Dr. Awadhesh Pd. Singh is currently retired from Government Medical College, Bettiah, Bihar where he was working as Professor of Surgery. He has 45 years of experience wherein he has worked as surgery teacher at RMC Ranchi; S. K. Medical college, Muzaffarpur; D. M. C. Laheriasarai; J. L. N. Medical College Bhagalpur and Govt. Medical College Bettiah. He completed his M.B.B.S.( Hons) from Darbhanga Medical college in 1981 and M.S. from RMC, Ranchi, Jharkhand. On World Liver Day, Health Room invited him to shed some light on liver disease, Cirrhosis. The purpose of the interview is to make people aware of Liver Cirrhosis and take immediate steps for prevention or treatment of the disease.
Excerpts from the interview:
Hello Dr. Awadhesh Prasad Singh, and Welcome to Health Room!
1. What are the functions of liver?
Liver is a dynamic organ protected by right lower ribs and helps in digestion, metabolism of carbohydrates, fats and proteins, storage of glycogen and vitamins, excretion of bile and detoxification of alcohol, drugs and chemicals.
2. What is Liver Cirrhosis and what are the different causes that can lead to Cirrhosis?
Cirrhosis of the liver is a chronic disease wherein useful parenchymal tissue is replaced by useless fibrous organ. It is due to repeated trauma by viral infections, Hepatitis B, Hepatitis A and D. Other causes are chronic alcoholism, obesity, fatty fiver, high blood cholesterol and triglycerides. The over use and abuse of analgesics and toxic drugs can also cause cirrhosis.
3. What are the common symptoms of this disease?
Alarming early symptoms of liver disease can be fatigue, lethargy, weakness, nausea, abdominal fulness, vomiting, diminished appetite and weight loss. Jaundice, itchy skin, swelling in the legs, feet and ankles, swelling with fluid in abdomen (ascites). Other symptoms are dark yellow urine and pale white stools.
Still advanced disease will have vomiting of blood and passing of black tarry stools due to oesophageal varices (Haematemesis and Malaena), bleeding from piles. In males, gynecomastia and loss of libido. Hepatic encephalopathy.
4. What are the different stages of liver cirrhosis?
In early stages there is inflammation of liver tissue due to viruses, alcohol, regular consumption of fried foods, burgers. pizza, analgesics and drug abuse. (Steatosis)
In stage 2, obstruction develops in liver leading to raised portal pressure and development of varices and piles. Alcohol kills liver cells which results in scarring of the liver leading to fibrosis.
In stage 3 there is advanced liver fibrosis characterised by swelling of abdomen, legs and foot. Its the Cirrhosis stage.
In stage 4 there is liver failure.
5. What are the treatments to Cirrhosis?
There's no specific treatment. Damage can be stopped by removing the cause. A balanced diet is recommended. Avoid saturated fats, fatty foods ,burg, ,pizza and white flour ( maida), red meat. Apple, grapes and salads are helpful. Regular exercises and walking/ brisk walk for half an hour. Stop alcohol, stop smoking. Stop misuse of antibiotics, analgesics and acetaminophen. Reduce blood levels of cholesterol and triglycerides. Reduce portal pressure by propranolol, it reduces gut bleeding and rebleeding. Sclerotherapy and banding treatments are recommended for oesophageal varices A liver transplant for cirrhosis wherein there's a whole liver transplant from deceased donor. Living donor transplant, split donations are also some options. Liver transplant is by far the most successful treatment nowadays.