The early symptoms of cirrhosis are not obvious. When minor lesions occur, most healthy tissues are still able to cope with the needs of daily metabolic activities, so they are not prone to uncomfortable symptoms. Many patients with liver disease ignore the early manifestations of liver disease, so cirrhosis is aggravated. The latest medical authority statistics show that 50% of patients with cirrhosis are found to be in advanced cirrhosis or liver cancer, so this is one of the reasons for the high mortality rate of cirrhosis.
The early symptoms of cirrhosis are.
1, systemic symptoms: mainly weakness, easy fatigue, loss of physical strength. A few patients may have facial pigmentation.
2, chronic dyspepsia symptoms: loss of appetite, abdominal distension or with constipation, diarrhea or vague pain in the liver area, obvious after exertion.
More than 1/3 of patients suffering from chronic hepatitis or cirrhosis have darker skin around the face and eyes than before the disease, which is due to the increased production of melanin as a result of reduced liver function.
4, the early symptoms of cirrhosis may also appear breast swelling, testicular shrinkage, the liver plays an important role in the balance of sex hormones in human blood. As the early symptoms of cirrhosis increase estrogen and decrease androgen, men can see breast enlargement, swelling and pain, testicular atrophy. For women, sex hormone disorders during cirrhosis can also cause menstrual disorders, breast shrinkage and pubic hair thinning.
5, a few early symptoms of cirrhosis can be seen as spider nevus, mild to moderate enlargement of the liver, mostly seen in patients with alcoholic cirrhosis, usually without pressure pain. The spleen may be normal or mildly enlarged.
Late stage symptoms of cirrhosis
1, systemic symptoms: fatigue and weakness is one of the symptoms of advanced cirrhosis, most of the symptoms of advanced cirrhosis have dry and rough skin, gray and dark face.
2, gastrointestinal symptoms: loss of appetite is the most common advanced cirrhosis symptoms, sometimes accompanied by nausea, vomiting. The general performance is poor nutritional status, appetite significantly decreased, after eating that is to feel epigastric discomfort and fullness, nausea, and even vomiting, advanced cirrhosis of the liver to fat and protein tolerance is poor, into greasy food, easy to cause diarrhea. Patients with cirrhosis feel bloated due to ascites and gas accumulation in the stomach and intestines, and toxic bullae can appear in the late stage.
3, portal hypertension: manifested as esophageal varices, splenomegaly and ascites, especially esophageal varices are the most dangerous. Because of the thin wall of varices, it is easy to rupture and lead to gastrointestinal hemorrhage.
4, cirrhosis ascites formation: late stage of cirrhosis ascites often appear before the abdominal distension, a large amount of water to make the abdomen bulge, the abdominal wall taut hair highlight, like a frog’s belly, the patient walking difficulties, sometimes the diaphragm is significantly elevated, breathing and umbilical hernia.
5, bleeding tendency and anemia: epistaxis, gum bleeding, skin bruising, gastrointestinal mucosal erosion and bleeding, nasal bleeding, vomiting blood and black feces, women often have excessive menstruation and other symptoms in the late stage of cirrhosis.
6. Endocrine disorders: In the late stage of cirrhosis, the function of the liver declines more obviously, which directly leads to the reduction of estrogen inactivation, the rise of estrogen secretion, and a large amount of estrogen in the blood, accompanied by the suppression of androgens and other phenomena.
Complications
Cirrhosis often leads to death due to complications. Upper gastrointestinal bleeding is the most common complication of cirrhosis, while hepatic encephalopathy is the most common cause of death in cirrhosis. Therefore, the principles of cirrhosis are: proper diet and nutrition, improvement of liver function, anti-liver fibrosis treatment, and active prevention and treatment of complications.
(1) Hepatic encephalopathy. It is the most common cause of death. In addition to the above-mentioned causes of circulatory encephalopathy in humans, it is also prone to hepatic encephalopathy when the liver is severely damaged, plus the presence of the following causative factors (i) Upper gastrointestinal bleeding is the most common causative factor. (ii) Excessive intake of nitrogenous substances, such as excessive protein in the diet, oral amine salts, methionine, etc. ③Disorders of water, electrolytes and acid-base balance. ④ Hypoxia and infection. ⑤ Hypoglycemia. ⑥Constipation. (7) Hypnosis, sedation and surgery.
(2) Massive upper gastrointestinal bleeding. Upper gastrointestinal bleeding is the most common co-morbidity, mostly occurs suddenly, and the bleeding volume is usually large, more than 1000ml, and it is difficult to stop bleeding by itself. In addition to vomiting fresh blood and blood clots, it is often accompanied by tarry stools. Among them, there are six kinds of portal hypertensive factors, with ruptured esophagogastric fundic variceal vein bleeding being the most common, and other bleeding causes such as acute hemorrhagic erosive gastritis and cardia mucosa tearing syndrome.
(3) Infection. Patients with hepatitis cirrhosis often have immunodeficiency and may have fever, nausea, vomiting and diarrhea, and in severe cases, shock. Patients with rapid growth of ascites, abdomen may have different degrees of pressure pain and signs of peritoneal irritation, ascites is mostly exudate, but because the exudate is often diluted by the original leaky ascites, its nature can be between leakage and exudate. Cirrhosis is easily complicated by various infections such as bronchitis, pneumonia, tuberculous peritonitis, biliary tract infection, intestinal infection, spontaneous peritonitis and Gram-negative bacillary sepsis.
(4) Primary hepatocellular carcinoma. The relationship between cirrhosis and hepatocellular carcinoma is remarkable, and it is speculated that the mechanism may be that hepatitis B virus causes hepatocyte damage followed by hyperplasia or atypical hyperplasia, which leads to sensitivity to carcinogenic substances (such as aflatoxin) and leads to carcinogenesis under small dose stimulation. According to data analysis, the combined rate of liver cancer and cirrhosis is 84.6%, showing that liver cancer is closely related to cirrhosis.
(5) Liver and kidney syndrome: Patients with liver cirrhosis can develop functional renal failure, also known as liver and kidney syndrome, due to factors such as insufficient effective circulating blood volume. It is characterized by spontaneous oliguria or anuria, dilutional hyponatremia, hyponatremia and azotemia. Hepatorenal syndrome can occur when cirrhosis is combined with intractable ascites and is not properly treated. It is characterized by oliguria or anuria, azotemia, hyponatremia or hyponatremia, and no organic renal lesions, so it is also called functional renal failure. The prognosis for this complication is extremely poor.
(6) Portal vein thrombosis: thrombosis is related to the slow flow of blood in the portal vein during portal vein obstruction, portal vein sclerosis, portal vein endocarditis and other factors. If the thrombus is formed slowly, confined to the extrahepatic portal vein, and organic, or rich in collateral circulation, there may be no obvious clinical symptoms, but if complete obstruction is suddenly produced, severe abdominal pain, abdominal distension, blood in stool, vomiting, shock, etc. may occur.
(7) Respiratory injury: In recent years, some scholars have collectively referred to the various pulmonary changes caused by liver disease as hepatopulmonary syndrome, the essence of which is the occurrence of pulmonary vasodilatation and abnormal arterial oxygenation during liver disease, which can cause hypoxemia.
(8) ascites: normal people have a small amount of fluid in the abdominal cavity, about 50 ml, when the amount of fluid is greater than 200 ml is called ascites. Ascites is a common complication of decompensated cirrhosis.