Chronic Liver Disease: Causes, Symptoms, Signs and Treatment

Liver Cirrhosis
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Liver Cirrhosis
Introduction
Liver cirrhosis marks the end-stage of many chronic hepatic diseases and results in over a million deaths every year globally (Vaz et al., 2020). The disease is presently the 11th most frequent cause of death in the world with liver cancer being the 16th leading cause of mortality globally. A combination of liver cirrhosis and liver cancer accounts for 3.5% of the total number of deaths in the world (Mekuria et al., 2020). However, liver disease-related deaths in the United States has been underrated during the past decades with new figures reported to be almost 66,000 deaths each year (Setiawan et al., 2016). Hepatic cirrhosis is mainly epitomized by nodule formation and liver fibrosis following a chronic injury that results in the variation of the regular lobular organization of the liver (Mekuria et al., 2020). Cirrhosis is mainly caused by viral infections such as hepatitis A, B, and C, deranged immune system, cancers and tumors, genetic conditions such as Wilson’s disease, and drug and alcohol abuse (Berzigotti, 2017). While the etiology of hepatic cirrhosis is poorly understood, expanding knowledge on the causes of the disease provides an insight into preventing and treating the condition to reduce the global burden to health care systems.
Etiology and risk factors
Cirrhosis is often a result of infections, toxic or allergic, vascular, and immunopathological processes, or inborn metabolic errors (Yildiz & Sivri, 2020). In addition, other risk factors such as age, gender, environmental and genetic factors, as well as lifestyle are known etiological influences of the disease. Kamimura et al (2019) have noted that the aging of the organ function among the elderly contributes to the progression of cirrhosis and this calls for careful consideration while caring for geriatric patients with the disease. The aging liver exhibits both functional and morphological changes, including reduced weight, low blood flow, loss of detoxification and metabolic functions, as well as declining expression of growth factors (Kamimura et al., 2019). Based on gender, men are twice as likely to die from liver cirrhosis compared to women and Lisa et al (2020) have found out that men with alcohol-related liver diseases are 95% more likely to suffer serious complications requiring transplants than their counterparts. Environmental and genetic factors also play a key role in the pathogenesis of hepatic cirrhosis. Emdin et al (2021) have identified a missense variant in the human APOE gene as well as a noncoding variant located near the EFN1A gene to be associated with increased risk of the disease. Other polygenic factors such as being overweight and lifestyle issues like alcoholism potentiate disease progress.
Pathophysiological processes
Fibrosis and the histological development of nodules following chronic liver injury define the disease process in hepatic cirrhosis. In fibrosis, there is a replacement or encapsulation of injured tissue by a scar. This process is a result of the perpetuation of the normal process of wound healing leading to abnormal advancement of fibrogenesis at different rat...