Cirrhosis is a consequence of chronic liver disease characterized by replacement of liver tissue by fibrotic scar tissue as well as regenerative nodules, leading to progressive loss of liver function. Cirrhosis is most commonly caused by alcoholism and hepatitis C, and was the 12th leading cause of death in the United States in 2000.Anderson RN. "Deaths: leading causes for 2000" National vital statistics reports. 2003;50:16 PMID 16485447 Ascites is the most common complication of cirrhosis and is associated with a poor quality of life, increased risk of infections, and a poor long term outcome. In advanced stages of cirrhosis, the condition is irreversible and the only option would be a liver transplant.

Symptoms and signs

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The following signs and symptoms may occur in the presence of cirrhosis or as a result of the complications of cirrhosis. Many are nonspecific and may occur in other diseases and does not necessarily point to cirrhosis. Likewise, the absence of any does not rule out the possibility of cirrhosis.

• Spider angiomata. Vascular lesions consisting of central arteriole surrounded by many smaller vessels due to an increase in estradiol.
• Palmar erythema. Exaggerations of normal speckled mottling of the palm, due to altered sex hormone metabolism.
• Nail changes.
  • Muehrcke's nails --- paired horizontal bands separated by normal color due to hypoalbuminemia
  • Terry's nails --- proximal two thirds of the nail plate appears white with distal one-third red, also due to hypoalbuminemia
• Clubbing. Angle between the nail plate and proximal nail fold > 180 degrees
• Hypertrophic osteoarthropathy. Chronic proliferative periostitis of the long bones that can cause considerable pain.
• Dupuytren's contracture. Thickening and shortening of palmar fascia that leads to flexion deformities of the fingers. Thought to be due to fibroblastic proliferation and disorderly collagen deposition. It is relatively common (33% of patients).
• Gynecomastia. Benign proliferation of glandular tissue of male breasts presenting with a rubbery or firm mass extending concentrically from the nipples. This is due to increased estradiol and can occur up to 66% of patients.
• Hypogonadism. Manifested as impotence, infertility, loss of sexual drive, and testicular atrophy due to primary gonadal injury or suppression of hypothalamic or pituitary function.
• Liver size. Can be enlarged, normal, or shrunken.
• Splenomegaly. Due to congestion of the red pulp as a result of portal hypertension
• Ascites. Accumulation of fluid in the peritoneal cavity giving rise to flank dullness (needs about 1500 mL to detect flank dullness).
• Caput medusa. In portal hypertension, the umbilical vein may open. Blood from the portal venous system may be shunted through the periumbilical veins into the umbilical vein and ultimately to the abdominal wall veins, manifesting as caput medusa.
• Cruveilhier-Baumgarten murmur. Venous hum heard in epigastric region due to collateral connections between portal system and the remnant of the umbilical vein in portal hypertension.
• Fetor hepaticus. Sweet pungent smell in breath due to increased dimethylsulphide due to severe portal-systemic shunting.
• Jaundice. Yellow discoloring of the skin, eye, and mucus membranes due to increased bilirubin (at least 2-3 mg/dL). Urine may also appear dark.
• Asterixis. Bilateral asynchronous flapping of outstretched, dorsiflexed hands seen in patients with hepatic encephalopathy.
• Other. weakness, fatigue, anorexia, weight loss

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cbab3331 (cbab3331 ) Wed, 04 Nov 2009 16:39:57 -0000
Liver Cirrhosis Cure.: Huge Conversion Rate From A Professionally Written Sales Letter - 60% Commission So You .. http://bit.ly/2KlwJS
@rick_snee It's my attempt to die of both cirrhosis and diabetes.
SirChuggles56 (Chris Taylor) Wed, 04 Nov 2009 11:35:20 -0000
@rick_snee It's my attempt to die of both cirrhosis and diabetes.
@CelandineFleury I was drinking orujo last night. Spanish grappa. Cirrhosis in a bottle.
VicDarkwood (Vic Darkwood) Wed, 04 Nov 2009 10:41:42 -0000
@CelandineFleury I was drinking orujo last night. Spanish grappa. Cirrhosis in a bottle.
@CelandineFleury Well, I sincerely hope I don't need a 'cure' for liver cirrhosis and that this preventative measure will do the trick.
VicDarkwood (Vic Darkwood) Wed, 04 Nov 2009 10:34:00 -0000
@CelandineFleury Well, I sincerely hope I don't need a 'cure' for liver cirrhosis and that this preventative measure will do the trick.
@Alyssa_Milano im most proud of myself for saying i wldnt drink after my dad passed of cirrhosis last yr&I have not had a sip in 14 mnths!
miss_andrearod (Andrea ) Wed, 04 Nov 2009 07:29:42 -0000
@Alyssa_Milano im most proud of myself for saying i wldnt drink after my dad passed of cirrhosis last yr&I have not had a sip in 14 mnths!
Now on http://www.HIVandHepatitis.com: #AASLD coverage: tenofovir for HBV at 3 yrs; entecavir bests adefovir for decomp cirrhosis #hepB
HIVandHepatitis (HIVandHepatitis.com) Wed, 04 Nov 2009 07:29:19 -0000
Now on http://www.HIVandHepatitis.com: #AASLD coverage: tenofovir for HBV at 3 yrs; entecavir bests adefovir for decomp cirrhosis #hepB

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