Cirrhosis

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Written by Wu Hai Wu
Gastroenterology
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Will cirrhosis continue to progress if there are no symptoms?

Cirrhosis may not have symptoms, yet it can still progress. There are various causes of cirrhosis, such as viral hepatitis, alcoholic hepatitis, autoimmune hepatitis, drug-induced hepatitis, and fatty liver disease, among others. If the underlying causes are not removed, cirrhosis can continue to progress even without symptoms. For example, in chronic hepatitis B, if no effective antiviral treatment is administered, the patient may progress to decompensated cirrhosis in the absence of symptoms, which in severe cases, can lead to the development of liver cancer. Therefore, once cirrhosis is diagnosed, it is crucial to actively identify the cause and adopt different treatments according to the specific cause, such as abstaining from alcohol if the cirrhosis is alcohol-related.

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Written by Wu Hai Wu
Gastroenterology
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Can early-stage liver cirrhosis be cured by surgical resection?

Early-stage liver cirrhosis cannot be cured through surgical resection. Patients with early-stage liver cirrhosis need to clearly identify the cause of the cirrhosis if they wish to be cured. For instance, if the cirrhosis is due to alcohol, it requires actively quitting drinking. If the cirrhosis is caused by viral hepatitis, then active antiviral treatment is necessary for these early-stage patients. To cure the disease, it is essential to actively protect the liver and treat the underlying cause. If a patient with early-stage liver cirrhosis shows signs of liver cancer, then surgical treatment should be undertaken to remove the lesions as soon as possible.

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Written by Li Qiang
Intensive Care Unit
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Is late-stage liver cirrhosis with liver failure easy to control?

In the late stages of cirrhosis, when the condition has progressed to liver failure, it becomes very difficult to manage. At this stage, due to liver failure, the first issue to arise is abnormal coagulation function, such as easy bleeding in patients. This will lead to severe hypoalbuminemia, causing swelling throughout the body. Additionally, bilirubin levels are very high, leading to various metabolic diseases, such as metabolic encephalopathy, which affects other organs as well. In the late stages of cirrhosis, there is also a large amount of ascites. At this time, portal hypertension is common, leading to complications such as gastric and esophageal varices rupture, bleeding, and hepatic encephalopathy, making the condition very difficult to control. If the cirrhosis is a benign lesion, at this time, adjusting liver function through methods such as artificial livers or plasma exchange can improve the condition to a manageable extent. It is critical to act quickly to perform a liver transplant, as there are no other effective treatments besides transplant, and the condition is very difficult to control.

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Written by Huang Gang
Gastroenterology
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What should I do about 7 episodes of gastrointestinal bleeding due to cirrhosis?

There are manifestations of cirrhosis, and it is accompanied by upper gastrointestinal bleeding, which occurs frequently. At this time, a gastroscopy should be conducted, in combination with an ultrasound examination of the liver, to determine whether portal hypertension is causing the bleeding. If the condition is serious, surgical treatment, such as disconnection or shunting, may be needed to relieve the pressure on the portal vein and mitigate the bleeding. Alternatively, vascular ligation can also be performed under gastroscopy to ligate the ruptured vessels, which can also stop the bleeding. Otherwise, long-term repeated heavy bleeding can easily lead to hemorrhagic anemia, and in severe cases, it can cause hemorrhagic shock, posing a life-threatening risk.

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Written by Wu Hai Wu
Gastroenterology
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What is the difference between the symptoms of cholecystitis and the symptoms of cirrhosis?

The symptoms of cholecystitis differ significantly from those of cirrhosis. The symptoms of cholecystitis mainly manifest as pain in the upper right abdomen, along with chills and fever, while the symptoms of cirrhosis primarily include fatigue, poor appetite, and may also present with jaundice, abdominal distension, and swelling of the lower limbs. To determine whether a patient has cholecystitis or cirrhosis, it is recommended to visit the gastroenterology department of a standard hospital as soon as possible for a comprehensive examination. This should include abdominal imaging, liver function tests, complete blood count, among others, to further clarify the diagnosis and adopt corresponding treatment measures.

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Written by Si Li Li
Gastroenterology
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Can cirrhosis be contagious?

Diseases that cause cirrhosis include viral hepatitis, such as chronic hepatitis B, chronic hepatitis C, and others, as well as alcoholic liver disease or autoimmune liver disease, all of which can lead to cirrhosis. Only cirrhosis caused by viral hepatitis can be contagious, and it only transmits hepatitis B or C virus, not cirrhosis directly. After a patient is infected with hepatitis B or C virus, they may gradually develop chronic hepatitis B or C. Over a long period of time, the virus damages the liver cells which can eventually lead to cirrhosis. Thus, cirrhosis itself is not contagious; only the virus can be transmitted.

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Written by Wu Hai Wu
Gastroenterology
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Is stool black in the early stages of cirrhosis?

In the early stages of cirrhosis, it is generally not common to see black stools. Patients in the early stages of cirrhosis may not experience complications associated with the condition, such as portal hypertensive gastropathy and esophagogastric varices, nor would they likely suffer from peptic ulcers, etc. However, if patients with cirrhosis do not actively seek treatment or undergo regular check-ups, they could develop conditions like peptic ulcers and possibly esophagogastric varices that may rupture and bleed, leading to black stools. If black stools occur, it is important to promptly complete an endoscopic examination to confirm the diagnosis. Under endoscopy, hemostatic treatment should be performed. It is also crucial to actively rehydrate, suppress gastric acid secretion, and protect the gastric mucosa among other treatments.

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Written by Huang Gang
Gastroenterology
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What items are rechecked in the early stages of cirrhosis?

In the early stages of cirrhosis, it is essential to first re-examine liver function, including transaminases, albumin, total protein, and bilirubin. This is very important. Additionally, it is necessary to recheck the complete blood count to monitor the number of white blood cells and platelets. Another important assessment is a liver ultrasound to observe whether the liver surface is smooth, the width of the portal vein, the presence of portal hypertension, and whether the spleen is enlarged. Furthermore, a re-examination of coagulation function to check for any changes is crucial. In the early stages of liver disease, these are the primary examinations that should suffice. Based on the results, the severity of the condition should be determined. When necessary, in cases of viral-induced cirrhosis such as hepatitis B or C, aggressive antiviral symptomatic treatment should be administered.

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Written by Wu Hai Wu
Gastroenterology
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Does fatty liver occur in the early stages of cirrhosis?

Cirrhosis in its early stage does not necessarily involve fatty liver, as there are multiple causes for cirrhosis. Besides fatty liver causing steatohepatitis, which can lead to cirrhosis, other causes include viral hepatitis, drug-induced hepatitis, and autoimmune hepatitis, which can also lead to cirrhosis. Cirrhosis resulting from the above conditions will not involve fatty liver. However, if cirrhosis is caused by steatohepatitis, it is possible that fatty liver occurred in its early stage. Once fatty liver develops, proactive interventions are necessary, such as weight loss and medication, which might reverse fatty liver.

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Written by Wu Hai Wu
Gastroenterology
56sec home-news-image

Does early-stage liver cirrhosis cause petechiae on the skin?

In the early stages of cirrhosis, it generally does not cause petechiae on the skin. However, if the disease progresses to a later stage, the decline in coagulation function and reduction in platelets may lead to skin manifestations such as petechiae and ecchymosis. Therefore, if a patient with cirrhosis experiences petechiae in the early stages, it is important to seek further consultation at a reputable hospital's department of gastroenterology and hepatology. When necessary, a consultation at the dermatology department may also be required to complete coagulation function tests and a routine blood examination to assess the patient's condition. If the patient's condition, including the symptoms mentioned above, is due to cirrhosis, further comprehensive evaluations are needed, including gastroscopy and imaging studies of the liver, to rule out the occurrence of liver complications.