Cirrhosis: Most Effective Dietary Supplements

Cirrhosis is a chronic and irreversible liver disease characterized by the gradual transformation of normal liver tissue into fibrous tissue. This diffuse fibrosis is accompanied by the formation of regenerative nodules, leading to severe disruption of the liver's structure and function. As cirrhosis progresses, the liver becomes increasingly unable to perform its essential functions, such as detoxifying the blood, synthesizing proteins, and producing bile, leading to serious complications.

Pathophysiology

Cirrhosis is primarily due to chronic liver aggression, which can be caused by viral infections (hepatitis B, C), alcoholism, or metabolic disorders. This aggression results in continuous activation of hepatic stellate cells, which play a central role in the fibrotic process. Normally responsible for vitamin A storage, these cells transform into collagen-producing cells upon liver injury. Collagen accumulates and alters the normal architecture of hepatic sinusoids, disrupting exchanges between blood and hepatocytes. Excessive accumulation of extracellular matrix (ECM) in the liver leads to reduced oxygen and nutrient exchanges, worsening fibrosis. Moreover, this situation causes anoxia (lack of oxygen) at the hepatic cell level, promoting free radical production. These free radicals, in turn, stimulate fibrous tissue formation, making the process self-sustaining and worsening the disease.

Symptoms

Cirrhosis can present insidiously, with non-specific symptoms in the early stages. Patients may experience general weakness, weight loss, decreased appetite, and abdominal pain. In more advanced stages, more specific signs appear, including: 3; Jaundice (yellowing of the skin and eyes) due to bilirubin accumulation. 3; Pruritus (itching), related to increased bile salts in the blood. 3; Ascites, fluid accumulation in the abdomen due to portal hypertension. 3; Edema, often localized to the ankles, due to fluid retention. 3; Gastrointestinal hemorrhages related to esophageal varices rupturing, a complication of portal hypertension. 3; Hepatic encephalopathy, manifested by neurological disorders, from confusion to coma, due to accumulation of toxins in the blood that the damaged liver can no longer eliminate properly.

Etiologies

Several causes may be at the origin of cirrhosis, including: 3; Chronic infections: Viral hepatitis B and C are major causes of cirrhosis worldwide. 3; Alcoholism: Chronic alcohol consumption is a common cause in Western countries. 3; Non-alcoholic fatty liver disease: Related to obesity and metabolic syndrome, this condition can evolve into cirrhosis in some patients. 3; Metabolic diseases: Certain conditions, such as hemochromatosis (iron accumulation) or Wilson's disease (copper accumulation), can cause severe liver damage. 3; Chronic cholestasis: Biliary tract diseases such as primary biliary cirrhosis or primary sclerosing cholangitis disrupt bile elimination, progressively damaging the liver. 3; Autoimmune causes: Autoimmune hepatitis can cause chronic liver inflammation that progresses to cirrhosis.

Complications

Cirrhosis is a progressive disease that leads to severe complications: Portal hypertension: Liver fibrosis disrupts normal blood flow, causing an increase in pressure in the portal vein, which can lead to esophageal varices and hemorrhages. Ascites: Fluid accumulation in the abdominal cavity is a frequent complication due to portal hypertension and hypoalbuminemia (decreased blood protein levels). Hepatic encephalopathy: Patients may develop severe neurological symptoms, caused by the accumulation of toxins that the liver can no longer eliminate. Hepatocellular carcinoma: Liver cancer is a frequent complication in patients with advanced cirrhosis.

Diagnosis

Diagnosis of cirrhosis relies on a thorough clinical examination and a series of paraclinical exams. Patients presenting signs such as jaundice, ascites, or liver enzyme abnormalities (such as increased transaminases) should undergo blood tests, ultrasound, and, in some cases, liver biopsies to confirm the presence of fibrosis and regenerative nodules. Hepatic elastography, a non-invasive technique, also allows measurement of liver stiffness and evaluation of fibrosis degree.

Treatment

The management of cirrhosis includes: 3; Removal of the causal agent: for example, cessation of alcohol consumption. 3; Treatment of the underlying cause: antiviral for viral hepatitis, immunosuppressants for autoimmune hepatitis. 3; Treatment of complications: diuretics for ascites, antibiotics for infections, lactulose for encephalopathy. 3; Liver transplantation: option for patients with decompensated cirrhosis. Managing cirrhosis requires a multidisciplinary approach and continuous monitoring to prevent and treat the severe complications associated with this chronic disease.