What Is Non-Alcoholic Cirrhosis Of Liver?

The liver is one of the most important organs in our body, performing 500-odd functions, the most important of which are to do with digestion, blood filtration, waste secretion, blood sugar regulation, and blood-clotting to prevent excessive blood loss.

While it keeps our body free of diseases by removing toxins, the liver itself is vulnerable to diseases if we have a bad lifestyle and ignore the risks and warning signs of liver trouble. Cirrhosis is one of the worst things that can happen to the liver, and it can happen even without alcohol. Non-alcoholic cirrhosis of the liver is the last stage of Non-Alcoholic Fatty Liver Disease, and NAFLD has become a leading cause of chronic liver disease globally.

We have to understand that anyone, including teetotallers, can be at risk of non-alcoholic cirrhosis unless they take steps to reverse NAFLD before it can get to the irreversible stage of cirrhosis.

What does liver cirrhosis mean?

Cirrhosis simply means scarring. Cirrhosis is a late-stage liver disease, in which healthy liver tissue is mostly 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 blood flow through the liver and slows the liver’s ability to process nutrients, hormones, drugs, and natural toxins. 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, as it can lead to complete liver failure.

Non-alcoholic cirrhosis symptoms

The symptoms of cirrhosis depend on the stage of your disease. In the early 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 illnesses.

Early symptoms and signs of cirrhosis include:

• Loss of appetite
• Feeling weak or tired
• Nausea
• Fever
• Unexpected weight loss
   

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

• Easy bruising and bleeding
• Yellow tint to the skin or whites of the eyes (jaundice)
• Itchy skin
• Swelling (edema) in legs, feet, and ankles
• Fluid build-up in your belly/abdomen (ascites)
• Brownish or orange color to your urine
• Light-colored stools
• Confusion, difficulty thinking, memory loss, and personality changes
• Blood in the stool
• Redness in the palms
• Spider-like blood vessels surround small, red spots on the skin
• In men: loss of sex drive, enlarged breasts, shrunken testicles
• In women: premature menopause (permanent end of menstruation)

Non-alcoholic liver cirrhosis causes

• Fatty liver disease associated with obesity and diabetes, and not alcohol. This condition is called non-alcoholic steatohepatitis.
• Chronic viral infections of the liver (Hepatitis Band Hepatitis C)
• Inherited diseases:
  • Hemochromatosis (excess iron stored in the liver)
  • Wilson’s disease (excess copper stored in the liver)
  • Cystic fibrosis (sticky, thick mucus builds up in the liver)
  • Glycogen storage diseases (the liver can’t store or break down glycogen, a form of sugar)
• Autoimmune hepatitis (your body’s 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 the digestive system; bile helps digest fats)
• Chronic heart failure (causes fluid to back up in your liver, swelling in other areas of your body, and other symptoms)

Changes from liver diseases that lead to cirrhosis are gradual. Liver cells are injured, and if that 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.

Complications of cirrhosis in non-drinkers

There are many complications of cirrhosis in non-drinkers. Because cirrhosis develops over many years, some of these complications may be your first noticeable signs and symptoms of the disease. They are:

• Portal hypertension: This is the most common of the serious complications arising from liver cirrhosis. 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. As the pressure in the veins builds, the veins can bleed or even burst, causing severe internal bleeding.

Additional complications of portal hypertension include:

• Swelling (edema) in legs, ankles, or feet
• Build-up of fluids in the abdomen (called ascites)
• Swelling/enlargement of the spleen (splenomegaly)
• Formation and dilation (expansion) of blood vessels in the lungs, 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. This is a type of kidney failure
• Confusion, difficulty thinking, changes in behavior, even coma. This occurs when toxins from the intestines aren’t removed by the damaged liver and circulate in the bloodstream and reach the brain
• Malnutrition: The 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 reached the stage of liver cirrhosis, including non-alcoholic liver cirrhosis.
• 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 vital functions.

Diagnosis of non-alcoholic cirrhosis

To diagnose liver cirrhosis, your doctor 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; 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 mean 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 (an indicator of cirrhosis)
  • 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 tests 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 the 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). Ultrasound measures the fat content and amount of stiffness in your liver. Endoscopies might be required to detect bile duct problems, and/or to detect enlarged veins or bleeding in your esophagus, stomach, or intestines.
• Biopsy: A sample of liver tissue 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 diagnose liver cancer.

Stages of non-alcoholic cirrhosis of the liver

If you have been diagnosed with non-alcoholic cirrhosis of the liver, you’re already beyond the early stages of liver disease. Having cirrhosis means your liver has scar tissue in it because it has been damaged irreparably.

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.

Decompensated cirrhosis means your cirrhosis has worsened to the point that you have noticeable symptoms. Your doctor recognizes your condition based on your history, and physical and laboratory findings. You have at least one complication, which includes jaundice, ascites, hepatic encephalopathy, hepatorenal syndrome, variceal bleeding, or liver cancer. You’re usually admitted to the hospital for care.