End Stage Liver Disease – Causes, Symptoms, Prognosis And Treatment
What is end stage liver disease (ESLD)?
This term refers to the irreversible condition caused by chronic liver disease. This condition is also an indicator of a looming liver failure. It is not hard to tell that this condition is serious and it can help to know more about it. In this way, we can do something to put a halt to its advanced progress and for us to have a good idea of how to extend proper care to loved ones who might be suffering from it (it could even be you).
End Stage Liver Disease Causes
There are several liver diseases that can lead to end stage liver failure. These include
1. Alcohol liver cirrhosis
2. Hepatocellular carcinoma (liver cancers)
3. Viral hepatitis infections
4. Autoimmune disorders
5. Drug toxicity
End Stage Liver Failure Symptoms
Because ESLD is often the result of other liver problems, the only way to determine its onset is through close monitoring. There are also certain signs that we need to keep an eye on.
1. Jaundice. Foremost among these symptoms is jaundice. This condition refers to the yellow discoloration of the skin and sclera (white of the eyes). It is generally one of the first signs of liver problems and it continues on to the end stages.
2. Cholestasis. This refers to the reduced flow of bile or the stoppage of bile flow. This is caused by the swelling of the liver that causes obstructions in the bile ducts. This, in turn, results to the disrupted flow of bile and interferes with the ability of the vital organ to strain bilirubin from the blood. As blood travels to the kidneys, bilirubin that has not been filtered by the liver can mix with urine. This results to urine that is dark in color. The condition can also result to gray or light colored stools.
3. Encephalopathy. Hepatic or liver encephalopathy refers to the condition wherein there is reduced functioning of the brain due to toxins present in the body caused by the failure of the liver to perform its most important purpose. This condition is often characterized by behavioral changes, loss of consciousness, drowsiness, impaired judgment, disorientation, and confusion. If the condition progresses, it can lead to coma.
4. Portal hypertension. The portal vein carries blood from the stomach and intestine, and spleen into the liver. It can be inflamed from liver disease, as well as from the development of hepatic scar tissue. This causes disruptions in the blood flow into the liver (as well as within). This causes blood pressure in the portal blood vessel to shoot up and results to the rerouting of blood to other vessels, thereby bypassing the liver. With increased blood volume, the walls of the blood vessels can weaken, leading to internal bleeding, which can be highly fatal.
End Stage Liver Disease Prognosis
To help in predicting prognosis (likely outcome) among patients suffering from ESLD, medical experts can make use of two types of scoring systems.
1. Model for End-Stage Liver Disease (MELD). This scoring system involves bilirubin and serum creatinine levels, and international normalized ratio.
2. Child-Turcotte-Pugh Score (CTP Score). This scoring system involves serum albumin and bilirubin levels, international normalized ratio, the presence (or absence) of ascites, and encephalopathy.
Treatment for End Stages of Liver Disease
Treatment for ELSD cannot reverse the damage caused to the liver. What it may do is stop or slow down the progress of the disease, as well as reduce the risks of complications. The kind of treatment required depends on what has caused liver failure, and if there are certain complications that have resulted from the failure.
1. Home care treatment includes
a. Putting a stop to the consumption of alcohol.
b. Avoiding medications that can cause damage to the liver, like acetaminophen and ibuprofen.
c. Cutting down on salt, especially if there are fluid retention problems.
d. Eating well-balanced meals with sufficient amounts of calories and protein.
e. Cutting down on protein intake if hepatic encephalopathy has been observed.
2. Medical treatment is also available; however, they are only directed at the relief of complications that come with ESLD. These include:
a. Steroids, penicillamine, and colchicines for Wilson’s disease
b. Beta blockers for portal hypertension
c. Diuretics and IV antibiotics for ascites
d. Lactulose and low-protein diet for encephalopathy
3. Surgery is another option but the only form of surgery that has been observed to significantly increase the chances of survival in the long-term is liver transplantation. In liver transplantation, the damaged part of the liver is removed. It is then replaced with a healthy portion of a liver from a compatible organ donor.
Unfortunately, end stage liver disease is as serious as it sounds
End stage liver disease is truly a life-threatening condition. But with proper medical attention and supportive care, the chances of survival, and even some recovery, can be improved. It helps to learn more about this condition so we can have an idea of how to best deal with.