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What is liver fibrosis
Liver fibrosis is the scarring of tissue. The liver is able to recover, however, this system does not work to its full capacity if the liver is damaged or the injury is prolonged and very serious. All attempts at regeneration cause an accumulation of connective tissue (these are tough, inert fibers) instead of functioning liver cells.
Liver fibrosis is not a specific disease, but rather a symptom of another liver problem. The most common conditions that lead to liver fibrosis are alcoholism, chronic hepatitis C, and non-alcoholic fatty liver disease (NAFLD).
By itself, liver fibrosis does not cause any symptoms. Doctors can look for signs of liver fibrosis with blood tests and an ultrasound, CT scan, or MRI. If it is detected early, it can be treated. But if it goes unnoticed and the damage continues, fibrosis can progress to cirrhosis.
Degrees of liver fibrosis in adults
Specialists identify 5 degrees of scarring of the liver tissue.
- No fibrosis. In this case, there is no evidence of liver cell death (necrosis) or scarring, despite inflammation of the liver (hepatitis).
- Portal (mild) fibrosis. In this case, there are areas of necrosis and scarring affecting the small and medium branches of the portal vein, which carries blood from the small intestine. The structure and function of the liver remain normal.
- Periportal (moderate) fibrosis. This is a variant with an increase in foci of necrosis, scarring and impaired liver function.
- Bridge (severe) fibrosis. At this stage, scarring has disrupted normal blood flow to the liver, and function is further impaired.
- Cirrhosis. This is permanent scarring and irreversible loss of liver function.
Causes of liver fibrosis in adults
Fibrosis can occur when the liver is severely damaged or suffers from chronic or severe injury. As the liver tries to repair itself by making new cells, it cannot fully do so and scars form. Dead liver cells are replaced by fibrous tissue. This tissue eventually interferes with normal liver function.
Liver fibrosis is a symptom of several underlying diseases. The most common reasons are:
Alcoholism. The liver breaks down alcohol and removes harmful by-products that damage liver cells. But the more alcohol she has to dispose of, the more she is damaged – she is simply unable to cope with large volumes of toxins.
chronic hepatitis C. The hepatitis C virus (HCV) attacks the liver, causing damage and inflammation. Most people do not have symptoms of the disease for several years after infection. As a result, liver problems, including fibrosis, often occur at the time of diagnosis. Fortunately, there are effective treatments.
Non-alcoholic fatty liver disease. This is a buildup of fat in the liver that can cause inflammation and damage, leading to fibrosis. The disease is not associated with alcohol consumption. But it often happens in obese people with type 2 diabetes.
Other potential underlying causes of liver fibrosis include bile duct blockage, autoimmune diseases, hereditary metabolic disorders, conditions that cause decreased blood flow to the liver, and certain medications (amiodarone, corticosteroids, isoniazid, methotrexate, and methyldopa).
There is also a congenital form of liver fibrosis that is present at birth.
Symptoms of liver fibrosis in adults
Scarring from liver fibrosis can affect the liver’s ability to work effectively. However, fibrosis itself does not cause any symptoms. You may have it and not know it.
If fibrosis progresses to cirrhosis, the main symptoms may include:
- permanent bruising on the body and bleeding;
- fatigue, confusion and weakness;
- itching;
- poor appetite, nausea and weight loss;
- swelling of the abdomen (ascites) and legs (pastosity);
- yellowing of the skin and eyes (jaundice).
Cirrhosis of the liver is a serious disease that can lead to life-threatening complications. Seek immediate medical attention if you experience any of the above symptoms.
Treatment of liver fibrosis in adults
In the early stages, liver damage is usually reversible. However, even with severe fibrosis, improvement can be observed if treated in time.
Left untreated, fibrosis and cirrhosis can lead to liver failure.
Diagnostics
Doctors can look for signs of liver fibrosis with blood tests called liver function tests (liver tests). Most people get these tests during routine medical checkups. It is also possible to see liver fibrosis on ultrasound or other examinations.
Regular visits to the doctor for an annual check-up can help identify potential liver problems while there is still time to fix them.
Modern treatments
There is no specific treatment for liver fibrosis. To treat liver fibrosis, it is important to address the underlying cause. For example, stop drinking alcohol. Lose weight. Or take antiviral drugs in case of hepatitis.
When fibrosis progresses to cirrhosis, a liver transplant is likely to be needed.
Prevention of liver fibrosis in adults at home
To reduce the risk of liver fibrosis, you need to:
- stop drinking alcohol;
- losing weight is the most effective treatment for non-alcoholic fatty liver disease, and continuing to maintain a healthy body weight through proper nutrition and exercise;
- control blood sugar and blood pressure;
- Regular visits to the doctor – this will help identify liver fibrosis in the early stages.
Popular questions and answers
We asked for answers to popular questions about liver fibrosis gastroenterologist Valery Lomov.
Why is liver fibrosis dangerous?
Who is at risk for liver fibrosis?
● patients with viral hepatitis B and C;
● patients who use alcohol in hepatotoxic doses for more than 5 years;
● people suffering from obesity, autoimmune liver diseases, and storage diseases (hemochromatosis, Wilson’s disease).
The development of liver fibrosis is also possible with the toxic effect of certain groups of drugs.