What items are rechecked in the early stages of cirrhosis?

Written by Huang Gang
Gastroenterology
Updated on March 24, 2025
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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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Will the platelet count be low in the early stages of cirrhosis?

The early stage of cirrhosis does not cause a decrease in platelets. Patients in the early stages of cirrhosis often have no obvious symptoms and may only exhibit fatigue, weight loss, jaundice, etc. However, once a patient with cirrhosis develops splenic hyperfunction, it can easily lead to a decrease in platelets, where the platelet count may drop to 100,000 per microliter. In such cases, it might be necessary to perform procedures like splenic embolization or splenectomy for antimicrobial treatment, and it is also important to prevent other complications of cirrhosis, such as esophageal and gastric varices, etc.

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Written by Huang Ya Juan
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Early symptoms of cirrhosis

Liver cirrhosis is generally divided into compensated and decompensated stages: The compensated stage is actually an early stage of liver cirrhosis. During this stage, most patients do not show symptoms, or they may experience some mild symptoms such as abdominal discomfort, fatigue, loss of appetite, abdominal bloating, indigestion, diarrhea, etc. Decompensated stage: Early stages often present with fatigue and weakness, and later stages can include weight loss, loss of appetite, aversion to oily foods, abdominal bloating, diarrhea, fever, etc.; The liver is the only site of albumin synthesis, and during cirrhosis, reduced serum albumin can cause edema and ascites; the liver synthesizes most clotting factors, and cirrhosis can lead to coagulation disorders, clinically manifesting as gum bleeding, skin bruising, and nosebleeds; During cirrhosis, there can also be metabolic disorders of bilirubin and bile acids, leading to jaundice; Cirrhosis can also cause hormonal metabolic abnormalities, especially in patients with alcoholic cirrhosis, who may exhibit many characteristics of male dysfunction, including impotence, erectile dysfunction, testicular atrophy, loss of body hair and muscle mass, feminization, etc. Female patients may experience cessation or reduction of menstruation, excessive menstruation, infertility, etc.; Both male and female patients can develop osteoporosis, leading to spontaneous fractures.

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Symptoms of alcoholic liver cirrhosis

Long-term alcohol consumption can lead to alcoholic liver disease, with alcoholic liver cirrhosis being one of its main manifestations. Initially, it presents with reduced liver function, symptoms such as loss of appetite, abdominal pain, bloating, vomiting, aversion to oily foods, diarrhea, and nausea, which are indicative of hepatitis. Additionally, there may be darkening of the skin, menstrual irregularities, and even signs like liver palms and spider angiomas due to metabolic disorders. Furthermore, disruptions in carbohydrate metabolism can lead to nutritional excess, increasing lipid levels in the body and leading to fatty liver and hyperlipidemia. There can also be abnormal protein synthesis, resulting in ascites, pleural effusion, and other symptoms of liver dysfunction. Additionally, abnormalities in vitamin metabolism can cause rough skin and edema. Coagulation factors are often abnormal as well, leading to symptoms such as bleeding gums and nosebleeds. Therefore, it is crucial to seek medical attention promptly in these situations to restore normal health.

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Do I need to take liver-protective medicine in the early stages of cirrhosis?

As for whether it is still necessary to take liver-protective medication in the early stages of cirrhosis, it depends on whether there is liver function impairment in patients with early-stage cirrhosis. If there is liver function impairment, such as elevated transaminases and bilirubin, then it is necessary to take some liver-protective medications. If liver function is normal, then it is sufficient to treat only the cause of the disease. For example, if cirrhosis is caused by chronic hepatitis B virus infection, but the patient's liver function is normal, then antiviral treatment alone is sufficient. If the cirrhosis is due to alcohol abuse, then strict abstinence from alcohol is required, and the condition can generally be stabilized.

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Why does cirrhosis cause increasing weight loss and what can be done about it?

The reason why patients with cirrhosis are becoming thinner might be due to the decreased protein synthesis function of the liver after cirrhosis, leading to progressively lesser protein in the body, which results in the patient becoming thinner. It could also be because cirrhosis leads to poor digestion and absorption in patients, thereby reducing their absorption capacity and causing them to lose weight. Under these circumstances, some medications can be used for treatment, such as the infusion of albumin to supplement plasma proteins in the body. It is also important to actively treat the underlying cause of cirrhosis. For example, in the case of alcoholic cirrhosis, active efforts to abstain from alcohol and rehabilitative treatment are necessary. If the cirrhosis is caused by chronic hepatitis B virus infection, antiviral treatment should be administered.