Cirrhosis is defined as a condition of irreversible scarring liver as a
result of liver tissue by fibrosis due to final phase of chronic liver diseases
of that can lead to poor function of the liver and liver failure. According to
the statistics, Number of discharges with chronic liver disease or cirrhosis as
the first-listed diagnosis: 101,000 in 2009 and Deaths per 100,000 population:
10.3 in 2010(a). Hepatitis B infection cause of the disease is very prevalent in
South-East Asia.
Symptoms
1. Psychosocial issues and health-related quality of life (HRQOL)
According to the study by the Tehran University of Medical Sciences and
Tehran University of Medical Sciences, showed that Increasing severity
of CHBV leads to a decline in HRQOL. Cirrhosis
worsens HRQOL, whereas treatment and psycho-education improves it.
Frequency of mood disorders seems to be increased in patients with CHBV,
although not all studies have shown this trend. Some factors such as
alcohol consumption and low social support negatively impact patients'
mental health. Those with CHBV generally have better HRQOL and mental
health than their hepatitis C (HCV)
counterparts. Patients with psychiatric disorders, particularly those
with prolonged institutionalization, have a generally higher risk of
acquiring CHBV infection compared to the general population(18) .Other
study indicated that
severity of cirrhosis measured by the
Child-Pugh score was not correlated with depression or anxiety, and only
had a weak correlation with poor sleep. The psychological distress in cirrhosis
such as depression, anxiety, and insomnia were correlated specifically
to increased levels of aspartate aminotransferase (AST), increased
ratios of low frequency to high frequency power, or reduced nonlinear
properties of HRV (alpha1 exponent of detrended fluctuation
analysis)(19).
2. Fatigue, Pruritus and Jaundice
In the study to summarize the clinical characters of refractory primary biliary cirrhosis
(PBC) versus typical ones and explore the risk factors of prognosis,
found that Some clinical severe manifestation (fatigue, pruritus and jaundice)
and higher biochemical markers levels (ALT, AST, ALP, GGT, TBIL, DBIL
and IgM) seem to predict a worse response to UDCA and a rapid
progression of disease in PBC patients(20).
4. Lower serum aminotransferase, bilirubin, and immunoglobulin G (IgG) for patient with autoimmune hepatitis (AIH)(21).
5. Migraine symptoms
In the study to assess the effects of H. pylori eradication on migraine symptoms in patients with hepatitis-B-virus-related cirrhosis,
the results clearly showed that the intensity, duration, and frequency
of attacks of migraine were significantly reduced in all the patients in
whom H. pylori has been eradicated(22).
6. Cognitive symptoms
According to the study by the Newcastle
University, PBC associates with substantial functional impairment. PBC
symptom distribution evolves over time, with cognitive symptoms
making ever-greater contribution to overall symptom burden. The major
potentially modifiable determinant responsible for the functional
impairment appears to be orthostatic symptoms(23).
Other indicated that a
significant proportion of fatigue in PBC associates with one or both of
autonomic dysfunction (OGS > or =4) and sleep disturbance (ESS >
or =10)(24).
7. Other symptoms include
Loss of appetite( Progression of the disease), Itching (liver
malfunction), Easy bruising and bleeding (platelet destruction), Weight
loss (Malnutrition), Leg swelling (as a result of fluid retention),
discrepancies between serum albumin levels(progression of the
disease) etc(25).
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Sources
Sources
(a) http://www.cdc.gov/nchs/fastats/liverdis.htm
(19) http://www.ncbi.nlm.nih.gov/pubmed/23339829
(20) http://www.ncbi.nlm.nih.gov/pubmed/23328240
(21) http://www.ncbi.nlm.nih.gov/pubmed/15954109
(22) http://www.ncbi.nlm.nih.gov/pubmed/17669102
(23) http://www.ncbi.nlm.nih.gov/pubmed/21593676
(24) http://www.ncbi.nlm.nih.gov/pubmed/18237872
(25) http://www.ncbi.nlm.nih.gov/pubmed/22969847
Health Researcher and Article Writer. Expert in Health Benefits of Foods, Herbs, and Phytochemicals. Master in Mathematics & Nutrition and BA in World Literature and Literary criticism. All articles written by Kyle J. Norton are for information & education only.
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