
Liver Cirrhosis
Liver cirrhosis is a chronic progressive fibrotic disease caused by prolonged liver damage or inflammation. Fibrous tissue and regenerative nodules replace the normal liver structure, gradually losing liver function. Cirrhosis represents the final stage of many chronic liver diseases and may progress to liver failure or liver cancer in severe cases.
Symptoms
Liver cirrhosis in the early stages may present no symptoms, while advanced stages can lead to severe complications such as ascites, hepatic encephalopathy, and liver cancer.
Early Symptoms
- Fatigue and weakness.
- Loss of appetite, nausea, and weight loss.
- Mild discomfort or dull pain in the upper abdomen or right upper quadrant.
Late Symptoms
- Jaundice: Yellowing of the skin and whites of the eyes.
- Ascites: Abdominal swelling caused by fluid accumulation in the abdominal cavity.
- Lower Limb Edema: Swelling in the legs.
- Hepatic Encephalopathy: Symptoms include confusion, personality changes, or coma.
- Bleeding Tendencies: Due to reduced clotting factors, presenting as gum bleeding or subcutaneous bruises.
- Gynecomastia in Males: Enlarged breasts due to hormone imbalances caused by liver dysfunction.
- Spider Angiomas: Abnormal dilation of blood vessels visible on the skin.
Causes and Factors
Causes
- Viral Hepatitis: Hepatitis B and C are the leading causes of liver cirrhosis in Hong Kong.
- Fatty Liver Disease: Closely associated with obesity, diabetes, and hyperlipidaemia.
- Alcoholic Liver Disease: Chronic excessive alcohol consumption leading to liver damage.
- Cholestatic Diseases: Primary Biliary Cholangitis (PBC). Primary Sclerosing Cholangitis (PSC).
- Autoimmune Liver Diseases: Autoimmune Hepatitis (AIH).
- Other Causes: Iron overload (Hemochromatosis), Copper metabolism disorder (Wilson's Disease), Drug-induced liver injury or exposure to toxic substances.
Risk Factors
- Chronic Viral Hepatitis Infections: Hepatitis B and C infections.
- Chronic Alcohol Consumption: Prolonged heavy drinking.
- Obesity and Metabolic Syndrome: Increases the risk of fatty liver and its progression to cirrhosis.
- Exposure to Hepatotoxic Substances: Certain medications or chemicals that damage the liver.
- Family History: Hereditary conditions such as Hemochromatosis or Wilson's Disease.

Diagnosis
Clinical Examination | The doctor will inquire about a history of chronic liver disease, alcohol use, or viral hepatitis infection.
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Blood Tests |
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Imaging Studies |
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Liver Biopsy | Used to confirm the degree of fibrosis and cirrhosis, mainly when the cause is unclear. |
Treatments
Controlling Underlying Causes |
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Managing Complications |
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Liver Transplantation | Recommended for end-stage liver disease (complete liver failure) or uncontrollable complications. In Hong Kong, patients must undergo evaluation and be listed on the transplant waiting list. |
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