The liver is a relatively “silent” organ, so if the inflammation is mild, the symptoms are not very obvious, and the elevation of serum transaminases is not very large, it may be neglected. A small amount of inflammatory damage to the liver tissue and a small amount of fibrous repair can develop into cirrhosis after a long period of accumulation. Cirrhosis that develops from hepatitis and has hepatitis activity at the time of cirrhosis is medically called active cirrhosis, which is all described in this article. It is quite common for chronic hepatitis B to develop into cirrhosis, which can account for up to 40% cumulatively, but may not be detected clinically in all cases. ultrasound and CT diagnose only 40% of the actual number, and liver puncture can only diagnose 80%. In some cases, cirrhosis is accidentally detected by surgery for stomach disease, otherwise, it may remain unknown for life. Potentially developing cirrhosis can be asymptomatic. There may be intermittent small increases in serum aminotransferases, which are easily reversible with anti-inflammatory and enzyme-lowering drugs. Most of the cases are “small triple positive”, with serum viral levels fluctuating around 1×105 copies/mL, and are often not taken seriously by patients. The lesions develop unknowingly, and sometimes the actual status of the lesions is often not known when the patient goes to the doctor. Of course, there are various processes from chronic hepatitis B to cirrhosis, and the one I am describing is mainly the one you are experiencing, the one that is easily overlooked and requires a lot of vigilance. Is cirrhosis all that terrible? There are many different kinds of cirrhosis: some are mild, so mild that you don’t even know it; some are severe, so severe that you must have a new liver. I want to talk with you today, just for your past delay, and then do not delay to turn the light one into a heavy one. There are 2 pathological factors in the formation of cirrhosis: first, extensive fibrosis of liver tissue; second, extensive regeneration of small nodules of hepatocytes. The development of chronic hepatitis B cirrhosis, the lightest, in fact, only a few small nodules formed in severe hepatitis, commonly known as early cirrhosis, this cirrhosis with serum, B ultrasound and CT examination can not, only liver puncture can be detected. In early cirrhosis, after antiviral treatment, the lesions are reversible and most of them can be removed from the cirrhosis hat. So when cirrhosis is suspected but not identified, it is important to have a liver aspiration because cirrhosis that can only be diagnosed by liver aspiration can have the best consequences with antiviral treatment. Most cirrhosis is compensated, compensated meaning that by and large you can still load up and live and work like you used to, and maybe you are one of these and it is mild, which is easy to overlook. If it is more severe, you may have some vague symptoms: easy fatigue, not eating very well, abdominal discomfort, or tightness in the right upper abdomen. Serum transaminases are elevated and other liver function tests are abnormal. Ultrasound most often reveals a large spleen, and there may be individual, less definite ultrasound presentations. More severely, symptoms may be slightly more frequent, with elevated serum transaminases on liver function tests, slightly lower albumin, the appearance of liver palms and spider nevi, and ultrasound showing an uneven liver surface and widening of the portal and splenic veins. Further progression to severe disease brings us to decompensated cirrhosis: jaundice, ascites, encephalopathy, bleeding and reduced albumin. Loss of compensation is the result of prolonged viral replication and inflammatory activity, and is advanced active cirrhosis. Can compensated cirrhosis still be treated? Yes, of course it can! You will be able to live the same life and do the same work as before, but with a slightly reduced quality of life. You can’t drink, you can’t overeat, you can’t do heavy physical work, you can go jogging, but you can’t participate in 100-meter races. For example, others pick 100 pounds to walk 100 miles; you can only pick 70 to 80 pounds, but you can also walk to the end. First of all, you need to have your condition checked out and then ask your doctor to discuss it with you according to your condition. You need to understand your condition for the best outlook. The main thing you delayed in the past was the antiviral treatment, and now you still have to start with the antiviral This cirrhosis is caused by the hepatitis B virus, and now the liver is still damaged by inflammation, and it is still active cirrhosis. Thus, it is necessary to remove the virus and control the inflammation in order to brake the progress of the disease. I have talked about the medications for antiviral treatment several times in the Blog, so please refer to it. In general, treatment for active cirrhosis is more effective than for hepatitis. If you are older and not very fit, it is safer and more stable to use nucleoside analogs; if you are younger, not very sick and have a higher quest, you can also use interferon. The next thing is to check for comorbidities of cirrhosis and to deal with these comorbidities All the blood in the human abdominal cavity from the internal organs is returned to the heart by the portal vein through the liver. With cirrhosis of the liver, the resistance to portal blood flow increases, called portal hypertension, which leads to several comorbidities. Compensated cirrhosis can also have dangerous comorbidities, the most important one being gastroesophageal varices, and if the varices rupture and bleed, the condition may “slide” at once, which is the biggest risk. And if it bleeds once, it will recur frequently in the future. It is necessary to prevent it before it happens! This requires a gastroscopy: in mild cases, medication can be taken to prevent bleeding, and it is important to take it in place; in too severe cases, a ligature should be done. Patients with gastroesophageal varices should not eat hard, irritating foods; they should also avoid closed stools. A more common comorbidity is hypersplenism. The spleen is the body’s functional blood bank, and a normal spleen only destroys and removes senescent blood cells. Blood from the spleen also flows to the liver through the portal vein. In cirrhosis, the spleen becomes bruised and enlarged, and hypersplenism occurs, destroying normal blood cells as well. With fewer white blood cells, pneumonia and sepsis are likely to occur; with fewer platelets, there is a lack of material to plug the rupture when a blood vessel breaks. Blood cells that are too low are also at risk, so severe hypersplenism requires partial destruction of the spleen (splenic embolism), or even necessitates the removal of the spleen. Liver cancer occurs in 1-4% of patients with active cirrhosis each year, and ultrasound and methemoglobin should be checked every 6 months. This early detection is only possible for “small hepatocellular carcinoma”, which is a specific diagnosis and is curable. When active cirrhosis is treated with antiviral therapy, the portal hypertension will be reduced and the above mentioned comorbidities will be alleviated; especially the incidence of liver cancer will be very low. Then to improve liver function, which is the most fundamental Do not believe in some grass ah, Chi ah, there is no “fairy grass”, fairy grass is the market operation out. According to medical common sense to enhance food nutrition, folk food taboos are not science, may not be credible. Drugs are certainly needed, but to be used accurately and appropriately. The name of the drug does not necessarily mean that there is that effect, the virus cleared, inflammation control, liver fibrosis will naturally reduce. Most of the inexpensive and commonly used drugs are worth using; most of the expensive and highly advertised ones are not worth using. Live a regular life and work within your means. You need to find a doctor near you who can be a long-term consultant and is familiar with your condition; you need to visit him regularly for checkups and consultations.