Disease Symptoms

Liver cirrhosis are chronic afflictions with progressive evolution, morphologically characterized through the disorganization of the liver architecture due to the metaplasia of connective tissue – which form sclerosis bands that surround or fragment the lobules – determined by hepatocytary destruction and nodular regeneration; biologically through the severe alteration of mesenchymal activation syndromes, by portal hypertension and by hepatocytary insufficiency and through the possible exacerbation of the excretobiliary syndrome and of hepatocyolisis; clinically, through advanced stages of liver insufficiency, accompanied by the signs of portal hypertension.



Chronic liver disease – advanced symptoms
The debut of the illness can be asymptomatic or non-characteristic. The first signs are fatigue, anxiety, insomnia or bile dyspepsia (loss of appetite, sickness, bloating, intolerance to alcohol, dyscholia), as well as hemorrhaging. Sometimes, the illness evolves for long periods of time without any signs, and the first manifestation could be some upper digestive hemorrhaging, or the diagnosis is reached during surgical intervention. In this initial period, aside from the aforementioned phenomena, there are also signs in the mucous membranes and in the teguments, liver and spleen modifications, endocrine and nervous modifications, ascitis, edemas, hydrothorax, as well as cardiovascular, renal and hematologic disorders.



Jaundice occurs episodically in some cases of cirrhosis, as a sign of crash by hepatocytary necrosis, while in other cases – such as bile cirrhosis – jaundice occurs permanently. The liver has an increased volume in 80% of cases, it has increased consistency, it may even become hard to the touch, with sharp edges, with a regulated or finely granulated surface, and on rare occasions with macronodules. Even in atrophic cases the liver is big in the beginning and later it shrinks to the point where it disappears under the ribs.

Portal hypertension is seen in the beginning through meteorism ("the wind before the rain") and through the occurrence of collateral circulation within and without (esophageal varix). Ascitis occurs often as a sign accompanying the disease, and can be seen in any form of cirrhosis. Edemas occur in more advanced stages, usually accompanying ascitis. They are white, soft, and when they are not influenced by treatment they constitute a somber element for diagnosis. Right hydrothorax can be encountered in 3 - 4% of cirrhosis cases.

Endocrine modifications are always present. In cirrhosis cases there is a pretty early gonadic insufficiency: decreased libido, sexual impotence, gynecomastia, testicular atrophy, amenorrhea, infertility. Nervous disorders are encountered throughout the evolution of the cirrhosis, sometimes even as a debut phenomenon.



Throughout the development of the condition, these disorders can return or gain greater intensity; on many occasions, the presence of drowsiness, excessive asthenia or states of restlessness and insomnia can be warning signs for the hepatic drama that is about to ensue. Cardiovascular disorders: the hypervolemia from cirrhosis can lead to the opening of arterial-venous anastomoses, causing little vascular stars and erythrosis. The same arterial and venous circuits, added with ventilation disorders and secondary pulmonary hypertension, are responsible for the in-statement of cyanosis. Renal disorder is one of the chronic liver disease – advanced symptoms where diuresis drops. Renal insufficiency is encountered in some 11% of cases.