What is chronic liver disease ?
Chronic liver disease is marked by the gradual destruction of liver tissue over time and replacement of normal liver with nodules of scar tissue. Several liver diseases fall under this category. The end results of the gradual destruction are cirrhosis and fibrosis of the liver.
If you have hepatitis C, you should receive the vaccine for hepatitis A and B unless blood tests show that you are already immune to these viruses. You can develop more serious infection from hepatitis A or B than someone who does not have hepatitis C.
If you already have evidence of cirrhosis, you should have a test called endoscopy to look for esophageal varices, enlarged veins in the esophagus that can cause life-threatening bleeding. In an endoscopy, a flexible viewing tube is inserted through your mouth into your esophagusYou also should be screened periodically with a blood test (alpha fetoprotein) and an ultrasound study to search for an early liver cancer.
Corticosteroids and other medications such as azathioprine to suppress the immune system are the main treatment of autoimmune chronic hepatitis. These drugs usually decrease symptoms, reduce liver inflammation, and prolong survival.
Viruses that cause hepatitis include : -
- Hepatitis B and C : - These viruses cause two-thirds of all cases of chronic hepatitis. People infected with hepatitis C have the greatest risk of developing chronic hepatitis Both of these viruses usually begin with mild symptoms. Over time, perhaps a decade or more, both may lead to the serious complication of cirrhosis due to ongoing destruction of liver cells and resultant scarring. A minority of patients with cirrhosis develop liver cancer over time.
- Hepatitis D : - Hepatitis D infects only patients already infected with hepatitis B, and generally results in a flare of active hepatitis.
- Autoimmune chronic hepatitis : - In this form of chronic hepatitis, the immune system mistakenly destroys the body's own liver cells.
At first, chronic hepatitis often does not cause any symptoms. People with symptoms most commonly complain of fatigue. Fatigue worsens throughout the day and may even be debilitating.
Other common symptoms include : -
- Mild upper abdomen discomfort
- Loss of appetite
- Aching joints
If chronic hepatitis becomes more severe, people may experience additional symptoms, including:
- Jaundice (yellowing of the skin and eyes)
- Abdominal swelling
- Weight loss
- Muscle weakness
- Dark urine
- Easy bruisability and spontaneous bleeding
- Confusion which may progress to coma
- Portal Hypertension
- hypersplenism (with or without splenomegally)
- varices (lower oesophageal and rectal)
- Synthetic Dysfunction
- Hepatopulmonary Syndrome
- Hepatorenal Syndrome
- Hepatocellular Carcinoma
The goals of treatment for chronic hepatitis are to prevent the disease from getting worse and to prevent cirrhosis and liver failure. In mild cases of chronic hepatitis from hepatitis B or hepatitis C, treatment may not be necessary, and the condition may not get worse. With active infection, or if a liver biopsy shows early signs of damage, treatment is more likely to be recommended to eliminate active infection. Treatment isn't recommended for everyone because of the side effects and the risk that active infection may return.
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