Liver Cirrhosis is a disease of the liver when its function is negatively affected due to long-term damage developed slowly over a considerable time of several months or years. The disease may be asymptomatic in the early stages but may show symptoms in the later stages like over-tiredness, development of yellow skin, swelling in the lower legs, fluid buildup and its spontaneous infection in the abdomen, appearance of spider-like blood vessels on the skin etc. The major causes of cirrhosis are overuse of alcohol, hepatitis B, hepatitis C, and non-alcoholic fatty liver disease.

When the liver is damaged beyond repair, the liver tissue can be replaced with scar tissue. In extreme cases, even replacement may not help in the prophylaxis and can prove to be fatal.

Hepatic portal hypertension and Liver cirrhosis

A major complication of liver cirrhosis is portal hypertension characterized by increased resistance to blood flow and subsequent higher pressure in the portal venous system. Portal hypertension is the increased high blood pressure (greater than 6mmHg) in the hepatic portal system which constitutes the portal vein and its branches draining from intestines to the liver. Its symptoms are:

  • Increased spleen size (Splenomegaly)
  • Esophageal varices or extremely dilated and swollen veins
  • Abdominal pain and swollen veins on the anterior side of its wall
  • Hemorrhoids
  • Ascites of free fluid in the peritoneal cavity
  • Anorectal varices

Secondary effects such as gastrointenstinal bleeding can be caused by hypertension due to the formation and rupture of esophageal varices by a process called portocaval anastomosis. The high blood pressure redirects the blood flow from the hepatic portal system into the gastrointestinal areas with lower venous pressure. This makes the small veins in these areas extremely dilated, thin-walled (varicosities) and prone to rupture. Patients diagnosed with varices should be given treatments like non-selective beta-blockers, and nitrates after confirmation with endoscopy.