die. Over time, scar tissue replaces the damaged liver cells and the liver can’t function properly.

What are the complications of cirrhosis?

There are many complications of cirrhosis of the liver. Because cirrhosis develops over many years, some of these complications may be your first noticeable signs and symptoms of the disease.

Portal hypertension: This is the most common serious complication. Portal hypertension is an increase in the pressure in your portal vein (the large blood vessel that carries blood from the digestive organs to the liver). This increase in pressure is caused by a blockage of blood flow through your liver as a result of cirrhosis. When blood flow through veins is partially blocked, veins in your esophagus, stomach or intestines can become enlarged (a condition called varices). As the pressure in these veins builds, the veins can bleed or even burst, causing severe internal bleeding.

Additional complications of portal hypertension include:

• Swelling (edema) in your legs, ankles or feet.
• Buildup of fluids in your abdomen (called ascites).
• Swelling/enlargement of your spleen (splenomegaly).
• Formation and dilation (expansion) of blood vessels in the lungs (hepatopulmonary syndrome), leading to low levels of oxygen in the blood and body and shortness of breath.
• Failure of kidney function as a result of having portal hypertension as a complication of cirrhosis (hepatorenal syndrome). This is a type of kidney failure.
• Confusion, difficulty thinking, changes in your behavior, even coma. This occur when toxins from your intestines aren’t removed by your damaged liver and circulate in the bloodstream and buildup in your brain (a condition called hepatic encephalopathy).

Hypersplenism: Hypersplenism is an overactive spleen. This condition causes quick and premature destruction of blood cells.

Infections: Cirrhosis increases your risk of getting and fighting serious infections, such as bacterial peritonitis (infection of the tissue that lines the inner wall of your abdomen).

Malnutrition: Your liver processes nutrients. A damaged liver makes this more difficult and leads to weight loss and general weakness.

Liver cancer: Most people who develop liver cancer have cirrhosis of the liver.

Liver failure: Many diseases and conditions cause liver failure including cirrhosis of the liver. As its name implies, liver failure occurs when your liver isn’t working well enough to perform its many functions.

Diagnosis and Tests

How is cirrhosis of the liver diagnosed?

Your healthcare provider will first ask about your medical history and over-the-counter and prescription drug use. They will also ask about any supplements or herbal products you may take. Your provider may suspect you have cirrhosis if you have a long history of alcohol abuse, injectable drug abuse or have had hepatitis B or C and have the symptoms listed in this article.

To diagnosis cirrhosis, your provider will perform a physical exam and may order one or more of the following tests:

• Physical exam: Your doctor will examine you, looking for the signs and symptoms of cirrhosis including: the red, spider-like blood vessels on your skin; yellowing of your skin or whites of your eyes; bruises on your skin; redness on your palms; swelling, tenderness or pain in your abdomen; enlarged firmer-feeling, bumpy texture to the lower edge of your liver (the part of your liver below the rib cage that can be felt).
• Blood tests: If your doctor suspects cirrhosis, your blood will be checked for signs of liver disease. Signs of liver damage include:
  • Lower than normal levels of albumin and blood clotting factors (lower levels means your liver has lost its ability to make these proteins).
  • Raised levels of liver enzymes (suggests inflammation).
  • Higher level of iron (may indicate hemochromatosis).
  • Presence of autoantibodies (may indicate autoimmune hepatitis or primary biliary cirrhosis).
  • Raised bilirubin level (suggests liver isn’t working properly to remove bilirubin from the blood).
  • High white blood cell count (indicates an infection).
  • High creatinine level (a sign of kidney disease that suggests late-stage cirrhosis).
  • Lower levels of sodium (is an indicator of cirrhosis).
  • Raised level of alpha-fetoprotein (indicates presence of liver cancer).

In addition, other blood work will include a complete blood count to look for signs of infection and anemia caused by internal bleeding and a viral hepatitis test to check for hepatitis B or C.

• Imaging tests: Imaging test show the size, shape and texture of the liver. These tests can also determine the amount of scarring, the amount of fat you have in your liver and fluid in your abdomen. Imaging tests of your liver that could be ordered include computerized tomography (CT) scan, abdominal ultrasound and magnetic resonance imaging (MRI). A special ultrasound, called a transient elastography, measures the fat content and amount of stiffness in your liver. Two different types of endoscopies might be ordered: an endoscopic retrograde cholangiopancreatography to detect bile duct problems, and/or upper endoscopy to detect enlarged veins (varices) or bleeding in your esophagus, stomach or intestines.
• Biopsy: A sample of liver tissue (biopsy) is removed from your liver and examined under the microscope. A liver biopsy can confirm a diagnosis of cirrhosis, determine other causes or extent of liver damage or enlargement or diagnosis liver cancer.

Are there stages of cirrhosis?

If you have been diagnosed with cirrhosis of the liver, you are already beyond the early stages of liver disease. Having cirrhosis means your liver has scar tissue in it because it has been damaged.

Liver specialists and researchers have developed many different scoring systems to predict outcome and to guide treatment for chronic liver disease. Some specific liver diseases also have their own scoring systems. However, not every liver disease has a scoring system and there’s no scoring system if you happen to have more than one liver disease at the same time.

For these reasons, perhaps it’s easier to talk about cirrhosis according to a classification system you are more likely to hear from your healthcare provider. He or she may refer to you having either compensated cirrhosis or decompensated cirrhosis.

Compensated cirrhosis means you have cirrhosis but you don’t yet have noticeable symptoms (you are asymptomatic). Your lab work and imaging findings may not be abnormal. A liver biopsy may be the only way to confirm a diagnosis of cirrhosis. Median survival in patients with compensated cirrhosis is approximately nine to 12 years. (Median is the middle point in set of numbers, so an equal number of individuals survived less than 9 to 12 years as the number of individuals who survived over this time range. )

Decompensated cirrhosis means your cirrhosis has worsened to the point that you have noticeable symptoms. Your healthcare provider recognizes your condition based on your history, physical and lab findings. You have at least one complication, which includes jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome, variceal bleeding or liver cancer. You are usually admitted to the hospital for care. Median survival in patients with decompensated cirrhosis is approximately two years.

Management and Treatment

Is there a cure for cirrhosis of the liver?

No, there is no cure for cirrhosis. The damage already done to your liver is permanent. However, depending on the underlying cause of your cirrhosis, there may be actions you can take to keep your cirrhosis from getting worse. These actions include:

• Stop drinking alcohol.
• Treat chronic hepatitis (if you have it).
• Avoid medications that stress the liver.
• Eat a healthy, well-balanced, low-fat diet, such as the Mediterranean diet.

Follow other tips listed under the Prevention section in this article.

What are the goals of cirrhosis treatment?

The goals of treatment for cirrhosis of the liver are to:

• Slow further damage to your liver.
• Prevent and treat symptoms.
• Prevent and treat complications.

How is cirrhosis of the liver treated?

Treatment depends on what’s causing your cirrhosis and how much damage exists.

Although there is no cure for cirrhosis, treatments can delay or stop its progress and reduce complications.

Treatments for the causes of cirrhosis are as follows:

• Alcohol-related liver disease: If you’ve developed cirrhosis from alcohol abuse, stop drinking alcohol. If you need help, ask your healthcare provider for recommendations for alcohol addiction treatment programs.
• Hepatitis B or C: Several approved antiviral medications are available to treat hepatitis types B and C.
• Nonalcoholic fatty liver disease: Management of nonalcoholic fatty liver disease includes losing weight, following a healthy diet, getting physical exercise and following your provider’s instructions for managing your diabetes.
• Inherited liver diseases: Treatment depends on the specific inherited disease. Treatments are aimed at treating symptoms and managing complications. Treatment of alpha-1 antitrypsin deficiency may include medicine to reduce swelling in your abdomen and legs, antibiotics to treat infections and other medicines for complications. For hemochromatosis, treatment is to remove blood to reduce the level of iron in your blood. For Wilson disease, treatment is medicines to remove copper from your body and zinc to prevent absorption of cooper. For cystic fibrosis, medications are prescribed to improve lung function, methods to clear mucous and treatment of complications. Treatment for glycogen storage diseases that involve the liver is to keep glucose at the right level.
• Autoimmune hepatitis: Treatment includes medications to suppress your immune system.
• Diseases that damage or block bile ducts in the liver: Treatments include medications such as ursodiol (Actigall®) or surgery to open narrowed or blocked bile ducts.
• Heart failure: Treatment depends on the cause and stage of your heart failure. Medications include drugs to treat high blood pressure, reduce cholesterol, remove excess fluids (edema) from your body and improve heart pumping function. Other treatments include implantation of devices to help pump blood or monitor heart rhythm, surgeries to unblock arteries or replace or repair heart valves and transplant surgery to replace your heart.
• Medications that may be contributing to cirrhosis: Your provider will review all of your medications to determine if any are causing problems for your liver and if so, stop the drug, lower the dosage or change to a different drug if possible.

How are the complications of cirrhosis treated?

Portal hypertension: Portal hypertension is mainly the result of chronic end-stage liver disease. Treatment consists of treating its many complications. Treatments of portal hypertension include:

• Giving beta blockers or nitrates to lower blood pressure in your veins.
• Cutting off blood flow through the varices to stop or reduce further bleeding with procedure using tiny elastic bands (band ligation) or with sclerotherapy.
• Redirecting blood from the portal vein to reduce pressure in the portal vein and to control variceal bleeding. This is achieved using either one of two techniques – distal splenorenal shunt or transjugular intrahepatic portosystemic shunt.
• Prescribing lactulose to absorb toxins in the blood that result from hepatic encephalopathy, which cause symptoms including confusion and other mental changes.
• Draining excess fluid in your abdomen (ascites) in a procedure called paracentesis or taking a diuretic medication to decrease extra fluids (edema) in your legs and other areas of your body.

Bacterial peritonitis: Antibiotics and infusion of a protein (albumin) will be prescribed. Typically patients are admitted to the hospital for treatment and monitoring. Following a diagnosis of bacterial peritonitis, an oral antibiotic will be prescribed for daily use to prevent recurrence of infection.

Liver cancer: Treatment depends on the stage of your cancer and other factors. One or more treatments may be tried. Options include surgery to remove part of your liver or your whole liver (to be replaced with a new liver as part of a liver transplantation) and nonsurgical tumor-destroying methods including ablation, chemotherapy, targeted therapy (drugs zero in on cancer genes or tissue), immunotherapy and radiation bead therapy (inject bead that give off radiation into the blood vessels that feed the tumor).

Kidney failure: Treatment may include medication, dialysis and kidney transplant, depending on the cause and extent of failure.

Liver failure: Treatment depends on if you have acute or chronic failure. For chronic liver failure, diet and lifestyle changes include stopping alcohol and medications that harm the liver; eating less red meat, cheese and eggs; losing weight; controlling high blood pressure and diabetes and cutting down on salt.

Acute treatments for liver failure include intravenous fluids to maintain blood pressure, laxatives to help flush toxins from the body and blood glucose monitoring.

If you have either acute or chronic liver failure, your liver specialist may recommend a liver transplant. Liver transplants can come from a living or deceased donor. Only a portion of the donor liver needs to be transplanted. The liver is the only human organ capable of growing back.

Many tests are required of both you (the liver transplant recipient) and the person donating a portion of their liver or the cadaver liver (liver from a deceased person). If your doctors determine that you need a liver transplant, you will be placed on a national liver transplant waiting list, which lists patients by blood type, body size and severity of end-stage liver disease.

Prevention

How can I prevent cirrhosis of the liver?

Food and drink issues:

• Don’t abuse alcohol. If you do drink alcohol, limit how much you drink and how often. If you drink more than two drinks a day if you are a man or more than one if you are a woman, you are increasing your risk. A drink is a glass of wine or a 12-ounce can of beer or a 1.5 ounce serving of hard liquor. If you have liver disease, you should not drink alcohol at all.
• Eat a well-balanced, low-fat diet, such as the Mediterranean diet. A well-balanced healthy diet consists of fruits, vegetables, lean proteins and whole grains.
• Don’t eat raw seafood, especially oysters and clams. These foods can contain a bacteria that can cause serious illness.
• Cut back on the amount of salt in your diet. Use other seasonings to flavor your foods.

Healthy body habits:

• Maintain a healthy weight. Excess body fat can damage your liver. Ask your healthcare provider for a weight loss plan if you are overweight.
• Exercise regularly.
• See your healthcare provider regularly for check-ups. Follow medical recommendations to control obesity, diabetes, hypertension (high blood pressure) and cholesterol (high bad cholesterol [LDL] and/or low good cholesterol [HDL]) and high triglycerides.
• Quit smoking if you smoke.

Healthy liver practices:

• Avoid high-risk behaviors that can lead to infection with hepatitis B or C, such as sharing needles for illegal drug use or having unprotected sex.
• Get vaccinated against hepatitis B. If you already have hepatitis, ask your provider if drug treatment is appropriate for you.
• Get your annual flu shot and ask if a pneumonia vaccine makes sense for you (people with cirrhosis are more likely to get infections).
• Avoid nonsteroidal anti-inflammatory drugs (such as ibuprofen [Advil®, Motrin®] indomethacin [Indocin®] celecoxib [Celebrex®] and aspirin) and high doses of acetaminophen (Tylenol®). Acetaminophen can be taken safely at a dose up to 2,000 mg daily. These drugs can cause or worsen liver function.
• Take all medications and keep all appointments as recommended by your healthcare provider.

Outlook / Prognosis

What can I expect if I have cirrhosis?

Damage already done to your liver is permanent. But your liver is a large organ. If part of your liver is still working, you might be able to slow the progression of disease, depending on its cause. For instance, if your cirrhosis is caused by alcohol abuse, you need to stop drinking immediately. If you are obese or have diabetes, you will need to lose weight and manage your blood sugar so you can lower the damage caused by fatty liver disease.

You and your healthcare provider or team will work together to determine what’s causing your cirrhosis and what complications may have resulted from your cirrhosis and treat them accordingly.

What’s the life expectancy for people with cirrhosis?

Life expectancy depends on several factors including the cause and severity of your cirrhosis, your response to treatments, presence of cirrhosis complications, your age and any other existing general health problems. Ask your liver specialist about your life expectancy since every person is unique, with unique overall health issues and specific liver health issues.

If your cirrhosis is advanced, liver transplantation may be an option. You and your doctors will discuss if this is an option for you.

What’s a Child-Turcotte-Pugh score and MELD score?

A Child-Turcotte-Pugh (CTP) score, also known simply as the Child-Pugh score, is a clinical score that tells your doctors how severe your liver disease is and forecasts your expected survival rate. The scoring system provides a score on the presence of five clinical measures (the lab values of bilirubin, serum albumin and prothrombin time; presence of ascites and hepatic encephalopathy) and the degree of severity of each of these measures.

The Model for End-stage Liver Disease (MELD) score is a score that is used to rank the urgency for a liver transplant. The worse your liver function is, the higher your MELD score and the higher your position is on the transplant list. The Pediatric End-stage Liver Disease (PELD) score is similar to MELD but is a scoring system for children under the age of 12.

Living With

When should I call 911 or go to the emergency room?

If you have cirrhosis and experience the following, call 911:

• Your poop (stools) are black and tarry or contain blood (may be maroon or bright red in color).
• You are vomiting blood.
• The whites of your eyes are turning yellow.
• You have difficulty breathing.
• You have abdominal swelling.
• You have muscle tremors or shakiness.
• You are confused, irritable, disoriented, sleepy, forgetful or “foggy.”
• You have a change in your level of consciousness or alertness; you pass out.

What type of healthcare providers will treat my cirrhosis?

Depending on the stage of your cirrhosis, different healthcare providers may be involved in your care. Healthcare professionals likely to be part of your care team include:

• Your primary care provider.
• Gastroenterologist (doctor who specializes in conditions of your digestive tract).
• Hepatologist (doctor who specializes in conditions of your liver).
• Nephrologist (doctor who specializes in conditions of your kidney).
• Dietitian.
• Members of a liver transplant team include: hepatologist, transplant surgeon, anesthesiologist, infectious disease specialist, nephrologist, dietitian, transplant pharmacist, physical and occupational therapist, case manager/social worker and nurses.

A note from Cleveland Clinic

Cirrhosis of the liver is a late-stage result of liver disease and its complications. Cirrhosis causes your liver to not function properly. Your liver plays a vital role in many of the processes and functions that keep you alive.

Although scarring from liver disease causes permanent damage, it’s still possible to live a long life. Depending on the underlying cause, it’s possible to slow or stop cirrhosis from worsening. Many of the causes and complications that lead to cirrhosis are treatable or manageable. If you drink alcohol, stop. If you have nonalcoholic fatty liver disease, lose weight and control your metabolic risk factors. If you have diabetes, make sure you are following your healthcare provider’s management recommendations. Take all medications for all your medical conditions as directed by your healthcare team. Get vaccinated for hepatitis A and B.

If you have end-stage cirrhosis, don’t lose hope. You and your healthcare team will work together to closely manage your condition and put you on a wait list for a donor liver.

Cirrhosis – NHS

Cirrhosis is scarring (fibrosis) of the liver caused by long-term liver damage. The scar tissue prevents the liver working properly.

Cirrhosis is sometimes called end-stage liver disease because it happens after other stages of damage from conditions that affect the liver, such as hepatitis.

Your liver may keep working even when you have cirrhosis. However, cirrhosis can eventually lead to liver failure, and you can get serious complications, which can be life threatening.

Treatment may be able to stop cirrhosis from getting worse.

Information:

Coronavirus advice

Get advice about coronavirus and liver disease from the British Liver Trust

Symptoms of cirrhosis

You may not have any symptoms during the early stages of cirrhosis.

As your liver becomes more damaged, you may:

• feel very tired and weak
• feel sick (nausea)
• lose your appetite
• lose weight and muscle mass
• get red patches on your palms and small, spider-like blood vessels on your skin (spider angiomas) above waist level

If cirrhosis gets worse, some of the symptoms and complications include:

See a GP if you think you may have cirrhosis.

Diagnosing cirrhosis

If a GP suspects cirrhosis, they’ll check your medical history and do a physical examination to look for signs of long-term liver disease.

You may have tests to confirm the diagnosis, such as:

• blood tests
• scans, such as an ultrasound, CT, MRI, or transient elastography scan
• a liver biopsy, were a fine needle is used to remove a sample of liver cells so they can be examined under a microscope

If tests show that you have cirrhosis, a GP should refer you to see a doctor who specialises in liver problems (hepatologist).

If you have complications from cirrhosis, or a high chance of getting complications, you may be referred to a specialist liver centre.

Treating cirrhosis

There’s no cure for cirrhosis at the moment. However, there are ways to manage the symptoms and any complications and slow its progression.

Treating the problem that led to cirrhosis (for example, using anti-viral medicines to treat hepatitis C) can stop cirrhosis getting worse.

You may be advised to cut down or stop drinking alcohol, or to lose weight if you’re overweight. 

A GP can help you get support if you need help to stop drinking or to lose weight.

If your liver is severely damaged, a liver transplant may be the only treatment option.

What causes cirrhosis

In the UK, the most common causes of cirrhosis are:

Cirrhosis can also be caused by a problem affecting your bile ducts (such as primary biliary cholangitis) or immune system (such as autoimmune hepatitis), some inherited conditions, and the long-term use of certain medicines.

Alcohol-related liver disease

Drinking too much alcohol damages the liver. Over time, this can lead to alcohol-related liver disease.

Cirrhosis is the final stage of alcohol-related liver disease. It usually happens after many years of heavy drinking.

How to prevent cirrhosis

Limit alcohol

The best way to prevent alcohol-related cirrhosis is to drink within the recommended limits.

The guidelines recommend:

• men and women should not regularly drink more than 14 units of alcohol a week
• you should spread your drinking over 3 days, or more, if you drink as much as 14 units a week

Stop drinking alcohol immediately if you have alcohol-related cirrhosis. Drinking alcohol speeds up the rate at which cirrhosis progresses, regardless of the cause.

A GP can offer help and advice if you’re finding it difficult to cut down the amount you drink. 

Read more about where to get alcohol support.

Protect yourself from hepatitis

Hepatitis B and C are infections in the liver caused by a virus.

The hepatitis B virus is spread in blood and body fluids. The hepatitis C virus is usually spread in blood.

Common ways of spreading these viruses include having sex with an infected person without using a condom, or close contact with an infected person’s blood, such as sharing their toothbrush or sharing needles to inject drugs.

Vaccination for hepatitis B is part of the NHS childhood vaccination schedule. The vaccine is also available to anyone who has an increased chance of getting hepatitis B.

There is no vaccine for hepatitis C at the moment.

Aim for a healthy weight

To reduce your chance of getting non-alcoholic fatty liver disease (NAFLD), which can lead to cirrhosis, make sure you’re a healthy weight by eating a healthy, balanced diet and exercising regularly.

The liver

The liver is an important organ that does hundreds of jobs that are vital for sustaining life.

For example, the liver:

• stores glycogen, a type of fuel the body needs for energy
• makes bile, which helps us digest fats
• makes substances that help blood to clot and repair damaged tissues
• processes and removes alcohol, toxins or medicines from the blood
• helps the body fight infections

Your liver is very tough. It’ll keep working even when it’s damaged and can continue to repair itself until it’s severely damaged.

Video: cirrhosis – Phil’s story

In this video, Phil talks about why he was shocked to discover he had cirrhosis.

Media last reviewed: 1 February 2021
Media review due: 1 February 2024

Page last reviewed: 29 June 2020
Next review due: 29 June 2023

Treatment for Cirrhosis | NIDDK

In this section:

How do doctors treat cirrhosis?

Doctors do not have specific treatments that can cure cirrhosis. However, they can treat many of the diseases that cause cirrhosis. Some of the diseases that cause cirrhosis can be cured. Treating the underlying causes of cirrhosis may keep your cirrhosis from getting worse and help prevent liver failure. Successful treatment may slowly improve some of your liver scarring.

How do doctors treat the causes of cirrhosis?

Doctors most often treat the causes of cirrhosis with medicines. Your doctor will recommend that you stop activities such as drinking alcohol and taking certain medicines that may have caused cirrhosis or may make cirrhosis worse.

Alcoholic liver disease

If you have alcoholic liver disease, your doctor will recommend that you completely stop drinking alcohol. He or she may refer you for alcohol treatment.

Nonalcoholic fatty liver disease

If you have nonalcoholic fatty liver disease, your doctor may recommend losing weight. Weight loss through healthy eating and regular physical activity can reduce fat in the liver, inflammation, and scarring.

Chronic hepatitis C

If you have chronic hepatitis C, your doctor may prescribe one or more medicines that have been approved to treat hepatitis C since 2013. Studies have shown that these medicines can cure chronic hepatitis C in 80 to 95 percent of people with this disease.⁵

Chronic hepatitis B

For chronic hepatitis B, your doctor may prescribe antiviral medicines that slow or stop the virus from further damaging your liver.

Autoimmune hepatitis

Doctors treat autoimmune hepatitis with medicines that suppress, or decrease the activity of, your immune system.

Diseases that damage, destroy, or block bile ducts

Doctors usually treat diseases that damage, destroy, or block bile ducts with medicines such as ursodiol (Actigall, Urso). Doctors may use surgical procedures to open bile ducts that are narrowed or blocked. Diseases that damage, destroy, or block bile ducts include primary biliary cholangitis and primary sclerosing cholangitis.

Inherited liver diseases

Treatment of inherited liver diseases depends on the disease. Treatment most often focuses on managing symptoms and complications.

Long-term use of certain medicines

The only specific treatment for most cases of cirrhosis caused by certain medicines is to stop taking the medicine that caused the problem. Talk with your doctor before you stop taking any medicines.

How do doctors treat the complications of cirrhosis?

Treatments for the complications of cirrhosis include the following.

Portal hypertension

Doctors treat portal hypertension with medicines to lower high blood pressure in the portal vein. Treatments for the complications of portal hypertension include

• Enlarged veins in your esophagus or stomach, called varices. Your doctor may prescribe medicines to lower the pressure in the veins of your esophagus or stomach. This lowers the chance that the veins become enlarged and burst, causing internal bleeding. If you vomit blood or have black or bloody stools go to a hospital right away. Doctors may perform procedures during upper GI endoscopy or use surgical procedures to stop the internal bleeding.
• Swelling in your legs, ankles, or feet, called edema. Your doctor may prescribe medicines that remove fluid from your body. Your doctor will recommend limiting the amount of salt in your diet.
• Buildup of fluid in your abdomen, called ascites. Your doctor may prescribe medicines that remove fluid from your body. Your doctor will recommend limiting the amount of salt in your diet. If you have large amounts of fluid in your abdomen, your doctor may use a needle or tube to drain the fluid. He or she will check the fluid for signs of infection. Your doctor may prescribe medicines to treat infection or prevent infection.
• Confusion, difficulties thinking, memory loss, personality changes, or sleep disorders, called hepatic encephalopathy. Your doctor may prescribe medicines that help lower the levels of toxins in your brain and improve brain function.

Infections

If you have a bacterial infection, your doctor will prescribe an antibiotic.

Liver cancer

Your doctor may treat liver cancer with the medical procedures that remove or destroy cancer cells, such as surgery, radiation therapy, and chemotherapy. Doctors also treat liver cancer with a liver transplant.

Liver failure

Liver failure, also called end-stage liver disease, happens when the liver stops working. The only treatment for liver failure is a liver transplant.

Other Complications

Your doctor may treat other complications through changes in medicines, diet, or physical activity. Your doctor may also recommend surgery.

What can I do to help keep my cirrhosis from getting worse?

To help keep your cirrhosis from getting worse, you can do the following

Talk with your doctor about your risk for getting liver cancer and how often you should be checked.

When do doctors consider a liver transplant for cirrhosis?

Your doctor will consider a liver transplant when cirrhosis leads to liver failure. Doctors consider liver transplants only after they have ruled out all other treatment options. Talk with your doctor about whether a liver transplant is right for you.

Talk with your doctor about whether a liver transplant is right for you.

References

[5] Hepatitis C FAQs for health professionals. Centers for Disease Control and Prevention, Division of Viral Hepatitis website. www.cdc.gov/hepatitis/HCV/HCVfaq.htm. Updated February 23, 2018. Accessed March 26, 2018.

Cirrhosis of the liver – British Liver Trust

Day-to-day coping strategies
In general, it is best to aim for as near to a normal life as possible. However, there are some points that you should keep in mind to help you feel as healthy as you can.

• Take care of yourself by ensuring enough rest and exercise.

• Follow sensible hygiene measures if your immunity is low.

• Always discuss the use of over-the-counter drugs with your doctor since it is important to avoid some, especially painkillers such as aspirin and ibuprofen, if you have cirrhosis.

• Try to limit your exposure to colds and other infectious diseases.

• Talk to your doctor about having a flu vaccination in the winter months.

• Before travelling abroad, talk to your doctor about whether you should have any vaccinations.

• Join a support group for more information and personal support.

• Take an active interest in your healthcare.

• Gather as much information as you need from charity telephone helplines and their supporting websites.

If you find yourself becoming depressed, talk this over with your doctor who can discuss ways of overcoming this. If appropriate, certain medications can be helpful in helping you cope. Remember that liver function can improve if you take care of yourself and receive early treatment. However, you must ensure that health professionals know you have cirrhosis before giving or prescribing any treatment or medication for you.

Diet
It is important to eat well and to include a good balance of foods in your diet including vitamins, minerals and calcium. It is likely you will need extra energy and protein.

Cirrhosis affects your ability to store glycogen, a carbohydrate that gives you short-term energy. This means that your body has to use its own muscle tissue to provide energy between meals and this can lead to muscle wasting and weakness.

If you are affected in this way, snacking between meals is a way you can top up on calories and protein. Another good method is to eat three or four small meals in a day rather than one large protein or carbohydrate-heavy meal.

You may find having nourishing drinks a help. These can include homemade milkshakes or commercially-made products such as Build Up, Complan, Recovery and Nourishment. These are available at most chemists. It is a good idea to check with your doctor or dietician first to make sure they are suitable for you.

Try to avoid salty foods or adding salt to what you eat, to help control fluid retention.

Alcohol and cirrhosis
Almost everyone who drinks too much alcohol will suffer some liver damage, but this does not necessarily turn into cirrhosis. As many as nine out of ten people who drink to excess will develop a fatty liver, with one in ten progressing to cirrhosis.

In general, the more you drink, the greater your chance of developing alcohol related hepatitis or cirrhosis. A poor diet may make the problem worse.

All types of alcoholic drinks can lead to liver disease. If you have cirrhosis – whether it is caused by alcohol or not – you should not drink alcohol at all.

Chronic Liver Disease/Cirrhosis | Johns Hopkins Medicine

What is cirrhosis?

Cirrhosis is when scar tissue replaces healthy liver tissue. This stops the liver from working normally.

Cirrhosis is a long-term (chronic) liver disease. The damage to your liver builds up over time.

The liver is your body’s largest internal organ. It lies up under your ribs on the right side of your belly.

The liver does many important things including:

• Removes waste from the body, such as toxins and medicines
• Makes bile to help digest food
• Stores sugar that the body uses for energy
• Makes new proteins

When you have cirrhosis, scar tissue slows the flow of blood through the liver. Over time, the liver can’t work the way it should.

In severe cases, the liver gets so badly damaged that it stops working. This is called liver failure.

What causes cirrhosis?

The most common causes of cirrhosis are:

• Hepatitis and other viruses
• Alcohol abuse
• Nonalcoholic fatty liver disease (this happens from metabolic syndrome and is caused by conditions such as obesity, high cholesterol and triglycerides, and high blood pressure)

Other less common causes of cirrhosis may include:

• Autoimmune disorders, where the body’s infection-fighting system (immune system) attacks healthy tissue
• Blocked or damaged tubes (bile ducts) that carry bile from the liver to the intestine
• Use of certain medicines
• Exposure to certain toxic chemicals
• Repeated episodes of heart failure with blood buildup in the liver
• Parasite infections

Some diseases passed from parent to child (inherited diseases) may also cause cirrhosis. These may include:

• Alpha1-antitrypsin deficiency
• High blood galactose levels
• Glycogen storage diseases
• Cystic fibrosis
• Porphyria (a disorder in which certain chemicals build up in the blood)
• Hereditary buildup of too much copper (Wilson disease) or iron (hemochromatosis) in the body

What are the symptoms of cirrhosis?

Your symptoms may vary, depending on how severe your cirrhosis is. Mild cirrhosis may not cause any symptoms at all.

Symptoms may include:

• Fluid buildup in the belly (ascites)
• Vomiting blood, often from bleeding in the blood vessels in the food pipe (esophagus)
• Gallstones
• Itching
• Yellowing of the skin and eyes (jaundice)
• Kidney failure
• Muscle loss
• Loss of appetite
• Easy bruising
• Spider-like veins in the skin
• Low energy and weakness (fatigue)
• Weight loss
• Confusion as toxins build up in the blood

The symptoms of cirrhosis may look like other health problems. Always see your healthcare provider to be sure.

How is cirrhosis diagnosed?

Your healthcare provider will look at your past health. He or she will give you a physical exam.

You may also have tests including:

• Blood tests. These will include liver function tests to see if the liver is working the way it should. You may also have tests to see if your blood is able to clot.
• Liver biopsy. Small tissue samples are taken from the liver with a needle or during surgery. The samples are checked under a microscope to find out the type of liver disease.

Your healthcare provider may want you to have imaging tests including:

• CT scan (computed tomography). This is an imaging test that uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs.
• MRI (magnetic resonance imaging). This test makes detailed pictures of organs and structures inside your body. It uses a magnetic field and pulses of radio wave energy. A dye may be shot (injected) into your vein. The dye helps the liver and other organs to be seen more clearly on the scan.
• Ultrasound. This shows your internal organs as they work. It checks how blood is flowing through different blood vessels. It uses high-frequency sound waves and a computer to create images of blood vessels, tissues, and organs.

You may also have an upper endoscopy (EGD). A lighted flexible camera is placed through your mouth into your upper digestive tract to look for enlarged blood vessels that are at risk of bleeding because of your cirrhosis. 

If you have fluid in the belly (ascites), you may need a low sodium diet, water pills (diuretics), and removal of the fluid with a needle (paracentesis).

How is cirrhosis treated?

Cirrhosis is a progressive liver disease that happens over time. The damage to your liver can sometimes reverse or improve if the trigger is gone, such as stop drinking alcohol or if the virus is treated.

The goal of treatment is to slow down the buildup of scar tissue and prevent or treat other health problems.

In many cases, you may be able to delay or stop any more liver damage. If you have hepatitis, it may be treated to delay worsening of your liver disease.

Your treatment may include:

• Eating a healthy diet, low in sodium
• Not having alcohol or illegal drugs
• Managing any health problems that happen because of cirrhosis  

Talk to your healthcare provider before taking prescription medicines, over-the-counter medicines, or vitamins.

If you have severe cirrhosis, treatment can’t control other problems. A liver transplant may be needed.

Other treatments may be specific to your cause of cirrhosis, such as controlling excessive iron or copper levels, or using immune suppressing medicines.

Be sure to ask your healthcare provider about recommended vaccines. These include vaccines for viruses that can cause liver disease.

What are the complications of cirrhosis?

Cirrhosis can cause other health problems such as:

• Portal hypertension. The portal vein carries blood from your intestines and spleen to your liver. Cirrhosis slows the normal flow of blood. That raises the pressure in the portal vein. This is called portal hypertension.
• Enlarged blood vessels. Portal hypertension may cause abnormal blood vessels in the stomach (called portal gastropathy and vascular ectasia) or enlarged veins in the stomach and the food pipe or esophagus (called varices). These blood vessels are more likely to burst due to thin walls and higher pressure. If they burst, severe bleeding can happen. Seek medical attention right away.
• Ascites. Fluid collecting in your belly. This can become infected. 
• Kidney disease or failure
• Easy bruising and severe bleeding. This happens when the liver stops making proteins that are needed for your blood to clot.
• Type 2 diabetes. When you have cirrhosis, your body does not use insulin properly (insulin resistance). The pancreas tries to keep up with the need for insulin by making more, but blood sugar (glucose) builds up. This causes type 2 diabetes.
• Liver cancer

Key points about cirrhosis

• Cirrhosis is when scar tissue replaces healthy liver tissue. This stops the liver from working normally.
• Cirrhosis is a long-term (chronic) liver disease.
• The most common causes are hepatitis and other viruses, and alcohol abuse. Other medical problems can also cause it.
• The damage to the liver usually can’t be reversed.
• The goal of treatment is to slow down the buildup of scar tissue and prevent or treat any problems that happen.
• In severe cases, you may need a liver transplant.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.
• Before your visit, write down questions you want answered.
• Bring someone with you to help you ask questions and remember what your provider tells you.
• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
• Ask if your condition can be treated in other ways.
• Know why a test or procedure is recommended and what the results could mean.
• Know what to expect if you do not take the medicine or have the test or procedure.
• If you have a follow-up appointment, write down the date, time, and purpose for that visit.
• Know how you can contact your provider if you have questions.

Cirrhosis | Cedars-Sinai

Not what you’re looking for?

Overview

Cirrhosis occurs when the liver becomes scarred. As the scar tissue replaces healthy tissue, small bumps form on the organ, causing blockages, which can lead to bile backing up into the liver and the blood. Bile is a fluid that is made up of water, electrolytes, cholesterol, bilirubin and other substances needed for both digestion and ridding the body of waste products. Once the liver has been scarred, the damage cannot be reversed.

A normal liver:

• Removes toxic substances from the blood
• Keeps the blood free of germs
• Provides immune agents to ward off infections
• Produces nutrients
• Regulates blood clotting
• Absorbs fats and vitamins

A person cannot live without a functioning liver, which makes cirrhosis potentially life threatening.

Symptoms

In early stages, the condition rarely shows any symptoms. Often the disease advances slowly and can be controlled. However, as time goes by and more healthy tissue is replaced with scar tissue, the liver begins to fail and a person may experience:

• Nausea and vomiting
• Weakness and exhaustion
• Loss of appetite and weight loss
• Red, spidery blood vessels on the skin
• Mental confusion, such as forgetfulness, poor concentration, dullness and sleep problems

Other symptoms that can be caused by complications of cirrhosis include:

• Coma (this is sometimes called hepatic encephalopathy)
• Yellowish skin and whites of the eyes (jaundice)
• Portal hypertension (slowing of blood flow through the portal vein)
• Swelling in the legs and abdomen caused by the buildup of water
• Bruising too easily
• Bleeding in the upper stomach
• Severe itching, from bile deposits in the skin
• Less urine output
• Stools that are pale or dull red in color
• Problems with side effects of medications taken
• Infections
• Red palms or curled fingers
• Small testicles in men
• Hemorrhoids that bleed
• Lack of interest in sex
• Severe kidney problems

Causes and Risk Factors

Alcohol abuse is one of the most common causes of cirrhosis in the United States. Drinking too much can prevent the liver from processing protein, fats and carbohydrates in the body. Damage to the liver can develop after a period of ten or more years of excessive drinking. The amount of daily alcoholic intake that may result in cirrhosis differs from person to person and between men and women. More than 10% of people who drink to excess will get the disease.

Other health conditions that can lead to cirrhosis include:

• Chronic hepatitis C is also a major cause of cirrhosis in the U.S. The liver becomes inflamed and slow injury occurs because of viral infections associated with hepatitis C.
• Hepatitis B causes inflammation and damage to the liver over long periods of time. This type of hepatitis-caused cirrhosis is much more common in other parts of the world.
• Immune system problems in which the body attacks the liver
• Damaged or blocked bile ducts
• Long-term exposure to certain toxins in the environment
• Inherited diseases, such as cystic fibrosis, Wilson’s disease (copper buildup in organs) and hemochromatosis.
• Fat buildup in the liver, associated with diabetes, obesity and heart problems
• Reactions to prescription drugs (for example, some cholesterol-lowering drugs can cause damage to the liver)
• Complications from gallbladder surgery

Diagnosis

After taking a medical history and conducting a physical exam, a physician may perform a CAT scan, ultrasound or other imaging test to determine the state of the liver. A laproscope may be inserted into the stomach area to produce a picture of the liver. To confirm a diagnosis of cirrhosis, a liver biopsy may be done, which involves taking a small sample of tissue to be examined under the microscope.

Treatment

Since nothing can be done about scarring that has already occured, treatment is concentrated on helping patients avoid complications of the disease and blocking further damage. Treatment depends on the cause of cirrhosis and any complications that result. 

Options include:

• Eliminating alcohol intake (in cases of alcohol abuse) and maintaining a healthy diet
• Medications, including interferon and cortisteroids
• Endoscopy to treat enlarged blood vessels
• Diuretics or laxatives to reduce buildup of fluids
• Antibiotics
• Liver transplantation, which should be considered when cirrhosis is severe and the liver is failing to function

© 2000-2021 The StayWell Company, LLC. All rights reserved. This information is not intended as a substitute for professional medical care. Always follow your healthcare professional’s instructions.

Not what you’re looking for?

The liver is getting better – Spark No. 30 (5188) dated 01.08.2011

Russian scientists have invented a substance that can fight a previously incurable disease – cirrhosis of the liver. If the drug passes clinical trials and goes on sale, there will be 40 million fewer deaths per year in the world than

The wish “eternal minus” is well known to everyone who at least once in his life was interested in the problems of life with various viral hepatitis. “Minus” in the language of patients with hepatitis means good test results: it means that the virus has ceased to multiply uncontrollably, affecting liver cells, and a person can breathe calmly for a while.Sometimes for the onset of this respite, it takes a year, or even two, to take pills and injections daily, which have a strong toxic load on the entire body. If therapy is abandoned, the virus will gradually destroy the liver, causing cirrhosis, an irreversible process in which normal cells turn into connective tissue, which usually forms the skin and tendons.

The conventional wisdom that cirrhosis of the liver is the lot of alcoholics and drug addicts is quickly dispelled by doctors.Indeed, chronic alcohol intoxication is the cause of half of all cirrhosis cases. On average, every third alcoholic falls ill, usually 10-15 years after the onset of abuse, and the likelihood of cirrhosis after 15 years of drinking is 8 times higher than after 5 years. But then the question arises: who then suffers from cirrhosis in the other half of the cases? Teetotalers?

Cirrhosis grew stronger

Ancient doctors were convinced that the soul of every living creature lives in the liver, the liver was responsible for the health of the whole organism, and the ancient Roman priests of the haruspica used the liver of sacrificial animals to determine the future

cirrhosis will not die “is only partly true: a teetotaler is not threatened by only one of the main factors in the development of cirrhosis, although ethanol destroys the liver by itself, even the purest and highest quality.The fact is that ethyl alcohol has the ability to activate fibrogenesis in the liver tissues, that is, it is under its influence that the liver cells begin to produce collagen, triggering the processes of necrosis and fibrosis of hepatocytes – replacing the capable liver tissue with completely useless connective or scar tissue. As a result, the liver ceases to be a blood purification factory, and the human body begins to slowly poison itself. But the fact of the matter is that alcoholic cirrhosis is only one of the types of disease, and in total there are about a dozen of them.The causes of cirrhosis can be viral hepatitis, and diseases of the biliary tract, and the action of toxins, and an overdose of drugs, and infectious diseases.

Despite the fact that cases of liver death from alcohol abuse were recorded by doctors in ancient India, and the term “cirrhosis of the liver” (that is, “red liver”) appeared in medicine at the beginning of the 19th century, cirrhosis became a real scourge only in the last three decades. For example, according to the WHO, since 1960, the incidence of chronic hepatitis and cirrhosis has increased 6-8 times, and at the beginning of our millennium, liver diseases moved to 4th place in the ranking of the most deadly diseases, ahead of tuberculosis and coronary heart disease.A particularly difficult situation with cirrhosis has developed in Russia – due to all understandable historical reasons and the pathological attachment of the population to drunkenness. According to estimates of domestic epidemiologists, today in Russia there are several million patients with cirrhosis and chronic viral hepatitis. It is impossible to give more precise figures, since in Russia there is still no systematic registration of patients with viral hepatitis. According to doctors, the emergence of such statistics is hindered by the patients themselves – today the bulk of people with liver problems are not at all chronic alcoholics, but outwardly quite respectable entrepreneurs who survived the “dashing 90s” with crime, drugs, promiscuous sex and unrestrained drunkenness.However, the liver is not an image, and it is not easy to change it. Therefore, today’s respectable businessmen prefer to treat their “mistakes of youth” in complete anonymity.

The avalanche-like growth of hepatitis all over the world can be explained by purely civilizational reasons. As the head of the Russian Federal Center for the Prevention and Control of AIDS Vadim Pokrovsky said at a recent conference of the World Alliance Against Hepatitis, the leading role in the spread of liver diseases in the second half of the 20th century was played primarily by the introduction of injecting drugs, which resulted in the spread of intravenous narcotic drugs. …

In addition, WHO experts talk about the general deterioration of the human environment, which has a detrimental effect on the liver: the air in megacities is saturated with car exhaust, we use more and more household chemicals, drink more and more drugs and lead an increasingly irregular lifestyle. At the same time, doctors state that mankind was not ready for such a state of affairs – we still do not have sufficiently effective and safe drugs to treat liver disease.

Mythic organ

The liver is a mysterious organ. Ancient physicians were convinced that the human soul dwells in it. In some ways, they were right: among the more than 500 functions of the liver, there is also the synthesis of substances associated with human mood. It is known that the use of modern drugs against cirrhosis often causes depression and even nervous disorders, as it inhibits other liver functions.

Unlike all other organs, the liver is capable of regeneration: if 10 percent of the liver remains in the body, it can grow back.This remarkable ability is based on the myth of Prometheus, who overnight grew a liver that had been pecked out the day before.

But without a liver at all, a person cannot live a single day. It is a whole biochemical factory for the production of many essential enzymes, although its main function is still blood purification. Every hour the liver passes through itself more than a hundred liters of blood, carefully choosing from it everything that can harm a person. It is known to be able to deal with many powerful poisons.

If the cleaning function is impaired, the first thing the brain begins to suffer – encephalopathy begins, that is, a complex of neuromuscular disorders caused by severe liver failure. It all starts with a decrease in activity and apathy. Then the patient becomes aggressive and untidy, makes senseless acts. Changes in the hormonal sphere also occur, an excess of estrogen or testosterone deficiency is formed. As a result, men experience gynecomastia (breast enlargement to female sizes) and impotence.However, often patients already do not care what happens to them – due to self-poisoning, confusion of consciousness, muscle cramps, and impaired coordination of movements develop. The last stage is hepatic coma, first with periods of clear consciousness and excitement, then without reflexes and sensitivity to pain, then death.

Of course, not all liver diseases end in death – according to one of the classifications accepted in medicine, cirrhosis can result in death or in a stable state, and sometimes even improvement.But the word “recovery” is absent from this list – alas, changes in liver tissue with advanced cirrhosis are irreversible. Scientists are faced with the fact that the complexity and multifunctionality of the liver tissue does not allow inventing a universal medicine that would simultaneously have a positive effect on all liver functions at once or at least not violate several of them. As a result, if we compare the list of drugs that are used in cardiology and the list of drugs that treat the liver, the second list will be hundreds of times smaller.

However, until recently, many doctors relied on hepatoprotectors – drugs in which the essential phospholipid lecithin was used (for example, the advertised “Essentiale Forte”), that is, the main building material for cell membranes. It was assumed that artificial lecithin could replace natural and start the process of restoration of liver tissue at the cellular level. But later studies debunked the prospects of lecithin – it turned out that only half of the substance administered was absorbed by the body.And in general – it turned out that no phospholipid can work a miracle and restore tissues in which irreversible changes have already occurred.

Nevertheless, recent discoveries in the field of cloning, decoding of the human genome and the properties of so-called stem cells have opened up new perspectives for a long-awaited breakthrough in the study of the liver. Many scientists started talking about the fact that the affected liver does not need to be treated and restored at all, but it is easier to grow a new one – and not in a test tube, but inside an old organ.

Life Pill

The Americans were the first to announce the creation of a cure for liver cirrhosis back in 2001. Then doctors from the University of California at San Diego managed to find the RSK protein, which triggers the formation of fibrosis. It is associated with the work of the so-called stellate cells of the liver: the more such cells, the more connective tissue they produce. Scientists led by Martina Buck have found a substance that would block the action of a harmful protein and destroy the “extra” stellate cells that lead to cirrhosis.The first results were excellent: mice that simultaneously received hepatic toxin, causing the rapid development of cirrhosis, and the drug, cirrhosis did not get sick. True, further experiments revealed too many side effects, so the Americans took time out to improve the drug.

The second discovery was made not so long ago by the Japanese from Sapporo Medical University. With the help of a new substance, scientists for the first time managed not only to stop the formation of scar tissue, but also to truly reverse time – to destroy dead tissue and give the liver a chance to form a new one.

– The liver itself is responsible for the production and accumulation of connective tissue, – said the author of the work Yoshiro Niitsu, – it also creates some enzymes that break down fibrosis. After the elimination of fibrosis, the liver itself begins to repair tissue.

The Japanese drug is currently undergoing preclinical trials.

Another line of liver treatment was presented last year by British scientists at the University of Newcastle. Professor Colin McGucklin announced the receipt of the world’s first artificial liver.Scientists have grown the liver in a test tube from stem cells obtained from the umbilical cord blood of babies. They selected a complex composition of enzymes and hormones that pushed the stem cells to transform into liver cells. As a result, the British received several small, penny-sized pieces of the organ. In the rather distant future, such “patches” will be able to replace areas affected by cirrhosis and thereby save lives.

In light of the above achievements, the discovery of Russian scientists from the Scientific Research Institute of Pharmacology of the Siberian Branch of the Russian Academy of Medical Sciences and the Novosibirsk company “Scientific Futures Management” has no analogues in the world – it is fundamentally different from all previously proposed methods and, at the same time, it is quite realistic in terms of production time.

– The available drugs often turn out to be unable not only to completely restore the state of the organ, but also to prevent the development of the pathological process, – says one of the authors of the development, Gleb Zyuzkov, scientific secretary of the Scientific Research Institute of Pharmacology of the Siberian Branch of the Russian Academy of Medical Sciences. with completely new liver defense mechanisms.

A new substance with the poetic name immobilized hyaluronate-endo -? – N-acetylhexosaminidase (imHEAGA) was obtained as a result of more than 10 years of research.The mechanism of action of the future drug is based on the stimulation of stem cells. It is known that when the liver is damaged, the body tries to restore it precisely with the help of stem cells, which are both in the liver itself and in a kind of “depot” – in the human bone marrow. Stem cells that can transform into any other, if necessary, become hepatic, “patching up” the affected areas. But the more serious the disease, the sooner this process is inhibited and the possibilities for rebirth are depleted.At the Research Institute of Pharmacology, Siberian Branch of the Russian Academy of Medical Sciences, for the first time in the world, the possibility of controlling the functions of stem cells and increasing their reserve has been developed.

– In experiments on animals under the influence of imHEAGA, stem cells of both liver and bone marrow were stimulated, says Gleb Zyuzkov from the Institute of Pharmacology. …

It can be argued that today on the world pharmaceutical market there are no such drugs that can defeat liver cirrhosis.Moreover, even the development of similar drug candidates is not described in the world literature. With a favorable set of circumstances, scientists hope to release the drug in 5-6 years.

Liver is a small life

Since the treatment of cirrhosis is still a matter of the future, the main way to fight liver diseases is still related to their prevention. True, it is one thing when it comes to the stomach or lungs, which react quite quickly to external stimuli, the liver is another thing.The liver is a patient organ. Since there are almost no nerve endings in it, it “tolerates” our destructive behavior for a long time. Outwardly, liver diseases begin in a rather abstract way: a person feels tired, drowsy, irritable, digestion is upset from time to time. Patients often begin to feel the characteristic heaviness or pain in the right side already at a very advanced stage.

The liver is especially hard in the summer, when blows are inflicted on it on several fronts at once.Firstly, many begin to hastily lose weight by summer, shedding the hated kilograms in a short period. During fasting or a rigid diet, a large amount of fat is immediately released into the bloodstream, which passes entirely through the liver. The liver cells cannot cope with so much of this “good” – they become clogged and cease to perform their functions.

Secondly, the Russians’ classic vacation is invariably accompanied by barbecue, that is, a plentiful fatty meal along with spicy sauces and alcohol.The all-inclusive system, so beloved in our country, is especially noticeably undermining the health of the liver.

Both fasting and overeating equally “effectively” lead to the so-called fatty degeneration of the liver – chronic inflammation. Add to this smoking, the load from used repellents from mosquitoes and all sorts of blood-sucking agents that release toxic substances into the blood through the skin, smog from fires, as well as returning to the hot cities, where fumes from asphalt and exhaust from cars in the heat are absorbed by the body much more actively.Not coping with the increased load, the liver becomes sick – inflammation begins, which, if left untreated, develops into serious disorders.

– In recent years, there has been a surge in morbid obesity among the population of industrialized countries and the subsequent increase in the incidence of non-alcoholic liver disease, says hepatologist of the highest category Tatyana Ignatova from the Clinic of Occupational Diseases of the Moscow Medical Academy. Sechenov. – Moreover, the true prevalence of this disease is unknown.

The onset of problems can only be noticed during a preventive examination, that is, a medical examination, which, like everything obligatory, is treated with disdain in post-Soviet countries. According to a recent survey by ROMIR, almost half – 41 percent – of Russian adults have never thought about how their liver works.

Meanwhile, the liver is a grateful organ. If you pay attention to it, at an early stage absolutely all changes are reversible.

90,000 About how to remove fat from the liver, how to prevent the formation of cirrhosis and whether you need to be afraid of viral hepatitis

Department of Science “Newspapers.Ru ”, said Bella Lurie, Candidate of Biological Sciences, a member of the European Association for the Study of the Liver, head of the hepatological center“ Hepatit.ru ”.

Liver in the spotlight

We are constantly being convinced that our liver is in danger and needs to be “protected” daily. They endlessly show stories that poor nutrition, ecology, stress and our whole life are a mortal danger to the liver. The only salvation is to constantly take hepatoprotectors (“help the liver in the morning, afternoon and evening,” etc.).and drink pills that supposedly “cleanse the liver of toxins and toxins.” All this flow of information has nothing to do with scientific data and misleads the consumer with the sole purpose of acquiring and using drugs for life without any good reason.

If the liver is healthy, it does not require any pills. And it doesn’t need to be cleaned in any way. Cleansing the liver is a myth designed for uninitiated consumers of dubious services who do not understand the meaning of the processes taking place in the liver.Indeed, the liver itself performs the function of cleansing the body of toxins that enter it with food or are formed as a result of metabolism. These toxic substances in the liver are rendered harmless by chemical processing. The liver is not a sieve through which toxic substances pass and needs to be cleaned. The liver is a chemical plant, so “liver cleansing” is absolute pseudoscience.

The liver does not need pills if it is healthy.

How the liver is destroyed

But liver diseases do exist, and they are indeed very dangerous and can be life threatening if not treated promptly.Diseases of the liver are always associated with the fact that factors that really destroy it act on it. Such factors are: hepatitis B and C viruses, alcohol, fatty degeneration and rare hereditary diseases.

With all these diseases, the liver loses its unique ability to heal itself (it can be partially cut off, and it will recover completely), and instead of the destroyed liver, another tissue grows (connective or fatty), which does not perform the functions of the liver and differs significantly from it in structure.The liver becomes dense, blood flow is disturbed, which in the outcome of the disease ends with bleeding from the dilated veins of the esophagus, stomach, and so on. The final stage of the disease is cirrhosis and primary liver cancer.

Therefore, any liver disease requires treatment, the purpose of which is primarily to remove the cause of the destruction of the liver and prevent the formation of cirrhosis. This means that different liver diseases are treated differently.

There is no one miracle pill for all liver diseases.
Of the main causes of liver damage, hepatitis B and C viruses are the main and most common worldwide.

The number of people infected with hepatitis B and C reaches hundreds of millions. And the number of cases in the world is constantly increasing.

It is easy to get infected with hepatitis C and B viruses, for example, at the dentist, on a manicure, during operations, tattooing, etc. Any intervention that involves contact with blood can lead to infection with hepatitis B and C viruses.The hepatitis B virus is transmitted sexually, as well as from mother to child during pregnancy, in contrast to the hepatitis C virus. Viruses are not transmitted by the household route.

Given the ease with which viruses become infected, we are all at risk.

How to defeat viral hepatitis C

The incredible achievements of medical science allowed us to declare viral hepatitis C a curable disease! There are modern highly effective direct-acting antiviral drugs that are comfortable to use and do not have side effects that worsen the quality of life during treatment.However, these drugs require mandatory prescription by a doctor and proper control during treatment, since, in addition to direct action on the virus, they can interfere with very important metabolic processes.
Recovery from hepatitis C virus treatment does not occur in 100% of cases. The result largely depends on how early the patient consults the doctor. This means that it is necessary to regularly check for the hepatitis C virus.

Why you need to get vaccinated against hepatitis B

As for hepatitis B, it is a more contagious and dangerous viral disease.Unlike hepatitis C, hepatitis B is an incurable but controllable disease. This means that the only goal of hepatitis B treatment is to keep the liver healthy, in which the virus will remain. However, this virus should not be active and be a threat to the formation of cirrhosis.

In some cases, it is necessary to prescribe antiviral drugs, which, although they cannot completely kill the virus, make it inactive and harmless.

A huge achievement is the availability of vaccination against hepatitis B, which has been done all over the world for more than 30 years, and in Russia – for about 20 years, for all newborns on the first day after birth.This vaccination protects against the virus for 5–8 years, and then revaccination is required. Unfortunately, only small children are protected by the law, the rest must independently take care of their health and regularly vaccinate themselves and their children.

“Changes come overnight”

All the changes that viruses cause in the liver in hepatitis B and C are not manifested in any way. Because viruses are very small and the liver is very large. And while the processes are going on, a person can feel good, look good.He may even have good tests. Changes come suddenly, suddenly, immediately. The general state of health worsens, weakness appears, yellowness of the skin, itching, fluid may appear in the abdominal cavity. From this point on, unfortunately, nothing can be helped, except for supportive symptomatic therapy. That is why it is so important to be examined regularly and consult a doctor in a timely manner.

Viral hepatitis is not a disaster if you consult a doctor in a timely manner.

Another very important and widespread disease that is epidemic in nature is fatty hepatosis.Now every fourth in the world is affected by this disease. The disease consists in the fact that due to hormonal and metabolic disorders in the body, fat begins to be deposited in the internal organs – in the liver, kidneys, heart and blood vessels, pancreas. The consequence of this is liver damage up to cirrhosis, diabetes mellitus, cardiovascular diseases and their complications – heart attack and stroke.

“The button is turned on, which” removes “the person”

Many people associate the cause of fatty hepatosis with an improper lifestyle – diet and physical activity.This is an important side of the pathological process, but not the only one. The main cause of the disease is metabolic syndrome. This is a complex of metabolic and hormonal changes in the body, which, as a rule, occur in connection with age-related changes. Although recently it has often been observed in fairly young people.

Under the influence of external, unknown circumstances or as a result of age-related, genetically programmed processes, “a conditional biochemical button is turned on.”It triggers a number of pathological metabolic and hormonal processes that cause deadly diseases.
Complications in the form of heart attack and stroke, diabetes mellitus, cirrhosis are a threat to life.
There is only one way to treat fatty hepatosis: by removing the cause – metabolic disorders. The cause of fatty hepatosis is treated by an endocrinologist. The meaning of the treatment is that it is necessary to restore the disturbed metabolic parameters with special drugs.However, medications alone will not help. An obligatory part of the treatment is proper nutrition (for life, not in the “diet” mode) and physical activity. It is physical activity that restores in the body those important processes that are disturbed.

How to remove fat from the liver

Removing fat from the liver requires the efforts of two doctors – an endocrinologist, who treats the cause of the disease, and a hepatologist, who treats the consequence of the disease. It is possible to remove fat from the liver, as well as from other internal organs, only with appropriate medications.

It is important to understand that fatty hepatosis is internal obesity. Almost always, this disease is accompanied by external obesity, overweight. As a result of successful treatment, we get not only a healthy liver, but also a decrease in body weight. External changes in patients in the treatment of metabolic syndrome always attract attention, although they are not the direct task of treatment. The result of the treatment of fatty hepatosis is not only the restoration of normal liver function, but also the normalization of life-threatening processes.

The real result of the treatment of metabolic syndrome is an increase in the duration and quality of life.

Any serious liver disease can be treated or controlled and is not fatal if you see a specialist in a timely manner.

Hepatitis C: ru

Hepatitis C is an infectious liver disease caused by a virus. Anyone can develop hepatitis C virus infection and is more common in younger people.The incidence of hepatitis C is increasing.

The hepatitis C virus is predominantly transmitted through blood. Most cases of hepatitis C develop imperceptibly and become chronic with a long-term course without symptoms. Chronic hepatitis C responds well to new drugs. There is no current vaccine to prevent hepatitis C yet, but infection can be avoided.

The probability of being ill with hepatitis C in an acute form and recovering is, according to various sources, up to 10-30%.Acute hepatitis C is practically not diagnosed and in most cases becomes chronic.

Chronic hepatitis C does not go away on its own and requires treatment.

Infection, as a rule, will lead to the development of chronic hepatitis C. In most cases, the course of chronic hepatitis C is benign: in the form of carriage without symptoms, or mild hepatitis. However, in this case, a person needs a doctor’s supervision.

This is necessary because the risk of disease activation (and the development of dangerous outcomes) persists all this time.If chronic hepatitis C proceeds with significant changes in liver function tests, then such patients need antiviral therapy, since they have a high risk of developing liver cirrhosis.

The transition from acute to chronic hepatitis C occurs gradually and does not depend on the degree of manifestation of the acute phase. Over the course of several years, damage to liver cells increases, and fibrosis develops. In this case, liver function can be preserved for a long time.

The disease progresses slowly and this is a problem of unfavorable outcomes of hepatitis C in the future.In patients with active hepatitis, i.e. with constantly increased activity of transaminases, the risk of transformation into cirrhosis within 20 years reaches 20%. 5% of patients with cirrhosis may develop primary liver cancer.
The likelihood of developing liver cancer is higher with the simultaneous course of two infections – hepatitis B and hepatitis C. Long-term alcohol use is also associated with a higher risk of liver cancer.

When pregnant, infected women usually carry a pregnancy normally.Most babies are born healthy, although there is a risk of vertical transmission of hepatitis C from the mother to them.

Hepatitis C can be acute or chronic. There are three scenarios – variants of events occurring after acute hepatitis C:

• recovery within 6-12 months with the disappearance of hepatitis C markers. This is about 20% of those infected.
• the transition of infection to the so-called carrier of the hepatitis C virus, when the symptoms and laboratory signs of liver disease go away, and tests show the presence of the virus in the blood (persistence).Such cases (up to 20%) can be detected for the first time during “non-special”, “random” examination. The incidence of adverse outcomes in this variant of the course of hepatitis C has not been fully established. Even in the absence of laboratory evidence of liver damage, hepatitis C can progress.
• development of chronic hepatitis with any clinical and laboratory manifestations of liver damage. This is up to 60-70% of all people who have had acute hepatitis.

General hepatitis C outcome statistics are as follows.For every 100 people infected with the hepatitis C virus,

• 55-85 people will have a chronic infection (chronic hepatitis or carriage without symptoms)
• 5-20 people will develop cirrhosis of the liver within 20-30 years
• 1-5 people will die from the consequences of chronic hepatitis C (cirrhosis or liver cancer)

To prevent these consequences of chronic hepatitis C, it is necessary to undergo treatment.

There is a risk of dying from HCV-associated cirrhosis.More often these are patients with hepatitis C who consume alcohol. The ten-year survival rate for patients with liver cirrhosis is about 50%. This means that half of the patients die within 10 years.

Liver problems and being overweight

Liver problems can be associated with being overweight. Non-alcoholic fatty disease
(NAFLD) or fatty hepatosis (steatosis) is one of the most common liver diseases ¹ ,
which develops due to excessive accumulation of fat in the liver cells.NAFLD
refers to diseases associated with obesity and is observed in 4 out of 5 patients
obese ¹ .

In case of further progression of the disease, the connective tissue invades almost the entire organ, which makes it insufficiently efficient. This condition is called cirrhosis.

Symptoms of steatosis are nonspecific (most often there is weakness, fatigue, there may be discomfort or heaviness in the right hypochondrium, changes in appetite ² ). In some patients, the disease can be practically asymptomatic.

Diagnosis of steatosis is based on the data of the clinical picture, the results of laboratory and instrumental studies.

Also, with non-alcoholic fatty liver disease, there may be an increase in the activity of alkaline phosphatase (ALP) and gamma glutamyl transpeptidase (GGTP). ²
Treatment of fatty hepatosis associated with obesity necessarily includes recommendations for lifestyle changes ³ . Particular attention is paid to a diet with a gradual transition to proper nutrition and the formation of a balanced diet.In addition, dosed physical activity is prescribed, starting with walking, swimming and physiotherapy exercises.

One of the alleged reasons is that with severe dietary restrictions, the mobilization of its own fat from other tissues occurs, a large flow of released fatty acids enters the liver for processing, and the liver does not have time to process them, therefore fatty drops appear in the cells. The condition can be aggravated in the case of the addition of inflammation and the development of steatohepatitis.
Therefore, it is recommended to reduce body weight gradually (no more than 0.5-1 kg per week), slowly, so as not to harm the liver and the whole body ⁵ .

Benefits of losing weight
At the same time, gradual and smooth weight loss is a fairly effective method of preventing and treating NAFLD. This approach contributes to the positive dynamics of laboratory parameters, and even improves the histological picture of the liver ⁴ .

Lifestyle changes and treatment of fatty hepatosis

General dietary recommendations:

The optimal level of dynamic physical activity for this patient is also recommended: walking at an average pace, swimming, cycling ⁵ .

It is possible to connect NAFLD medication. For this purpose, drugs based on essential phospholipids can be used, which, by incorporating into the membrane of liver cells, help to restore them, strengthen them due to energetically “charged” polyunsaturated bonds, and protect them from free radicals. In addition, such agents prevent inflammation and help to reduce the level of fat load in the liver ^5.6 .

One way or another, despite the existing wave of “body positivity”, which was originally intended to protect the offensive and negative attitude towards overweight people, we must admit that obesity is not just a matter of aesthetics and beauty, but a medical condition indicative of metabolic distress …Ultimately, such changes have negative consequences for the whole organism. We urge you not to ignore this problem and take care of your health, not postponing “until later.” A doctor will always help you to understand all medical issues.

Date of publication of the material: November 17, 2020

MAT-RU-2003445-1.00-11 / 2020

Cirrhosis of the liver – symptoms, signs, treatment, causes, nutrition and stages

Table of Contents

Cirrhosis of the liver is a serious chronic disease. According to statistics, in developed countries it is one of the six leading causes of death for people aged 35 to 60 years. In the United States, about 50,000 people die from it every year. In Russia, where the population is half the size, the death rate from cirrhosis is comparable to that of the United States. *

This disease is an extensive liver damage in which the tissues of the organ die and are gradually replaced by fibrous (connective) fibers. In the process of replacement, the structure of the organ changes radically.Violation of the normal structure of the liver leads to the fact that it can no longer perform its functions. This is called liver failure.

Classification

Specialists distinguish several types of cirrhosis of the liver. For the reasons that led to the development of the disease, the following variants can be determined:

• Viral – caused, for example, by hepatitis C and various biliary tract infections
• Toxic – caused by the use of alcohol, certain medications, food poisons and other substances that have a toxic effect on the body
• Congenital – represents the consequences of some diseases that the patient’s parents suffered, for example, hemochromatosis or tyrosinosis
• Stagnant – its origin is associated with circulatory failure
• Exchange-alimentary – develops due to obesity, as well as in severe forms of diabetes mellitus

Separately, mention should be made of the group of liver cirrhosis of unclear etiology.We are talking about those cases when it is not possible to clearly determine the cause of the disease.

Causes

From the above, it can be seen that the onset and development of liver cirrhosis is due to many reasons. Alcohol abuse is the most common cause of illness in people. According to various estimates, this reason accounts for 40-50 to 70-80% of cases. *

The next most common factor influencing the onset and development of cirrhosis is the effect of viruses.In most cases, this is hepatitis C, as well as hepatitis B.

In addition, cirrhosis is caused by:

• Biliary tract diseases
• Various intoxications – for example, chemical or medicinal
• Unhealthy diet – first of all, chronic deficiency of vitamins and proteins in the diet

Cirrhosis caused by hereditary diseases is relatively rare. The same can be said about the aforementioned disease of unclear etiology, when it is not possible to determine the causes of its appearance.

In about 50% of patients, liver problems are caused by a combination of factors. For example, doctors often find cirrhosis caused by both heavy drinking and hepatitis B.

The main peak of incidence falls on the age group over 40 years old. Approximately 70-75% of those who suffer from cirrhosis of the liver are men.

The first signs and degrees of cirrhosis in adults

The first sign that a person is not doing well with the liver is asthenovegetative syndrome.At the same time, the patient constantly feels tired, although there is no reason for this. He feels weak, becomes irritable and reacts sharply to completely innocent words or actions. He often has a headache.

Then there is the so-called. dyspeptic complex of syndromes. It includes:

• Nausea, which sometimes develops into vomiting
• Belching
• Alternating diarrhea and constipation
• Pain in the abdomen, aggravated by eating fried, pickled and fatty foods, as well as by drinking alcohol
• Reluctance to eat, up to a complete lack of appetite for a long time
• Severity in the stomach
• Bloating

All of the above may indicate other diseases.Therefore, at this stage, it is far from always possible to clearly diagnose liver cirrhosis. Moreover, in about 20% of people suffering from it, it is possible to determine the true cause of the problem only after death.

Three stages of the disease are distinguished according to the severity

• Initial – symptoms either do not appear at all or are minimal
• Clinical – the symptoms are pronounced, and the doctor, when examining the patient, observes a typical picture of the disease
• Terminal – irreversible changes are detected, which leads to death

Symptoms of liver cirrhosis

Approximately 60% of patients show symptoms of liver cirrhosis quite prominently.The specific picture largely depends on the stage at which the disease is. But there are signs that are especially common.

The initial stage in most cases is not accompanied by biochemical disorders. But the disease progresses, and at the second stage, the so-called. hemorrhagic syndrome.

The main signs of hemorrhagic syndrome are:

• Bleeding from gums and nose
• In women – uterine bleeding
• Hematomas (bruises) on the body, appearing for unknown reasons
• Stomach and intestinal bleeding
• Ecchymosis – punctate subcutaneous hemorrhages that look like a rash

In this case, the patient increasingly feels weakness.Irritability is gradually replaced by apathy and indifference, memory and attention disorders appear. Sleep problems are possible: the patient suffers from insomnia at night and drowsiness during the day. Over time, coordination of movements is impaired, the patient experiences problems with writing, his speech becomes less and less legible.

When examining a patient , the doctor may visually detect the following symptoms:

• Liver and spleen enlarged
• There are dilated veins and spider veins on the anterior wall of the abdominal cavity
• Skin, mucous membranes and whites of the eyes turned yellow

Complications

Cirrhosis of the liver can lead to various complications. This can be, for example, bleeding from varicose veins of the esophagus or pneumonia, peritonitis and other complications caused by infections. The following negative consequences often occur:

• Hepatic coma – a disorder of the functions of the central nervous system, which manifests itself in a sharp decrease in the size of the liver, increasing drowsiness, disorientation, slowing down of thought processes and, ultimately, in the fact that the patient falls into a stupor, and then into a coma
• Thrombosis in the portal vein system – thrombi (blood clots) impede free blood flow in the liver, which leads to cell death
• Hepatorenal syndrome – leads to impaired renal function, especially often occurs in those who suffer from acute liver failure or alcoholic cirrhosis
• Liver cancer or hepatocellular carcinoma is a rapidly developing malignant tumor that is often associated with hepatitis C and hepatitis D

Cirrhosis of the liver is itself a dangerous disease.But when complications arise, the risk of death increases significantly. So, with hepatorenal syndrome, if you do not start treating it on time, death occurs 10-14 days after the development of this complication.

Diagnostics

Experts recommend to see a GP as soon as you think you have signs of liver cirrhosis. The doctor will refer the patient to laboratory tests. When he has the test results in his hands, he will send the patient to a gastroenterologist or immediately to a doctor specializing in liver diseases – a hepatologist.In some cases, for example, if signs of hepatic encephalopathy are detected, you will need to visit a neurologist. Also, when making a diagnosis, the following data are taken into account:

• History
• Visual inspection
• Instrumental diagnostics

The main laboratory tests , which are carried out with suspected liver cirrhosis, are:

• Liver complex for biochemical studies – it shows how well the liver performs its functions, and helps to find out if its activity is not impaired
• Complete blood count – it is done because signs of cirrhosis can be a decrease in the number of leukocytes and erythrocytes, as well as a noticeable decrease in hemoglobin levels
• Coagulogram – it needs to be done to find out if there are problems with blood clotting
• Fecal occult blood test helps to identify occult bleeding in the stomach and / or intestines
• Serological markers of viral hepatitis are used to clarify factors that could lead to the development of the disease
• Blood alpha-fetoprotein test should be done if liver cancer is suspected
• The level of creatinine, electrolytes must be established to determine renal failure

Treatment of liver cirrhosis

If a patient is diagnosed with liver cirrhosis , treatment can be done in different ways.The choice of a specific tactic is largely determined by the stage at which the disease is located and the reasons for which it arose. Also, experts take into account the individual characteristics of the patient. However, it is impossible to cure already formed cirrhosis. Modern medicine allows only to cope with the reasons due to which it arose.

Radical treatment for cirrhosis – transplantation of the affected organ. It is used if there is an immediate threat to the patient’s life.In all other cases, medical methods are used. As a rule, the patient should adhere to a strict diet, and in case of alcoholic cirrhosis, the intake of alcohol into the body should be eliminated. The choice of medicines depends on what type of cirrhosis doctors have to deal with. For example:

• Antiviral agents are used for viral hepatitis, in particular, pegylated interferons
• For biliary cirrhosis associated with a deficiency of bile acids in the intestine, medications are used to narrow the biliary tract
• For autoimmune hepatitis, drugs that suppress the immune system (immunosuppressants) may help

Nutrition and diet for cirrhosis

Diet in the treatment of cirrhosis is extremely important.Proper nutrition is both an excellent option for preventing a disease, and a way to eliminate the causes that led to its occurrence. If there are no complications, the patient is prescribed a full, high-calorie diet. It necessarily contains proteins, fats and carbohydrates. However, it is necessary to exclude from the diet everything that irritates the digestive organs. First of all, these are:

• Alcohol
• Chemical additives
• Preservatives

With cirrhosis, should be abandoned from the use of products that are:

• Sharp
• Sour
• Spicy
• Too salty

The diet should be prescribed by a specialist , who takes into account:

• Patient’s eating habits
• Individual product tolerance
• Already existing diseases of the digestive system

The diet is modified if there are any complications of cirrhosis or other diseases.

To normalize metabolic processes in liver cells, the doctor may prescribe a vitamin complex. As for any drugs, they must be used with caution. It is worth drinking only those tablets that are prescribed by specialists and for the use of which there are clear and unambiguous indications.

Advantages of the procedure in MEDSI

Treatment of liver cirrhosis is an important area of ​​activity of the MEDSI clinic.We use effective modern techniques to eliminate the causes that influenced the onset of this disease and to make the patient’s daily life more comfortable. Our clinic employs a team of international doctors. She has a comprehensive approach to solving each specific problem. An individual approach is guaranteed to any patient: the doctor selects an examination plan, which is based on genetic factors, risk factors, concomitant pathologies, drugs taken.

Communication with doctors starts with a diagnosis. Experienced specialists, who have the necessary laboratory equipment at their disposal, will perform the tests and study their results. Fast and accurate diagnosis is ensured by the latest generation of diagnostic equipment: magnetic resonance imaging, computed tomography, video colonoscope, etc.

The specialists of our clinic use state-of-the-art techniques – fast path surgery and minimally invasive treatment.We have operating rooms equipped with the necessary modern equipment. Also we have:

• Reanimation and intensive care unit
• Comfortable hospital with 3 meals a day, round-the-clock medical monitoring, single and double wards of the “Lux” class, toilet and shower rooms

Remember: cirrhosis is an extremely dangerous disease, and the sooner we start treatment, the more likely it is that the threat to the body will be significantly reduced.The staff of the MEDSI clinic are ready to answer your questions and provide the necessary consultations.

You can sign up for a consultation with a specialist around the clock. Call us at +7 (495) 7-800-500.

* Sadovnikova I. I. Liver cirrhosis. Issues of etiology, pathogenesis, clinical picture, diagnosis, treatment / Appendix of breast cancer “Diseases of the Digestive System” No. 2 of 04.11.2003

90,000 The CrimeRussia: Power structures: Lenta.ru

25 years ago, on October 6, 1991, the famous singer Igor Talkov was shot dead at a concert in St. Petersburg.This crime is considered to this day the loudest in the history of Russian show business, and the course of its investigation raises many questions: despite the fact that at the time of Talkov’s death there were only a few people with him, the investigators could not solve the case and expose the murderer … The history of this crime was recalled by “Lenta.ru”.

This text from the “Lenta.ru” cycle about crimes that puzzled the country’s best investigators and remained unsolved for decades, was first published on March 21.It is now being republished. Read the rest of the texts from the cycle here.

Igor Talkov’s childhood passed in the Tula region. The parents of the future musician (his father belonged to an old noble family) at one time fell into the millstones of Stalin’s repressions and met in the village of Orlovo-Rozovo, Kemerovo region, where both served time and played in an amateur theater of the local GULAG.

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After their release, they tried to return to Moscow, but the former political prisoners were denied housing, and the couple settled in the village of Gretsovka, Tula Region.Igor was born there on November 4, 1956.

The boy showed love for music since childhood – in addition to the usual school, he attended a music school, learned to play the button accordion. Igor definitely had abilities: having mastered the button accordion, he himself learned to play the piano, guitar and mastered the drum kit.

In high school Talkov founded his first musical group, called “Guitarists” (according to other sources – “Past and Thoughts”). At the same time he began to write songs – his debut works were the compositions “Soul” and “I’m not sorry”.

Another passion of Talkov was theater: although he was embarrassed to go on stage in a school drama club and only watched performances, he still dreamed of becoming an actor. Having received a certificate, Igor did not study for a long time at a local school as a locksmith, but dropped out and went to Moscow. There he tried to enter the theater institute, but failed the examination in literature.

After the failure with the theater institute, Talkov tried to study at the pedagogical and at the institute of culture, but in the end he dropped out of both educational institutions.For some time he was a member of the musical group “Fanta”, and besides music he was also fond of political activities, sympathizing with the dissident movement.

In 1975, on Tverskaya Square, Talkov made an accusatory speech against the political leadership of the USSR. It was an equally bold and reckless move. In those years, the authorities reacted extremely painfully to any criticism. Igor escaped criminal prosecution by going to the army. In the understanding of the punitive authorities, the educational impact of the army service was comparable to that of a colony, and in many respects they were right.

Talkov served in the engineering troops, where he finally decided to devote his life to music and created the Zvezdochka group.

After demobilization, Talkov went to Sochi, where he joined the musical group of Alexander Barykin. But he had to perform mainly in restaurants, and such “creativity”, despite a good income, sickened Talkov. Having thrown everything, the singer returned to Moscow.

For some time he performed with different groups, but his performance at the Song of the Year festival with the song Chistye Prudy in 1987 made him famous.Soon Talkov formed his own collective “Lifebuoy”, with which he went on a tour of the USSR.

A little later, a video was shot for the song “Russia”, which secured the status of a star to the musician

With the beginning of active concert activity, Talkov’s life became more conflict situations. In most cases, these were working moments related to the organization of performances, but in early October 1991, Talkov’s wife Tatyana witnessed two strange telephone conversations between her husband.In the first Igor asked: “Are you threatening me? Are you declaring a fight to me? Okay, I accept it. ” In the second, he dropped a cryptic phrase: “Are you bothering me again? There is nothing left to live ”. However, Talkov refused to answer the question of his wife who called him.

Igor Talkov and his concert director Valery Shlyafman, October 6, 1991

Shot: Pavel Grigoriev / YouTube

On October 6, 1991, a star concert was held at the Yubileiny Sports Palace in St. Petersburg, in which most of the popular performers took part …Talkov was among the speakers – according to the plan, he went on stage at 16:20, before the closing event, Oleg Gazmanov.

And singer Aziza was supposed to perform in front of Talkov. But then her lover, 28-year-old Igor Malakhov, decided to intervene in the matter. According to some sources, he wanted to knock out a more honorable place for his lady of the heart – closer to the final of the concert, changing the order of her performance with Talkov.

Igor Malakhov

Shot: Mikhail Nikolaev / YouTube

However, according to Aziza, no one changed the order on purpose, but she arrived at Yubileiny late and simply did not have time to prepare to go on stage.Trying to change the queue, Malakhov turned to a radio engineer, who sent him to negotiate with Talkov’s representatives in his dressing room.

The singer was preparing to perform in the dressing room when Malakhov knocked on him with an offer to perform before Aziza

Talkov took the news calmly, but the director of the singer Valery Shlyafman, who joined the group at the end of the summer of 1991, was outraged.

By the way, by that time Valery had already taken on the role of a brawler – some members of the Lifebuoy group noted that with the arrival of a new director on tour, petty quarrels and skirmishes became more frequent.According to Shlyafman, Malakhov immediately began to be rude to him.

In response, he told me this – literally: “Listen, Vasya, so that there is no disastrous outcome, do as I said. I am a big businessman in the shadow economy, so do what I say. ”

Valery Shlyafman

Then two bodyguards of the singer joined in, one of whom tried to hit Malakhov in the groin. But he – a seasoned kickboxer – got away from the blow, after which the opponents went out into the corridor. Having exchanged a couple of phrases with the guard, Malakhov was about to leave, but then Shlyafman caught up with him.

Director Talkov began to tease Malakhov, hinting at his cowardice. He immediately took out his revolver, which, as it turned out later, had three cartridges. Shlyafman, who was watching this, rushed back to the singer with a shout: “Igor, give me something – he got a gun!”

Talkov pulled out his gas pistol – he had acquired a weapon at the beginning of the year for his wife, but suddenly decided to take it with him to a performance at Yubileiny. Then the singer, accompanied by bodyguards, left the dressing room and fired a couple of shots towards Malakhov.

But due to the long distance and low-quality cartridges, this did not cause any harm to the opponent

According to other sources, Talkov did not shoot at all, but began to beat Malakhov, who was twisted by his bodyguards with the handle of a gas pistol, on the head.

Clamped on both sides on the floor, Malakhov managed to pull the trigger of the revolver twice, one bullet hit the floor, the other – into the box with the equipment. Aziza ran to the noise: despite the fact that the singer was pregnant, she rushed to protect Malakhov and threw her jacket over his head.

Aziza

Photo: Natalya Loginova / Kommersant

Soon after that, a fatal shot rang out in the direction of Talkov – before that, eyewitnesses heard the sounds of several misfires. According to witnesses, Igor said “How painful!”, Took a couple of steps and slid to the floor on the mirror hanging on the wall.

I ran up to him in the first minute and realized that life was slowly leaving him. Because a warm hand gradually turned cold

Olga Antipova

Administrator of the Yubileiny Sports Center

Bleeding Talkov was transferred to the dressing room, where a nurse from the Yubileiny first-aid post came running.She injected the singer with several drugs, and the artists who ran to the noise called an ambulance. 12 minutes after arriving at the scene, the doctors ascertained the death of Talkov – the bullet passed through the wrist (the singer instinctively tried to protect himself from the shot) and hit the heart area.

According to some reports, a few minutes before the ambulance arrived, two guys approached Talkov, who introduced themselves as students of a medical university. They began to give the singer a heart massage, which was unacceptable with such a wound – the bullet from their actions entered even deeper into the tissues.

After the fatal shot, the concert was interrupted, and the presenter turned to the audience.

Stop music! Now, please, a minute of silence. All militia in the hall should be urgently cordoned off the recreation center “Yubileiny”, as they just shot at Igor Talkov. Backstage there was a shot at Igor Talkov. If there are emergency doctors or any doctor in the hall, please come to me here on stage. Urgently!

presenter of the recreation center “Yubileiny”

Fearing unrest, the doctors did not say that the patient could not be helped, they put Talkov’s body on a gurney, put on an oxygen mask and took him away in an ambulance car.In hospital No. 10, the body was first taken to the intensive care unit, and then taken to the morgue.

Igor Talkov’s body is being taken to an ambulance

Shot: film “Don’t Execute My Murderer … History of the Death Penalty in Russia”

Farewell to the singer took place on October 9 at the Moscow Youth Palace, Talkov was buried at the Vagankovskoye cemetery. Malakhov was the first to be suspected of murdering the singer, against whom Shlyafman actively testified.

The lying Malakhov, twisting himself out, raising his hand with a pistol, fired one or two shots at point-blank range at Talkov, while he was standing nearby.Talkov somehow bounced against the wall

from the protocol of interrogation of Valery Shlyafman

But the investigators did not succeed in arresting the suspect right away: he escaped from Yubileiny before the arrival of a police squad. By the way, the police did not find the revolver from which Talkov was killed. According to Aziza’s recollections, when she got to her feet, she noticed that Shlyafman rushed into the dressing room.

The singer followed him and saw how Valery threw a revolver into the toilet tank to hide it

But Shlyafman claimed that he put the pistol on the tank, and the singer took it and handed it to her director, who handed the weapon to Malakhov.

According to this version, he got rid of an important piece of evidence – he disassembled the revolver and threw its parts into the Fontanka, Moika and Neva. On October 10, Malakhov was declared on the all-Union wanted list, but six days later he himself came to Petrovka, 38. The suspect did not deny that he had brought a revolver to the concert hall, but did not admit his guilt in the murder of Talkov.

Revolver of the Nagant system

Photo: Public Domain / Wikimedia

After interrogating Malakhov, they released him on recognizance not to leave.After a series of examinations and interrogations of witnesses, the detectives were forced to admit that Malakhov was telling the truth and had no direct relation to the death of the singer. By the way, situational expertise played a big role in this.

She testified that Talkov was shot from a standing position, and Malakhov was lying on the floor at the time of the shot

Nevertheless, the owner of the revolver was punished for illegal carrying of weapons: in May 1994, the district court sentenced him to 2.5 years in prison conditionally.

In 1998, Malakhov changed his last name to Rus, sold his Moscow apartment and for almost 20 years lived as a hermit in a small forest house in the Moscow region. He died in 2016: due to cirrhosis of the liver and diabetes, Igor was practically immobilized, but until the end of his life he continued to write songs, poems and books for children.

The next suspect was Valery Shlyafman. However, when the investigation became closely interested in him, he had already emigrated through Ukraine to Israel. After a while, he changed his last name, became Valery Vysotsky and got a job as a manager at a travel agency.

During a search in the Moscow apartment of the director’s common-law wife, a shirt was found in which he was wearing on the day of the crime.

Traces of gunpowder and drops of blood belonging to Igor Talkov were found on his clothes. Soon, investigators charged Shlyafman in absentia with causing death by negligence.

They tried to get their Israeli colleagues to cooperate in the investigation. An investigator from St. Petersburg even specially flew to the city of Ramat Gan, but he was not allowed to interrogate Shlyafman.

At the Israeli consulate, I asked for assistance in transporting this person and conducting the interrogation. To which I was told: if you want to violate the law of the State of Israel, you will be prosecuted. They say that law enforcement officers of other states cannot act on the territory of Israel

Oleg Blinov

Investigator in the case of Igor Talkov

Moreover, Israeli law enforcement officers considered that the evidence collected in Russia against Shlyafman was not enough for extradition.Valery denied that he had fled to Israel in order to escape criminal prosecution: according to him, he did not keep secrets from his departure and even warned Talkov’s widow about it.

Yubileiny Sports Palace (St. Petersburg), where Igor Talkov was killed

Photo: Public Domain / Wikimedia

A few years later, Shlyafman received a paper from Russia, according to which the investigation was terminated due to the expiration of the statute of limitations. However, he did not sign the document – he wanted to be found innocent.At the same time, he stubbornly called Igor Malakhov guilty of the crime.

For me, the culprit was found on the day the tragedy occurred. But the evidence has disappeared, so today it is unrealistic to find the killer. And it was like this: Malakhov was beaten on the back of the head, he automatically reached for the pistol and fired

Valery Shlyafman

Producer Mark Rudinstein also adhered to a different version – about premeditated murder: according to him, businessman Ismail Tagi-Zade was involved in the death of Talkov.He produced the film “Prince Silver”, where Talkov starred.

On the set, the producer and the actor had a conflict – according to some sources, the producer insulted Talkov’s wife. According to other information, after the change of director, the genre of the film changed, with which Talkov did not agree. After that, Igor refused to voice his role.

At the Moscow premiere of the film Talkov went on stage and, falling to his knees, addressed the audience. This is how Mark Rudinstein wrote about it in his book “Gangster” Kinotavr “”.

I have two requests for you. First, forgive me for taking part in this anti-Russian, anti-Orthodox, blasphemous movie. Secondly, do not watch this movie

Igor Talkov

After that, Tagi-Zade allegedly harbored a grudge and decided to liquidate Talkov, ordering him to Malakhov, a member of one of the organized criminal groups (OPG). There was also such a version: taking advantage of the turmoil, the singer was shot by a sniper hiding behind the scenes.

However, not only individuals, but also entire structures were suspected of involvement in the murder of Talkov at various times.For example, one of the nationalist organizations was associated with the crime: there was a version that its participants decided to eliminate the singer in order to then create from him the image of a patriot who suffered for the truth.

They associated with the murder of Talkov and the KGB: allegedly dissatisfied with his anti-Soviet creativity, the KGB decided to eliminate the “enemy of the state” by order of the country’s leadership. Talkov himself spoke about the intrigues of the Communist Party.

Communists have been approaching me for a long time to find my Achilles’ heel, to somehow discredit me.And cut off my tours, because I gathered large audiences … They [the communists] had to somehow hook me up a little bit

Igor Talkov

In November 2018, Talkov’s wife appealed to the investigating authorities with a request to recognize her as a victim and resume the investigation, which was soon done. However, this time the matter reached a dead end: it was still impossible to interrogate Shlyafman.

The Talkov family’s lawyer insisted that the case be brought to court in any case, and the director’s actions be re-qualified to paragraphs “e” and “i” of part 2 of Article 105 of the Criminal Code (“Murder out of hooligan motives, committed in a generally dangerous way”).But progress in this matter has not yet been achieved.

My conscience is clear. I sincerely worried and am still experiencing this story. As Joseph Kobzon said about her, “two people were killed with one bullet.” They killed Igor and wounded me very badly: conclusions, conversations, discussions

If you have witnessed an important event or you have news for the “Power structures” department, write here: [email protected]

The effect of alcohol on the human body

ABSTRACT

On the topic: “The effect of alcohol on the human body”

Completed by:

Nefedova Elena

Ulyanovsk

Contents

Introduction

.The effect of alcohol on the cardiovascular system

. Nervous system and alcohol

. The effect of alcohol on the digestive tract and liver

. The influence of alcohol on the reproductive system

. The effect of alcohol on mental and mental brain activity

Conclusion

References

Introduction

Prolonged use of alcoholic beverages inevitably leads to the development of chronic alcoholism.Its clinical picture may vary, but all drinkers have one thing in common: they are constantly looking for a reason to drink, if not, they just drink. But the higher the concentration of alcohol in the blood, the more harm it causes to the body. This scientifically proven fact explains the detrimental effect of strong alcoholic beverages on the progress of alcoholism. Excessive alcohol consumption is a scourge of modern society, closely linked with another global problem – chronic fatigue. Anyone who does not find the strength to overcome the addiction to alcohol will sooner or later be doomed, because the body of a drinking person wears out many times faster.Alcohol affects all organs and systems without exception, weakens the immune system and activates disease-causing processes.

In all fairness, it should be noted that alcohol is not always a poison. Under certain conditions and in small doses, alcohol can also benefit the body. This fact has been proven by many studies. For example, red wine helps to improve metabolism and eliminate toxins from the body, and also serves as an excellent prevention of atherosclerosis.Small amounts of champagne and white wine strengthen the heart. Mulled wine is drunk for colds and respiratory diseases. Drinking beer can protect the body from problems with the cardiovascular system, Alzheimer’s and Parkinson’s, cancer, and even slow down the aging process.

And even vodka can come in handy – it reduces cholesterol. Empirically, the norm was established, within the framework of which one can consume alcohol without much harm to oneself.For women, it is 10 ml of pure alcohol, for men – twice as much. For example, 20 ml of alcohol is contained in 30 ml of vodka, 100 ml of wine and 300 ml of beer.

And now let’s look at how alcohol affects the body of people who drink “in moderation and only on holidays” and those with chronic alcoholism.

alcoholism mental alcoholic liver

1. The influence of alcohol on the cardiovascular system

Once in our body, alcohol enters the bloodstream through the walls of the stomach and intestines.What happens to her cells?

In the normal state, erythrocytes are covered with a thin protective shell, which helps to repel them from each other due to the ability to electrify (due to friction against the walls of blood vessels). Alcohol dissolves this membrane and thus makes it impossible for red blood cells to move. The more alcohol a person consumes, the more such accumulations accumulate, and their size also increases. On average, the clots contain from 200 to 500 red blood cells, their size is approximately 60 microns.

The bloodstream carries these accumulations of red blood cells throughout the body until, on the way, a vessel is encountered, the diameter of which is smaller than the size of the clot. The clot blocks the vessel, and circulatory disorders begin. In youth, the human body has 10-fold reserves of capillaries, so problems with blood vessels may not appear immediately, but at an older age, when the supply of capillaries is exhausted.

The average alcohol lover is faced with various diseases at the age of 30, and this is not surprising, because 100 ml of vodka kills about 8000 body cells.By the way, beer consumption is no less dangerous, and young people drink it literally in horse doses. Beer lovers develop a so-called beer or bull heart. The walls of the heart become thinner, the heart itself increases in volume, arrhythmias and pressure surges begin.

In addition, under the influence of alcohol, the processes that regulate blood sugar levels are disrupted. Its periodic increase or decrease affects the functioning of the brain, the nervous system, not to mention the fact that a chronic alcoholic is a potential diabetic.

2. Nervous system and alcohol

The human brain is influenced by alcohol more than other organs. If we take the concentration of alcohol in the blood as a unit, then in the brain it will be 1.75 (for comparison, in the liver – 1.45, and in the cerebrospinal fluid – 1.50). When an alcoholic drinker drinks a shot of vodka “to his health”, intense destructive processes begin in his brain.

The brain contains 15 billion neurons (nerve cells). Their food is carried out using thin capillaries.Their lumen is so narrow that even a small clot of red blood cells can clog it. After 8-10 minutes after this, the cell that was left without food will die. Due to the fact that the cells of the brain are supplied with oxygen insufficiently, oxygen starvation or cell hypoxia begins. It is this state that looks like drunkenness.

Many people drink alcohol to relax, but do they know the cost of this relaxation? Under the influence of alcohol, certain parts of the brain become numb and disconnected from the perception of “unpleasant” information from the outside.A person has an illusion of freedom, lightness, stress relief. Meanwhile, individual parts of the brain are irrevocably dying off. Who can vividly describe this process in paints are pathologists. The brain of an alcohol drinker is usually covered with microscars and ulcers and is reduced in volume. The changes brought about by alcohol are impressive. The pia mater is in a state of edema and is filled with blood, the dura mater is tense. In the brain, as a rule, there are many small cysts formed where hemorrhages occurred and necrosis of the medulla began.

A more detailed study of the brain of a patient who died from acute alcohol intoxication, allows you to see a picture comparable to the consequences of poisoning with other potent poisons. There is severe swelling, filling with blood, often – rupture of blood vessels and hemorrhages on the surface of the cerebral gyri and inside the meninges.

In non-fatal cases of poisoning, similar symptoms and their consequences are observed: disorientation in space, attention, memory.Poisoning with a large dose of alcohol can lead to deep anesthesia and coma, due to disturbances in the activity of the entire nervous system, as well as the spinal cord and medulla oblongata. A lethal single dose of alcohol for an adult is about 1.5 liters of vodka, for children this dose is 5-6 times less. For a specific person, the critical dose can be calculated at the rate of 7.8 ml of alcohol for each kilogram of weight.

Under the influence of large doses of alcohol, unpleasant metamorphoses with character and psyche begin over time.What is called personality degradation occurs. If at this turning point a person does not find the strength to stop drinking, its full recovery may never happen.

The harmful effects of alcohol on the human body are confirmed by the experiments of Academician I.P. Pavlova. He found that after taking a small amount of alcohol, reflexes are restored on days 10-12. But reflexes are the lower forms of brain activity, while alcohol affects its higher forms.Experiments carried out with intelligent, educated people showed that after “moderate” doses of alcohol (30-40 ml), the restoration of higher brain functions occurs only 15-20 days. Conclusion: drinking alcohol more than once every two weeks will lead to the fact that the human brain will be constantly in a state of alcohol poisoning.

As for the motor processes regulated by the nervous system, they are chaotic and accelerated in a drunk, but this is a temporary phenomenon. In addition, the movements are indistinct – the influence of a premature reaction affects.

3. The effect of alcohol on the digestive tract and liver

The very first effect of alcohol is the digestive system. The higher the alcohol content in the drink, the more all organs suffer, especially the stomach and pancreas.

No wonder people who drink often complain of digestive problems and abdominal pain. But the pancreas is responsible not only for digestion, but also for the production of insulin. Therefore, among patients with alcoholism there is a very high percentage of diabetics.Unfortunately, diabetes and pancreatitis caused by alcohol abuse are rarely cured, so such patients are doomed to constant diets, pain and ailments.

The liver suffers no less from alcohol, the cells of which die under the influence of ethyl alcohol. In their place, scars are formed, which, of course, cannot perform the hepatic function. The liver becomes wrinkled and shrinks, the blood stagnates. Patients often die from bleeding caused by rupture of blood vessels.The above changes are called alcoholic cirrhosis of the liver. This irreversible disease is one of the most severe, according to the World Health Organization, and is one of the leading causes of death.

4. The influence of alcohol on the reproductive system

Science has a huge amount of evidence that testifies to the extremely negative effect of alcoholic beverages on the reproductive functions of both men and women. With women, the situation is aggravated by the fact that their alcohol dependence develops faster and stronger.Along with other organs, their ovaries are affected, menstrual dysfunction develops. The impairment of the brain caused by alcoholic beverages leads to the disruption of the functioning of many endocrine glands. Therefore, women who drink often experience menstrual irregularities, decreased sex drive, and infertility.

Men who abuse alcohol undergo similar changes: decreased sexual function, impotence and infertility. Several countries have conducted research on the effects of alcohol on male strength.The results were staggering: by the age of 40-45, alcohol abusers experience a decrease in sexual potency, which is accompanied by progressive testicular atrophy (they decrease in volume and become smaller). On average, every third man with chronic alcoholism has sexual weakness.

We are talking about the direct effect of alcohol on the reproductive organs, but there are other negative points. Ethyl alcohol molecules invade the germ cells and destroy the genetic code; therefore, alcoholic parents often have weak children with various physical and mental pathologies.Alcohol relaxes, reduces alertness, and therefore increases the possibility of casual sexual intercourse, and with them the risk of contracting a sexually transmitted disease.

5. The effect of alcohol on mental and mental brain activity

For absolutely any person, the average dose of alcohol, and this is one or two glasses, acts in the same way: coordination of movement is disturbed, motor reflexes become agitated, and then slow down, mental processes begin to become difficult immediately.Simply put, a heavily drunk person will still somehow be able to move, but it will be more difficult for him to think. The hardest hit by alcohol fumes is such thought processes as criticism and judgment. Their place is taken by uncontrollable feelings, self-confidence is growing – after all, the ability to criticize has disappeared. Chaotic movements, gestures, and anxiety testify to the onset of paralysis of will and consciousness. Internal moral barriers that restrain from absurd actions break down, and the person ceases to control himself.

Numerous experiments carried out by the best specialists in this field have shown that always the simplest mental processes (perceptions) do not suffer as much as more complex ones (associations). But the violations of the latter are of a deeper nature: firstly, their education is weakened, and secondly, their quality changes for the worse. In the head of a chronic alcoholic, motor or automatically memorized associations constantly arise, which hold on with enviable persistence, emerging again and again and sometimes quite out of place.They interfere with any attempts of a person to “strain their brains.” With regard to alcoholism, such associations can be called a pathological phenomenon, also seen in neurasthenia and psychosis.

If you drink a certain amount of alcohol with a break of one week, after the second dose, the restoration of the centers of higher brain activity will take from 10 to 20 days. And the systematic excessive consumption of alcohol will make the work of these centers impossible.

An interesting fact is that the very first to be lost are the achievements acquired by the last ones, for example, in the last four days.That is, after drinking a couple of glasses of vodka, a person is thrown back to the level of development at which he stood four days ago. Frequent alcohol consumption leads to the fact that the thinking ability and associative array become scarce, thinking becomes stereotyped, mediocre and slow. Mental processes are inhibited, while losing the originality inherent in a particular person. Such people spend a lot of time thinking about simple things.

Conclusion

How to avoid the negative effects of alcohol on the body? The answer is simple – don’t use it at all.In all other cases, this influence will be present to the extent that a person cares about his health. Unfortunately, no body system remains indifferent to alcohol, and its reaction leaves much to be desired. Therefore, you should not do a disservice to the body, tired after a busy day, and try to relax with a bottle of beer. Much more useful is hiking in the fresh air or a bath with the addition of aromatic essential oils. The main thing is to break the established fact in your mind that one bottle of beer will not hurt.With this conviction, one can come to the conclusion that one bottle will not hurt once every couple of days, then every day, and these are already sure signs of alcohol addiction.

Therefore, take care of your body, do not poison it with alcohol, because your health is only in your hands!

List of used literature

1.