I see misconceptions and misunderstandings about liver disease and Cirrhosis all the time and I just wanted to write down some things as I understand them, hopefully to clear some of the confusion. I kept this to a general overview, since getting into specific cases or situations would be huge and beyond my pay grade. I'm willing to clarify if needed.
Webster's Dictionary defines Cirrhosis as:
The widespread disruption of normal liver structure by fibrosis and the formation of regenerative nodules that is caused by any of various chronic progressive conditions affecting the liver (such as long-term alcohol abuse or hepatitis).
That's a technical sounding definition, which doesn't matter because, technically, it's wrong.
Hepatitis isn't something separate from long-term alcohol abuse. It's caused BY long-term alcohol abuse. And many other things. ALL Cirrhosis comes from years of Hepatitis. No matter the cause or type of hepatitis, they all end up at the same destination if steps aren't taken to stop their progression.
The following 4 sentences are a basic description of the process that transforms ahealthy liver into a cirrhotic liver:
Hepatitis is NOT a virus. Hepatitis is the irritation or swelling of liver cells from any "insult" to the liver which results in inflammation. A virus can be one of the infectious causes of hepatitis, but do not think "virus" when you hear hepatitis. Hepatitis = Liver Inflammation
Infectious causes of hepatitis:
Non-infectiouscauses of hepatitis:
ALL of the types of hepatitis listed above are also the causes of fibrosis in the liver.
Cirrhosis is severe fibrosis of the liver from an extended period (years) of hepatitis. A healthy liver might sustain one injury, develop hepatitis, rebuild itself, diminish the hepatitis, and then continue on, strong as ever. Two thirds of a healthy liver can be cut away, and that liver will rebuild itself entirely. BUT, when a liver is continually injured over an extended period of years (a chronic viral infection, ongoing alcohol consumption, autoimmune injury, etc),the hepatitis never goes away. The hepatitis remains, never subsiding, forming fibrosis all along the way. Fibrosis replaces healthy liver tissue and partially blocks the flow of blood through the liver. And the fibrosis will continue to replace healthy liver tissue as long as the injury and hepatitis continue.
Fibrosis in the liver is similar to scar tissue anywhere else on or in the body. Scar tissue no longer functions like the healthy tissue it has replaced. The scar from a severe burn or cut won't tan or sweat or grow hair like the surrounding skin. Fibrotic liver tissue doesn't filter blood, or create and distribute nutrients, or clear the blood of drugs and other poisonous substances, or regulate blood clotting,or resist infections by making immune factors, or remove bacteria from the bloodstream. And the severe accumulation of fibrosis called Cirrhosis never will regenerate and perform those functions again. Scar tissue is tough. A scar from a traumatic laceration can grow through a healthy muscle, rendering it useless. I know this. ALL the classic cirrhosis symptoms that we know and experience result from the loss of functioning liver cells and increased resistance to blood flow through the liver (portal hypertension).
