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Liver Disease / Hepatitis

Everything you need to know about cirrhosis

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Liver cirrhosis describes a condition in which scar tissue is progressively replacing healthy liver cells.

It is a progressive illness that develops slowly over many years. If allowed to continue, scar tissue build-up may eventually stop liver function.

To acquire cirrhosis, there must be long-term, ongoing damage to the liver. The condition becomes severe when healthy liver tissue is damaged and replaced by scar tissue, as it can start blocking blood flow through the liver.

This article of the Nccmed Knowledge Center describes the symptoms, causes , and treatments of liver cirrhosis, including complications information.

Symptoms

Blood test at lab
One of the primary methods of diagnosis is through a blood test.

Symptoms during the early stages of cirrhosis are uncommon.

However the ability of the liver to function properly is undermined as scar tissue accumulates. There may be the following signs and symptoms:

  • blood capillaries become visible on the skin on the upper abdomen.
  • fatigue
  • insomnia
  • itchy skin
  • loss of appetite
  • loss of bodyweight
  • nausea
  • pain or tenderness in the area where the liver is located
  • red or blotchy palms
  • weakness

The following signs and symptoms may appear as liver cirrhosis progresses:

  • accelerated heartbeat
  • personality changes
  • bleeding gums
  • lost mass in the body and upper arms
  • difficulties processing drugs and alcohol
  • confusion
  • dizziness
  • fluid buildup on ankles, feet, and legs, known as edema
  • hair loss
  • higher susceptibility to bruising
  • jaundice, or yellowing of the skin, whites of the eyes, and tongue
  • loss of sex drive
  • memory problems
  • more frequent fevers and increased risk of infection
  • muscle cramps
  • nosebleeds
  • pain in the right shoulder
  • breathlessness
  • stools become black and tarry, or very pale.
  • urine becomes darker.
  • vomiting blood
  • problems with walking and mobility

The liver tissue is replaced by fibrous scar tissue. It can also form regenerative nodules. These are lumps that show up as the liver tries to heal the damage.

Treatment

If a diagnosis of cirrhosis is made early enough, damage can be minimized by treating the underlying cause or the different complications that arise.

Treatment for alcohol addiction: It is necessary for the patient to stop drinking if the long-term, daily heavy alcohol intake has triggered their cirrhosis. For certain cases the doctor would prescribe an alcohol dependency treatment plan.

Medications: Drugs may be prescribed to the patient to control damage to the liver cells caused by hepatitis B or C.

Pressure control in portal vein: Blood can “back up” in portal vein, which supplies blood to the liver, causing high blood pressure in portal vein. Drugs are normally prescribed in certain blood vessels to regulate the increasing pressure. The aim is to avoid serious bleeding. An endoscopy can detect signs of bleeding.

If the patient vomits blood or passes bloody stools, they probably have esophageal varices. Requires urgent medical attention. Might assist with the following procedures:

Banding: A small band is placed around the base of the varices to control bleeding.

Injection sclerotherapy: After endoscopy, dye is injected into varicose veins, triggering blood clots and scar tissue to form. This helps to stem the bleeding.

A Sengstaken-Blakemore tube with a balloon: A balloon is placed at the end of the tube. If endoscopy does not stop the bleeding, tube down the patient’s throat and into their stomachs. The balloon is inflated. This places pressure on the varices and stop the bleeding.

Transjugular intrahepatic portosystemic stent shunt (TIPSS): If the therapies mentioned above did not stem the bleeding, the metal tube is passed in the liver to join the portal vein and liver, create a new route for blood to flow through. This reduces the pressure that causes varicose veins.

Other complications are treated in different ways:

Infections: The patient will be given antibiotics for infections that occur.

Liver cancer screening: the cirrhosis patients have a much higher risk of developing liver cancer. The doctor may recommend regular blood tests and imaging scans.

hepatic encephalopathy, or high levels of blood toxin: Medication can help treat excessive levels of toxins from blood.

In some cases, the damage caused by cirrhosis covers most of the liver and can not be reversed. In these cases, the person may need a new liver transplanted. It may take time to find a suitable donor, and this procedure is often recommended as a last resort.

Outlook

An individual with liver cirrhosis has a survival rate which depends on the extent of the scarring.

A 15-year follow-up study of 100 people with severe alcoholic cirrhosis in Norway showed that 71 percent of the study’s people had died within 5 years of diagnosis. The mortality rate was 90 per cent 15 years after diagnosis.

In people with cirrhosis, continued alcohol consumption and advanced age were linked to a higher mortality rate.

This is a limited study but it shows that cirrhosis is a severe condition that severely reduces life expectancy and impairs living quality.

Cirrhosis is responsible for 12 deaths in every 100,000 members of the population in the United States.

Stages

Cirrhosis is graded on a scale called the Childs-Pugh score as follows:

  • A: Relatively mild
  • B: Moderate
  • C: Severe

Doctors also classify cirrhosis as being either compensate or decompensated. Compensated cirrhosis means that despite the damage, the liver can still function normally. A liver with decompensated cirrhosis can not adequately conduct its functions and mostly causes severe symptoms.

Cirrhosis is often used as a final stage of liver disease rather than as being treated in terms of its own stages.

Causes

Frequent heavy drinking is a cause of cirrhosis
Frequent heavy drinking is a cause of cirrhosis

Common causes of cirrhosis are:

  • long-term alcohol abuse
  • hepatitis B and C infection
  • fatty liver disease
  • toxic metals
  • genetic diseases

Together, hepatitis B and C are said to be major causes of cirrhosis. Other causes are:

Regularly drinking too much alcohol

Toxins are broken down by the liver like alcohol. But, if the amount of alcohol is too high, the liver can get overworked and eventually the liver cells will get weakened.

Compared with other healthy people, heavy, frequent, long term drinkers are much more likely to develop cirrhosis. For cirrhosis to develop, heavy drinking typically needs to be sustained for at least 10 years.

Alcohol-induced liver disease typically has three stages:

  1. Fatty liver: This involves a build-up of fat in the liver.
  2. Alcoholic hepatitis: This occurs when the cells of the liver swell.
  3. Approximately 10 to 15 percent of heavy drinkers will subsequently develop cirrhosis.

Hepatitis

Blood-borne infection , hepatitis C will damage the liver and eventually lead to cirrhosis. In Western Europe , North America and many other parts of the world, hepatitis C is a common cause of cirrhosis. The hepatitis B and D may also cause cirrhosis.

Non-alcoholic steatohepatitis (NASH)

NASH starts with the accumulation of so much fat in the liver, in its early stages. The fat causes inflammation and scarring which eventually leads to possible cirrhosis.

NASH is more likely to occur in obese people, patients with diabetes, those with high blood fat levels and people with high blood pressure.

Autoimmune hepatitis

The person’s own immune system attacks healthy organs inside the body as if they were foreign substances. The liver often gets attacked. Cirrhosis will eventually develop in the patient.

Some genetic conditions

There are some inherited conditions that can lead to cirrhosis, including:

  • Hemochromatosis: Iron accumulates in the liver and other parts of the body.
  • Wilson’s disease: Copper accumulates in the liver and other parts of the body.

Blockage of the bile ducts

Some conditions and diseases, such as bile duct cancer, or pancreatic cancer, may obstruct the bile ducts and raise the risk of cirrhosis.

Budd-Chiari syndrome

This condition triggers blood clots, the blood vessel that carries blood from the liver, in the hepatic vein. This leads to liver enlargement, and collateral vessel growth.

Other disorders and illnesses that may lead to cirrhosis include:

  • cystic fibrosis
  • primary sclerosing cholangitis, or hardening and scarring of the bile ducts
  • galactosemia, or inability to process sugars in milk.
  • schistosomiasis, a parasite commonly found in some developing countries
  • biliary atresia, or badly formed bile ducts in babies
  • glycogen storage disease, or problems in the storage and energy release vital for cell function

Diagnosis

Since the disease has unusual early signs, cirrhosis is often diagnosed while the patient is being checked for some other disorder or illness.

Anyone with the following signs will see their doctor right away:

  • fever with shivering
  • shortness of breath
  • vomiting blood
  • dark or tarry stools
  • episodes of drowsiness or confusion

A doctor will examine the patient, and will feel around the area of the liver to decide whether it is enlarged. The patient will be asked about their history of medication and lifestyle like smoking.

The following tests may also be ordered:

  • Blood test: These measure how well the liver is functioning. If levels of alanine transaminase (ALT) and aspartate transaminase (AST) are high, the patient may have hepatitis.
  • Imaging tests: Ultrasound, CT, or MRI scans can be used to see whether the liver is enlarged and detect any scarring or nodules.
  • Biopsy: A small sample of liver cells is extracted and examined under a microscope. The biopsy can confirm cirrhosis and its cause.
  • Endoscopy: The doctor inserts a long, thin tube with a light and video camera at the end goes through the esophagus and into the stomach. The doctor looks out for swollen blood vessels called varices than can be a sign of cirrhosis.

Complications

Cirrhosis can lead to several other conditions, some of which are life threatening. These include:

Ascites or edema: Ascites is an accumulation of fluid in the abdomen, and edema is an accumulation of fluid in the legs. They can be treated with a diet low in salt and diuretics. In severe cases, fluid may have to be drained repeatedly. Sometimes surgery is needed.

Varices and portal hypertension: These are large swollen and esophagus and stomach veins. They can increase blood pressure in a vessel called the portal vein of that carries blood from the spleen and intestine to the liver. Varices can rupture, causing severe blood loss and blood clots.

Hepatic encephalopathy: This refers to high levels of toxins in the blood where the liver is filtering and not all of them successfully.

Hepatocellular carcinoma: This is the most common type of liver cancer. It is the third leading cause of cancer death worldwide.

hepatopulmonary syndrome (HPS): HPS Medical defined as a combination of liver disease, dilated blood vessels in the lungs, and abnormalities in gas exchange. It is linked to an increase in the mortality rate of people waiting for a liver transplant.

coagulation disorders: Cirrhosis can cause problems with blood clotting, resulting in potentially fatal bleeding and clotting.

Prevention

To stop cirrhosis, it is strongly recommended that you remain within acceptable regular and weekly alcohol limits. Please review the following useful information on drinking in moderation from the Centers for Disease Control and Prevention ( CDC).

Individuals suffering from cirrhosis should avoid alcohol altogether. Alcohol speed the disease progression up.

Be sure to take the following steps to prevent contracting hepatitis B and C:

  • Use a condom when having sex.
  • Do not share needles when injecting drugs.
  • People at risk of becoming infected with hepatitis B, such as healthcare workers, social care workers, and police personnel, can be vaccinated

Since cirrhosis can not be reversed or remedied once it reaches a certain stage, the best form of treatment is often considered to be prevention.

Immune System / Vaccines

When should people get the hepatitis B vaccine?

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Hepatitis B is a liver ailment caused by a virus. It might go away on its own or worsen, leading to cirrhosis or liver cancer. Since the 1980s, a vaccination against the virus that causes hepatitis B has been available.

Hepatitis B is a short-term condition that causes no long-term harm in many people. The Centers for Disease Control and Prevention (CDC) estimates that 2–6% of individuals with hepatitis B will acquire a chronic infection. Cirrhosis, liver failure, and liver cancer are all possible effects of a chronic hepatitis B infection.

Hepatitis B is caused by the hepatitis B virus (HBV), and a vaccination against it has been available in the United States since the 1980s. The vaccination protects people from being infected with hepatitis B and prevents them from contracting it.

Depending on the age range, multiple vaccination series are offered. For example, babies under the age of one year can receive the vaccination in three or four doses, while individuals beyond the age of one year can receive the vaccine in a two- or three-dose series. A person should consult with a physician to determine which vaccination series is best for them.

Multiple hepatitis B vaccination regimens will be discussed in this article. It will also look at who should get the vaccine and who should not.

Children under 1 year old

vaccine

A newborn may receive the vaccination in three or four doses, according to the Hepatitis B Foundation:

  • Three-dose vaccine series: All medically stable newborns in the United States with a birth weight of at least 2,000 grams should get their first dose of hepatitis B vaccination within 24 hours of delivery, according to medical specialists.
  • Four-dose vaccine series: Combination vaccinations, like the ones in this series, protect against a variety of illnesses. The first dose of the combo vaccination is usually given to a newborn when he or she is 6 weeks old. This implies that until the age of six weeks, a newborn is not protected against hepatitis B. As a result, within 24 hours of delivery, a newborn should get a dose of the hepatitis B vaccination.

The following table shows the recommended HBV immunization regimens for infants under the age of one year:

Vaccine seriesBrand nameDose 1Dose 2Dose 3Dose 4
3-dose vaccine seriesEngerix-B or Recombivax HBat birth4 weeks after birth6 months after the first dose
4-dose combination vaccine seriesVaxelis or Pediarixat birth

(hepatitis B vaccine)
at 6 weeks old

(combination vaccine)
at 14 weeks old

(combination vaccine)
at 6 months old

(combination vaccine)

Those over 1 year old and adults

The three-dose course is appropriate for both children and adults. Adults over the age of 18 are eligible for the two-dose series.

The following table shows the recommended HBV vaccine schedule for people over the age of one :

Vaccine seriesBrand nameDose 1Dose 2Dose 3
3-dose vaccine seriesEngerix-B, Recombivax, or Tinrixday 11 month after the first dose6 months after the first dose
2-dose vaccine seriesHepislav-Bday 11 month after the first dose

Accelerated vaccine schedule for children and adults

A person may get a vaccination series over a shorter amount of time than the normal schedule under specific conditions.

If a person is traveling to an area where they are at high risk of exposure or working as an emergency responder in a disaster region, they may be given an expedited vaccination series.

For adults and children

The vaccination is given in three doses over the course of two months, with a one-year booster dose.

The initial expedited dosages protect against HBV right away, and the booster dose aids in long-term protection.

The following is the authorized accelerated immunization schedule for adults and children:

Vaccine seriesBrand nameDose 1Dose 2Dose 3Dose 4
4-dose vaccine seriesEnergix-Bday 11 month later2 months after the first dose1 year after the first dose

For adults only

A combination vaccination that protects against hepatitis A and B is used in the four-dose combination vaccine schedule.

This vaccination series consists of three doses given over the course of one month. After a year, the user is given a booster dosage. This is a popular option for people who need to travel outside of the United States on short notice.

The two-dose immunization regimen consists of two doses given one month apart.

For adults above the age of 18, there are two accelerated vaccination schedules:

Vaccine seriesBrand nameDose 1Dose 2Dose 3Dose 4
4-dose combination seriesTwinrixday 11 week later1 month after the first dose1 year after the first dose
2-dose vaccine seriesHepislav-Bday 11 month later

For vertical transmission

It is important that infants delivered to females who have hepatitis B receive proper hepatitis B vaccination doses. If hepatitis B immunoglobulin (HBIG) is available, they may be obliged to take it.

Antiviral prophylaxis is also recommended by WHO to assist prevent hepatitis B transmission.

The two recommended hepatitis B immunization regimens for children born to hepatitis B carriers are listed in the table below:

Vaccine seriesBrand nameDose 1Dose 2Dose 3Dose 4
3-dose vaccine seriesEngerix-B and Recombivax HBat birth

(hepatitis B vaccine and HBIG)
1 month later6 months after first dose
4-dose combination vaccine seriesVaxelis or Pediarixat birth

(hepatitis B vaccine and HBIG)
at 6 weeks of age

(combination vaccine)
at 14 weeks of age

(combination vaccine)
at 24 weeks of age

(combination vaccine)

International schedule

A combination vaccination, which protects against numerous illnesses, including hepatitis B, is used in many countries.

The three recommended worldwide hepatitis B vaccination regimens are listed in the table below:

Vaccine seriesDose 1Dose 2Dose 3Dose 4
3-dose vaccine series for those under 1 year oldat birth1 month after the first dose6 months after the first dose
3-dose vaccine series for those over 1 year old and adultsday 11 month after the first dose6 months after the first dose
4-dose combination vaccine for those under 1 year oldat birth

(hepatitis B vaccine)
at 6 weeks of age

(combination vaccine)
at 14 weeks of age

(combination vaccine)
at 6 months of age

(combination vaccine)

Who should get vaccinated against hepatitis B?

All babies should have the hepatitis B vaccine, according to medical experts.

The following people, according to the CDC, are at a greater risk of getting hepatitis B than the general population:

  • people who inject drugs
  • people who are at an increased risk due to exposure in their job
  • people who travel to countries with high levels of hepatitis B
  • people with chronic liver disease
  • people with HIV
  • sexually active people who are not in mutually monogamous relationships
  • people in a sexual relationship with someone who has hepatitis B

Most people are safe from the hepatitis B vaccination. After getting the vaccination, a person may encounter certain typical mild side effects.

These are some of them:

  • soreness or swelling in the arm at the site of injection
  • headache
  • fever

Who should not get the hepatitis B vaccine?

If you have any of the following symptoms, you should consult a doctor before having the vaccine:

  • have had an allergic reaction to neomycin (Twinrix)
  • have had an allergic reaction to yeast
  • have had an allergic reaction to a previous dose of the vaccine or any component of a hepatitis B vaccine

A person can still get the vaccination if they have a small sickness, such as a cold. If someone is moderately or seriously unwell, they should not obtain the hepatitis B vaccine until they have recovered.

Conclusion

Hepatitis B is a liver ailment caused by a virus. It spreads by the transmission of body fluids from an infected person to an uninfected one.

Hepatitis B vaccinations are available in a variety of forms. The hepatitis B vaccination is administered in a series of doses. These vaccines are used in two-, three-, and four-dose vaccination regimens.

A combination vaccination that protects against hepatitis B and other infections is also available.

Sources:

  • https://www.who.int/news-room/fact-sheets/detail/hepatitis-b
  • https://www.cdc.gov/hepatitis/hbv/index.htm
  • https://www.niddk.nih.gov/health-information/liver-disease/viral-hepatitis/hepatitis-b
  • https://www.cdc.gov/vaccinesafety/vaccines/hepatitis-b-vaccine.html
  • https://www.medicalnewstoday.com/articles/hep-b-vaccine-schedule
  • https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html
  • https://www.hepb.org/prevention-and-diagnosis/vaccination/guidelines-2/

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Cholesterol

The similarities and differences between NAFL, NAFLD, and NASH

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A person’s liver normally has a little amount of fat in it. Nonalcoholic fatty liver disease (NAFLD) is characterized by an accumulation of excess fat in the liver. It is not caused by alcohol consumption.

NAFLD is classified into two types: nonalcoholic fatty liver (NAFL) and nonalcoholic steatohepatitis (NASH) (NASH).

Weight loss is the sole suggested treatment for NAFLD, and there are no drugs available to treat either condition at this time.

Continue reading to learn about the symptoms, causes, and treatments of NAFLD, NAFL, and NASH, as well as the differences between the three.

NAFLD

Radiography liver arteries
Daniela White Images/Getty Images

The liver normally includes a tiny amount of fat, according to the American Liver Foundation (ALF).

Fatty liver, on the other hand, develops when fat accounts for more than 10% of the organ’s weight.

NAFLD is the leading cause of chronic liver disease in the United States, affecting up to 25% of the global population.

Symptoms

NAFLD is characterized as a silent disease because there are usually no symptoms of the condition.

Some people, however, may suffer symptoms such as:

  • mental confusion
  • swelling in the legs and abdomen
  • weakness
  • weight loss
  • nausea
  • abdominal pain
  • fatigue
  • jaundice
  • loss of appetite

Causes

The ALF believes that approximately 100 million people in the United States have NAFLD. However, medical professionals do not fully comprehend what causes the condition. Although study is ongoing, scientists have established that certain health factors may lead to the development of NAFLD. The genetic make-up, food, and digestive system of a person may all have a role.

The following medical issues may increase a person’s risk of developing NAFLD:

While researchers believe that some genes may have a role in the development of this condition, more research is needed.

Aside from the aforementioned concerns, many herbal medicines or dietary supplements can cause liver damage, so anyone who intends to begin taking supplements should always discuss the risks with their doctor.

Treatments

A person’s NAFLD can be controlled or even reversed by leading a healthy lifestyle, which may include eating a nutritious diet or decreasing weight. According to experts, decreasing weight can help reduce fat in the liver as well as inflammation and fibrosis.

Diagnosis

If a doctor suspects a patient has NAFLD, NAFL, or NASH, he or she may order a battery of tests to confirm the diagnosis. These could include:

  • imaging tests
  • a medical history
  • a liver biopsy
  • blood tests

NAFL

NAFL, also known as simple fatty liver, develops when a mostly harmless buildup of fat in the liver. Steatosis is the medical term for this condition.

According to the National Health Service (NHS) of the United Kingdom, most people will only ever develop NAFL and will not be aware of it.

However, NAFL can progress and cause liver damage in some people.

Symptoms

NAFL does not often cause liver inflammation or damage. People may experience pain if their liver is larger than usual due to the extra fat in the organ’s cells. Typically, NAFL does not progress.

Causes

Fatty liver is not always caused by NAFLD. Before concluding that NAFLD is the cause of a person’s fatty liver, doctors may want to rule out other possibilities.

Fatty liver, for example, can be caused by:

  • taking certain medications
  • toxin exposure
  • alcohol-associated liver disease
  • Wilson’s disease or other rare genetic diseases
  • losing weight too quickly

Treatments

According to the National Institute of Diabetes and Digestive and Kidney Diseases, lifestyle adjustments may be able to prevent or reduce a person’s risk of getting NAFLD.

These are some examples:

  • following a nutritious diet
  • limiting portion sizes
  • regular physical activity
  • maintaining a moderate weight

Losing between 3% and 5% of a person’s body weight will often reduce fat in the liver.

Diagnosis

Because there are no symptoms, doctors frequently find NAFL when conducting medical tests for other reasons. A blood test, for example, will reveal high levels of liver enzymes. Further investigations, such as a comprehensive medical history and physical examinations, may be recommended by healthcare professionals.

NASH

Inflammation and liver damage occur when a person has NASH and high levels of fat in their liver.

Inflammation and liver damage can result in:

Symptoms

Again, NASH normally has no symptoms, but some people may develop cirrhosis as a result.

Cirrhosis symptoms include:

  • spider veins, which are visible blood vessels close to the surface of the skin
  • swelling in the abdomen
  • intense itching
  • being quick to bruise and bleed
  • jaundice, which refers to yellowing of the eyes and skin

If a person has any of the following symptoms, he or she should seek immediate medical attention:

  • vomiting blood
  • dark or black tarry stools
  • fever
  • slurred speech, and mental confusion
  • shortness of breath

Cirrhosis, if left untreated, can cause the liver to fail: Because the liver controls so many other body systems, it can cause a variety of health problems if it is not functioning properly.

Causes

According to the ALF, around 20% of people with NAFLD will acquire NASH. NASH is more common in older people, although it can also affect youngsters.

NASH is also more probable in people who have:

  • insulin resistance or type 2 diabetes
  • high blood pressure
  • excess weight or obesity
  • obstructive sleep apnea
  • body fat concentrated around the waist

Treatments

People should try to shed between 7% and 10% of their body weight to minimize liver inflammation and fibrosis. Experts advise doing this gradually rather than hastily, as decreasing weight too quickly can aggravate liver disease.

Doctors may prescribe drugs to manage NASH problems, which may necessitate minor medical treatments or surgery. People suffering from liver failure or cancer may require a liver transplant.

Diagnosis

Because a liver biopsy is required to determine how far the condition has progressed, it is the only test that can diagnose NASH. Liver biopsies can rule out other illnesses or provide a clearer picture of advanced liver disease or cirrhosis than imaging tests.

Similarities and differences between NAFL and NASH

NAFLNASH
Full nameNonalcoholic fatty liverNonalcoholic steatohepatitis
Excess fat in the liverYesYes
InflammationNoYes
Liver damageNoYes
ReversibleUsuallyDepends on progression
Treatment3–5% body weight loss7–10% body weight loss
Possible complicationsTypically noneFibrosis, cirrhosis, liver cancer, liver failure

Conclusion

NAFL, NAFLD, and NASH are all related in that they are both types of NAFLD.

While NAFL is easily curable and reversible, NASH may progress to the point where all that can be done is avoid additional harm.

The best treatment for all types of nonalcoholic fatty liver diseases is to lose weight slowly and steadily.

Sources:

  • https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/eating-diet-nutrition
  • https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/definition-facts
  • https://liverfoundation.org/for-patients/about-the-liver/diseases-of-the-liver/nonalcoholic-steatohepatitis-information-center/nash-causes-risk-factors/
  • https://www.medicalnewstoday.com/articles/what-are-the-similarities-and-differences-between-nafl-nafld-and-nash
  • https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5502701/
  • https://www.nhs.uk/conditions/non-alcoholic-fatty-liver-disease/
  • https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash
  • https://liverfoundation.org/wp-content/uploads/2019/11/NAFLD-Brochure-English.pdf
  • https://www.niddk.nih.gov/health-information/liver-disease/nafld-nash/symptoms-causes
  • https://britishlivertrust.org.uk/information-and-support/liver-health-2/symptoms-of-liver-disease/
  • https://liverfoundation.org/wp-content/uploads/2018/04/ALF-NAFLD-NASH-Infographic.pdf
  • https://www.liverhealthuk.com/post/what-is-the-difference-between-fatty-liver-and-nash

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Cancer / Oncology

What to know about ascites (excess abdominal fluid)

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A buildup of fluid in the abdomen is known as ascites. When the liver isn’t functioning properly, this can happen. Swelling and pain can occur when fluid fills the area between the organs and the abdominal lining.

Cirrhosis, or scarring of the liver, causes ascites, which is a common symptom.

When fluid builds up in the belly, a person may feel bloated and uneasy. Shortness of breath might be caused by the fluid pressing on the lungs.

A doctor can treat ascites with lifestyle changes, diuretics, and antibiotics, depending on the etiology of the condition. In some circumstances, they may need to use a needle to drain the fluid.

Read on to learn more about what causes ascites, as well as common symptoms, treatment options, and more.

Ascites

  • Ascites An ultrasound can identify the excess fluid, which a healthcare professional can then remove.  Protonic Ltd/Stocksy
  • Ascites Ascites can also cause fluid to build up in the abdomen, leading to a distended appearance. This causes pain and trouble breathing, and it can lead to severe complications.  Zay Nyi Nyi/Shutterstock
  • Ascites Ascites results from cirrhosis, or scarring of the liver. Fluid builds up and causes swelling, often in the legs and ankles.  Casa nayafana/Shutterstock

The medical word for a buildup of fluid in the abdomen is ascites.

When the blood pressure in the portal vein — which goes from the digestive organs to the liver — becomes too high, it might cause this. As a result of the increased pressure, kidney and liver function is impaired, leading fluid to collect.

People with liver disease or cirrhosis are 80 percent more likely to develop the condition.

Symptoms

Swelling in the abdomen from too much fluid can make it feel tight and painful.

Ascites symptoms might appear over a period of weeks or even days. While the edema may appear small at first, it can quickly worsen.

Among the signs and symptoms are:

Causes of ascites

The most prevalent cause of ascites is cirrhosis, or liver scarring.

Other possible causes include:

Ascites vs. belly fat

Although ascites and belly fat may appear to be the same thing, a doctor will be able to tell the two apart.

Ascites and fat have different movements and sensations. When a person is lying down or standing, a doctor can examine their abdomen. The contour of the abdomen may indicate that it is fluid-filled rather than fat-filled.

A person with ascites may also have a bloated, firm, and swollen abdomen. They may also have rapid weight and body form changes. These changes occur at a far faster rate than a person’s body fat mass generally increases.

Is ascites a life-threatening condition?

Ascites, in most situations, is not life threatening. However, the cause could be a more serious condition, such as liver failure, which could be fatal.

The death rate for people with ascites as a consequence of cirrhosis ranges from 15% in one year to 44% in five years.

If ascites is not treated, it can lead to serious consequences. They could, for example, get an infection in the fluid in their abdomen. If not handled appropriately, this can be dangerous.

Ascites treatment and management

Ascites can be treated in a number of ways. A doctor will determine which solutions are ideal for a patient’s condition.

Reduction of sodium

A doctor will most likely recommend that a person’s sodium intake be limited. In general, they should limit their salt intake to fewer than 2000 mg per day.

Diuretics

Diuretics, also known as water tablets, help a lot of people with ascites. These aid in the removal of excess fluid from the body, hence lowering edema.

Common diuretics like furosemide (Lasix) and spironolactone may be prescribed by a doctor (Aldactone).

Paracentesis

A doctor or medical expert performs a basic technique called paracentesis. To remove extra fluid, a needle is inserted into the abdomen.

A doctor may take a small sample of fluid for testing if they suspect an illness. A doctor will, however, remove a bigger amount of fluid if a person has a lot of swelling.

Shunts

A shunt may be inserted by a doctor to drain the fluid that has accumulated due to ascites.

They will numb and clean the area first. Then a long needle will be carefully inserted into the vein to open it. They will implant a tube from the neck to the abdomen after creating a minor incision in the chest area.

Diagnosis of ascites

The amount of fluid in a person’s abdomen determines the diagnosis. Physical examination is frequently used by doctors to diagnose ascites.

An ultrasound or CT scan of the abdomen may be used to confirm the diagnosis.

A doctor would usually take a sample of the fluid by putting a small needle into the abdomen wall while under local anaesthesia, withdrawing some fluid, and sending it to be tested.

To discover the cause of the fluid buildup, doctors will test the fluid for symptoms of cancer and infection.

Outlook

The cause of ascites has an impact on a person’s outlook. Antibiotics can be used to treat an infection that causes ascites in a person.

Paracentesis and shunts can help most people with ascites from cirrhosis improve their quality of life. They will, however, almost certainly not improve their chances of survival. Instead, they assist in the management of the condition while a person awaits a liver transplant.

Summary

A buildup of fluid in the abdomen is known as ascites. It is usually seen as a side effect of liver disease.

Bloating, indigestion, constipation, and shortness of breath are among symptoms. Medications can be used to treat it.

Sources

  • https://gi.org/topics/ascites/
  • https://www.ncbi.nlm.nih.gov/books/NBK470482/
  • https://www.medicalnewstoday.com/articles/318775
  • https://www.cancerresearchuk.org/about-cancer/coping/physically/fluid-abdomen-ascites/treating/shunts
  • https://www.cancerresearchuk.org/about-cancer/coping/physically/fluid-abdomen-ascites/about

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